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CPAP as cause of hypercapnia symptoms
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Kellysfriend Offline

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Posts: 11
Joined: Apr 2013

Machine: Resmed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX for Her
Humidifier: unsure
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Oceanside, CA

Post: #1
CPAP as cause of hypercapnia symptoms
Has anyone experienced hypercapnia symptoms as a result of using their CPAP?

I had no hypercapnia symptoms whatsoever and they came on using my Respironics REMstar Plus C-Flex CPAP. I stopped using it 6 days ago and the symptoms have cleared up considerably.
04-03-2013 03:57 PM
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Shastzi Offline

Advisory Members

Posts: 1,174
Joined: Dec 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: FitLife Total face mask
Humidifier: F&P HC150 with Hybernite heated hose.
CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

Sex: Undisclosed
Location: Florida, USA.

Post: #2
RE: CPAP as cause of hypercapnia symptoms
Humm. Do you know more details?
What pressure were you running when this happened?

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

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04-03-2013 04:06 PM
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Kellysfriend Offline

Members

Posts: 11
Joined: Apr 2013

Machine: Resmed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX for Her
Humidifier: unsure
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Oceanside, CA

Post: #3
RE: CPAP as cause of hypercapnia symptoms
Pressure is 11. Sorry, I cannot figue out how to get into my profile to correct it. This machine is suppose to decrease the pressure when the individual exhales. I was a bit befuddled because the mask did not have the "blow off valve," at least that is what I called it, just below where the tube connect to the mask. My other ones always had this "valve" or piece of plastic tube that freely swivled around and air leaked from it that blew off the carbon dioxide so the individual did not rebreathe the air. This mask has two annoying holes in the front of the mask.

(04-03-2013 04:06 PM)Shastzi Wrote:  Humm. Do you know more details?
What pressure were you running when this happened?
04-03-2013 04:15 PM
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trish6hundred Offline

Advisory Members

Posts: 6,450
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: #4
RE: CPAP as cause of hypercapnia symptoms
Hi Kellysfriend,
WELCOME! to the forum.!
Hang in there for more answers to your question.
Best of luck.

trish6hundred
04-03-2013 04:22 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #5
RE: CPAP as cause of hypercapnia symptoms
(04-03-2013 04:15 PM)Kellysfriend Wrote:  Pressure is 11. Sorry, I cannot figue out how to get into my profile to correct it. This machine is suppose to decrease the pressure when the individual exhales. I was a bit befuddled because the mask did not have the "blow off valve," at least that is what I called it, just below where the tube connect to the mask. My other ones always had this "valve" or piece of plastic tube that freely swivled around and air leaked from it that blew off the carbon dioxide so the individual did not rebreathe the air. This mask has two annoying holes in the front of the mask.

(04-03-2013 04:06 PM)Shastzi Wrote:  Humm. Do you know more details?
What pressure were you running when this happened?
Here is how to edit your profile
http://www.apneaboard.com/forums/Thread-Edit-profile

It sound like the mask you,re using is non-vented mask
non-vented masks must have valve to allow for proper ventilation of CO2 and not commonly used with CPAP or bilevel machines

You need a vented mask that have vents holes allow exhaled air to escape and prevent re-breathing own exhaled air
04-03-2013 04:55 PM
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Kellysfriend Offline

Members

Posts: 11
Joined: Apr 2013

Machine: Resmed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX for Her
Humidifier: unsure
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Oceanside, CA

Post: #6
RE: CPAP as cause of hypercapnia symptoms
Think I have it figured out. I was wrong. CPAP pressure is 7. Also, I found that code on the machine that equated to = A failure has been detected in the non-volatile memory on the Main PCA. Not sure if this has anything to do with how the machine is working or just how the data was not stored correctly. Most important I found these two statements under the Warnings, Cautions, and Notes section of the Service Manual that answered my question:

This warning applies to most Continuous Positive Airway Pressure (CPAP) devices. At low CPAP pressures, the air flow through the exhalation port may not be enough to clear all of the exhaled gas (CO) from the mask. You may breathe in some of the air that you have exhaled.

Most CPAP devices have the potential to induce rebreathing of exhaled air. To reduce this potential, use only Respironics circuit accessories, do not wear the mask and headgear for more than a few minutes while the unit is not operating, and do not block or try to seal the vent holes in the exhalation port.


(04-03-2013 03:57 PM)Kellysfriend Wrote:  Has anyone experienced hypercapnia symptoms as a result of using their CPAP?

