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[CPAP] Feel like I'm not exhaling fully- "chest aches"
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mary273175 Offline

New Members

Posts: 3
Joined: Jun 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Unsure
CPAP Pressure: 5.0 - 18.0
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #1
Feel like I'm not exhaling fully- "chest aches"
Hello everyone, this is my first post to this board, and my third night with my CPAP. Since my first evening, I've been noticing what I consider a light "ache" in my chest after using my CPAP, which is alleviated after removal. I checked the internet, which lead me to a thread on this site. I am having what I think is the same problem as the original poster in that thread- the ache from the "struggle" of breathing against the air pressure. Posters there mentioned that his/her machine would learn breathing patterns and reduce the pressure on exhaling, making that better. I'm not sure if my machine does this? I feel like it's just forcing me to Breathe!Breathe!Breathe! but I'm not really getting anything out.

My equipment

ResMed AirSense 10 AutoSet
AirFit P10 Mask

Pressure: 5 to 18
06-12-2015 09:30 PM
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eseedhouse Offline

Advisory Members

Posts: 881
Joined: Dec 2014

Machine: ResMed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: SimPlus
Humidifier: ResMed
CPAP Pressure: 7-10
CPAP Software: SleepyHead

Other Comments: Also on supplemental O2 at 3L/min. while sleeping.

Sex: Male
Location: Victoria, British Columbia

Post: #2
RE: Feel like I'm not exhaling fully- "chest aches"
Yes, the Airsense 10 Autoset provides exhalation pressure release. The range available is 1, 2, or 3 cm of water. From the normal menu the choice to turn it on or off is the fifth item down. If you want to set the level more finely you have to go into the "clinician" menu. Press the round button and the Home button together for about five seconds to get into that.

I like it on and set to three - your preferences may be different.

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
06-12-2015 10:38 PM
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DeepBreathing Offline
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Moderators

Posts: 2,295
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #3
RE: Feel like I'm not exhaling fully- "chest aches"
Hi Mary, welcome to Apnea Board.

It's not uncommon for new users to experience a mild ache around the chest, especially if they are operating at high pressures like you are. Your machine has a feature called EPR (exhale pressure relief) which will reduce the pressure as you exhale. This can be set at 0, 1, 2 or 3 cm. I'd suggest you try this and see if it helps. Some users find it's better without EPR and others also see an increase in central apneas with its use. However, it is there to help breathe out against the pressure, so give it a go and see how it works for you.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-12-2015 10:39 PM
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mary273175 Offline

New Members

Posts: 3
Joined: Jun 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Unsure
CPAP Pressure: 5.0 - 18.0
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #4
RE: Feel like I'm not exhaling fully- "chest aches"
(06-12-2015 10:39 PM)DeepBreathing Wrote:  Your machine has a feature called EPR (exhale pressure relief) which will reduce the pressure as you exhale. This can be set at 0, 1, 2 or 3 cm. I'd suggest you try this and see if it helps.

I apologize if this question is silly, but could you tell me which setting is the least amount of resistance? I was thinking and could interpret it as "0 means no pressure/resistance" or as "0 means no reduction in pressure/resistance."

It looks like I also have the option to have this feature on only during the ramp time- do you have any thoughts on this? I was thinking since the only time I'm aware of the feeling is when I'm still awake, it would make the most sense to only have it on then.

I appreciate your replies so far, thank you!
06-13-2015 09:42 AM
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justMongo Offline

Monitors

Posts: 3,851
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #5
RE: Feel like I'm not exhaling fully- "chest aches"
(06-13-2015 09:42 AM)mary273175 Wrote:  
(06-12-2015 10:39 PM)DeepBreathing Wrote:  Your machine has a feature called EPR (exhale pressure relief) which will reduce the pressure as you exhale. This can be set at 0, 1, 2 or 3 cm. I'd suggest you try this and see if it helps.

I apologize if this question is silly, but could you tell me which setting is the least amount of resistance? I was thinking and could interpret it as "0 means no pressure/resistance" or as "0 means no reduction in pressure/resistance."

It looks like I also have the option to have this feature on only during the ramp time- do you have any thoughts on this? I was thinking since the only time I'm aware of the feeling is when I'm still awake, it would make the most sense to only have it on then.

I appreciate your replies so far, thank you!