I had no hypercapnia symptoms whatsoever and they came on using my Respironics REMstar Plus C-Flex CPAP. I stopped using it 6 days ago and the symptoms have cleared up considerably.[/size]
04-03-2013 06:03 PM
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Kellysfriend Offline

Members

Posts: 11
Joined: Apr 2013

Machine: Resmed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX for Her
Humidifier: unsure
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Oceanside, CA

Post: #7
RE: CPAP as cause of hypercapnia symptoms
Thanks, I thought about the vents. There are two holes on the front of the mask that are very annoying, but they do not seem to be enough. In the past my masks have always had a little round tube that fit between the mask and the hose. I called it a "blow off valve." I was very surprised when I was not given on with this mask. I am going to make the DME company takt this back. It was not what my doctor ordered now that I found out the SD card only collects the usage, not the other info. I do not need the CPAP police, if the machine was collecting all of the other info this would have been caught the first month. Last week I was scared to death there was something wrong with my heart. I am at the age my mother was when she started having trouble.
04-03-2013 06:11 PM
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PaulaO2 Offline
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Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #8
RE: CPAP as cause of hypercapnia symptoms
All CPAP masks made in the last several years or more have exhaust ports. Some ports are where the swivel is but most have holes in the front of the mask where the air constantly flows out. It is more than enough to vent the outward breath.

It would help greatly if we knew which nasal mask you are using. If you do not know the mask, go to any of the online suppliers and look through their selection to find one that looks like yours. http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List

How did you know your symptoms were related to hypercapnia?

CPAP makers want you to use their masks because it makes them more money (and it gets them out of potential lawsuits). A Respironics machine does not work better or more efficiently if you are using a Respironics mask. How would the machine know which mask you are using? Some machines you can input "nasal mask" or "pillows" but not "Swift LT" or "Mirage Quattro".

PaulaO2
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04-03-2013 06:46 PM
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Kellysfriend Offline

Members

Posts: 11
Joined: Apr 2013

Machine: Resmed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX for Her
Humidifier: unsure
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Oceanside, CA

Post: #9
RE: CPAP as cause of hypercapnia symptoms
The mask is a ResMed Mirage FX for Her. There are little tiny vents circling the nose of the mask, so yes there are vents, are they good enough? I do not thinks so after reading the combination of conditions that co-exist causing the problem. Low pressure, humifier use, vents that are not big enough, and the way the CPAP operates, the pressure lowering when the individual exhales.

When I started putting 2 + 2 together I looked up the symptoms of carbon dioxide toxicity. The list of possible symptoms are wide:

Symptoms and signs of early hypercapnia include flushed skin, full pulse, tachypnea, dyspnea, extrasystoles, muscle twitches, hand flaps, reduced neural activity, and possibly a raised blood pressure. According to other sources, symptoms of mild hypercapnia might include headache, confusion and lethargy. Hypercapnia can induce increased cardiac output, an elevation in arterial blood pressure, and a propensity toward arrhythmias. In severe hypercapnia (generally PaCO2 greater than 10 kPa or 75 mmHg), symptomatology progresses to disorientation, panic, hyperventilation, convulsions, unconsciousness, and eventually death.



(04-03-2013 06:46 PM)PaulaO2 Wrote:  All CPAP masks made in the last several years or more have exhaust ports. Some ports are where the swivel is but most have holes in the front of the mask where the air constantly flows out. It is more than enough to vent the outward breath.

It would help greatly if we knew which nasal mask you are using. If you do not know the mask, go to any of the online suppliers and look through their selection to find one that looks like yours.

How did you know your symptoms were related to hypercapnia?

CPAP makers want you to use their masks because it makes them more money (and it gets them out of potential lawsuits). A Respironics machine does not work better or more efficiently if you are using a Respironics mask. How would the machine know which mask you are using? Some machines you can input "nasal mask" or "pillows" but not "Swift LT" or "Mirage Quattro".
04-04-2013 03:00 AM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #10
RE: CPAP as cause of hypercapnia symptoms
(04-04-2013 03:00 AM)Kellysfriend Wrote:  The mask is a ResMed Mirage FX for Her. There are little tiny vents circling the nose of the mask, so yes there are vents, are they good enough? I do not thinks so after reading the combination of conditions that co-exist causing the problem. Low pressure, humifier use, vents that are not big enough, and the way the CPAP operates, the pressure lowering when the individual exhales.
The vents holes for Mirage FX designed to leak at pressure 7 about 26 L/min which protects against rebreathing
Phillips Respironcis machines report total leak (vents leak plus excess leak) but the Plus model don,t report any leak rate or efficacy data, just usage hours used

C-Flex reduce pressure at the beginning of exhalation and return to set pressure just before inhalation so its not full reduction as ResMed EPR where pressure reduced during whole exhalation cycle more like mini bi-level pressure support

If you,re concerned about pressure being low, turn it off so you inhale and exhale at full set pressure
04-04-2013 04:24 AM
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