Zero means no pressure relief. Set to 3 means the exhale pressure relief will drop the pressure by 3 cm-H2O during exhale.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-13-2015 09:48 AM
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trish6hundred Offline

Advisory Members

Posts: 6,446
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #6
RE: Feel like I'm not exhaling fully- "chest aches"
Hi mary273175,
WELCOME! to the forum.!
Sometimes when you first start with CPAP, your chest may hurt just a bit 'till you get used to the therapy. Of course, if it persists, talk to your doc about it.
Hang in there for more responses to your post and much success to you with your CPAP therapy.

trish6hundred
06-13-2015 10:29 AM
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OpalRose Offline

Monitors

Posts: 3,175
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #7
RE: Feel like I'm not exhaling fully- "chest aches"
Hi mary273175,
I felt like that when I first started. I think we sometimes try too hard to breath with the mask on and over exert ourselves, if that makes any sense. Once I got used to the therapy, I started to relax and just breath normally.

The EPR is a great feature. I started at 3, and have since set it to 2 where I feel most comfortable.

OpalRose
06-13-2015 11:38 AM
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AshSF Offline

Advisory Members

Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #8
RE: Feel like I'm not exhaling fully- "chest aches"
There is a muscle called the thoracic diaphragm that actually expands and contracts to make your lungs inhale and exhale. That muscle is used to working against a set pressure for
Life so far without cpap.

On cpap, this muscle has to work against a different higher pressure to exhale all night. This is why it is tired in the morning. With time, it will adapt and get stronger. Then it won't be tired in the morning.

It's very much like working out in the gym first time and feeling sore 24-72 hrs later. But this feeling dissipates in a few cycles.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
06-13-2015 12:54 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #9
RE: Feel like I'm not exhaling fully- "chest aches"
(06-13-2015 09:42 AM)mary273175 Wrote:  It looks like I also have the option to have this feature on only during the ramp time- do you have any thoughts on this? I was thinking since the only time I'm aware of the feeling is when I'm still awake, it would make the most sense to only have it on then.

Hi mary273175, welcome to Apnea Board.

In a week or two all breathing muscle soreness will be gone, as muscles gain strength.

To help reduce chest muscle tiredness in the meantime, I suggest setting EPR to Full Time (not only during the Ramp).

By the way, after a few days or weeks, most users prefer for the Start Pressure (for the Ramp) to be higher than 4. At 4 or 5 we sometimes feel like we are not getting enough air when inhaling.

So don't be shy about increasing the Start Pressure to 5 or 6 or higher, whatever is most comfortable.

Would be good for you to download SleepyHead or ResScan software and check the statistical data and let us know the Apnea Hypopneas Index (an index is an average per hour) and the Obstructive Apnea Index, Central Apnea Index, Hypopnea Index and RERA (if your machine reports RERA). RERA (Respiratory Effort Related Arousal) refers to (partial) arousal caused by breathing effort. The arousals are usually only partial and we don't remember having them.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 06-13-2015 04:33 PM by vsheline.)
06-13-2015 01:22 PM
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Mosquitobait Offline

Advisory Members

Posts: 746
Joined: Apr 2015

Machine: Resmed AirSense 10 For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: integrated, Climate line tube
CPAP Pressure: 9-12
CPAP Software: ResScan SleepyHead

Other Comments: RLS and Bradycardia

Sex: Female
Location: Minneapolis

Post: #10
RE: Feel like I'm not exhaling fully- "chest aches"
(06-12-2015 10:39 PM)DeepBreathing Wrote:  Hi Mary, welcome to Apnea Board.

It's not uncommon for new users to experience a mild ache around the chest, especially if they are operating at high pressures like you are. Your machine has a feature called EPR (exhale pressure relief) which will reduce the pressure as you exhale. This can be set at 0, 1, 2 or 3 cm. I'd suggest you try this and see if it helps. Some users find it's better without EPR and others also see an increase in central apneas with its use. However, it is there to help breathe out against the pressure, so give it a go and see how it works for you.

Mary, I've been cpapping for 3 weeks and I agree with this. Others suggested that I set the EPR to 2 and that mild ache went away after a day or two and has not returned. I was actually having more problems the first couple of nights because I pulled that stupid muscle that runs along the rib cage and the cpap use aggravated it. Still, I was able to sleep on my back and breathe - just getting to sleep was a bit hard.
06-13-2015 03:32 PM
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