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CPAP triggering asthma/wheezing?
#1
Started CPAP two weeks ago and the morning after the first night I was wheezing. Called sleep doc/pulmonologist right away and he scheduled a pulmonary function test, which I haven't had yet. Used the machine about 7 hours a night for two weeks, and the wheezing and chest tightness got worse every day. I'm not sick, not sneezing, no fever, everything else is fine. But yesterday my problems breathing got so bad that I was using my rescue inhaler and felt so awful that I couldn't use the machine last night.

I have mild asthma, no regular medication, can go years without using a rescue inhaler. The last time I had asthma symptoms/wheezing was over two years ago when I was helping my daughter with a move that involved lots of dust. So it seems very likely to me that, somehow, the CPAP's warm, humid air being pushed into my lungs triggered this.

Saw the pulmonologist today and he said to stay off the machine until I am breathing normally, and he put me on a steroid inhaler for two weeks. Then I will try CPAP (actually APAP) again.

I've read other threads on AB and elsewhere, and I know this doesn't happen often, and in fact, it seems that often CPAP helps those with asthma. Time will tell whether it happens again with me. I certainly hope not.

"Perseverance, secret of all triumphs."
Victor Hugo
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#2
have you tried to use it without the humidifier running? How are you doing with the CPAP off? has it improved?
PaulaO2
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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.




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#3
Paula, I tried the second night without humidity, and I had the hideous dry mouth. First night was on auto so probably all the way up, third 6, then 5, then 4, then all 4's. Today my pulmonologist/sleep doc said not to use it without humidity.

First week AHI's with machine on CPAP, pressure 8, with percentage of time in Large Leaks in parentheses.
2.62 (7.6)
2.75 (13.93)
5.91 (15.11)
4.78 (0.02)
8.25 (0.09)
3.38 (0.57)
3.06 (0.15)

Second week AHI's for the second week on APAP, pressure 7 - 12, were as follows, with Large Leaks in parentheses.
3.1 (0.31)
1.99 (4.94)
4.44 (0.90)
4.82 (0.39)
1.59 (16.98)
3.77 (5.09)
2.94 (11.90)

It felt weird not being on the machine last night. I remember waking up a few times, and I used a chin strap, so I didn't get dry mouth.


"Perseverance, secret of all triumphs."
Victor Hugo
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#4
Okay, a few things.

One, slow down on changes. Yes, you only went from CPAP to APAP but a week worth of data is really not enough to judge anything by. You need more than that. I try to gather at least 14 days.

Two, slow down on the humidifier changes, too. Your lungs are going through a lot and you are basically taking them from the swamps of Florida to the deserts of Arizona and expecting them to keep up. They aren't going to. If you typically have problem with heat and humidity (which my brother does), then turning it down is a good idea. But one night or even two isn't enough. It needs to settle and adjust. For me, it is cold air. I go out in winter and try to breathe in. My lungs say nope, not happening. Is your pulmologist familiar with sleep apnea or just asthma? If just asthma, then question his advice and seek a second opinion. If both, then cool.

Third, give it time. Everything needs time. The fact the asthma kicked in quickly shows there is a definite problem but it also shows it can be fixed. My guess is it is "just" a game of finding the right humidity level plus time.

Oh, and if you have a full face mask, you don't need a chin strap. If you are going to go through the hassle of a chin strap, get another kind of mask such as nasal pillows. It would be interesting to see if you react as strongly with a different kind of mask. I doubt it but would be interesting.
PaulaO2
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Breathe deeply and count to zen.

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.




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#5
Thanks, Paula. I had done the CPAP pressure 8 for one week, as prescribed, and then changed it to 7 - 12 on the advice of people here, and used that for one week until my breathing got so bad that I stopped using the machine, and the doctor agreed for me to stop until my breathing/lungs get normal again. So when I start again, you think I should stick with the 7 - 12? I was usually 95% of the time below 11.5 on SleepyHead. I woke up almost every night a couple of times during the 7 - 12 with the feeling of my (closed) mouth being full of air and some air bubbling out through a small opening in my lips. Some of the reading I've done suggests that maybe I had set the pressure too high and was getting too much air, and I was breathing too hard, and maybe that's what caused chest tightness and wheezing. I had been thinking of maybe turning it down a bit, to 7 - 11 or 7 - 10, but won't unless someone here or the doctor gives me good reason to do so.

Oh, and my ERP is set at 2, and was set that way for all but the first day of therapy.

I have been frustrated with the humidity and hose temperature settings. So, to change the settings for the ClimateLine Air hose, the hose has to be plugged in, and the water tub has to be in as well. Then you are able to set it to Auto or Manual. If it is on Auto, which regulates humidity automatically, you can still change the temperature of the hose, right?. It seems that no matter what I tried to do during the last week, the settings always looked the same on SleepyHead, with Climate Control set to Manual, Humidity Status ON, and Humidity Level 4, even though I had Climate Control set to Auto on the machine, and even once when I had hose temp set to Auto. I tried turning the machine off and on again, but no change showed up in settings on SleeyHead Daily. When I try again, maybe I'll set the hose temperature as 72, since I like the cool air better, but no matter what I did before, it never felt cool.

My doctor is a pulmonologist and a sleep doctor. He's the one who ordered the sleep study and got the prescription for the machine.

I was not using the chin strap with the FFM. I got it in anticipation of trying pillows or a nasal mask, since I would always get dry mouth multiple times a night before therapy. I try to lie on my side all the time, and have pillows literally all around me, but I inevitably turn a bit in my sleep towards my back, since we can't be in the same position all the time. Here's another thing, I have major hip surgery coming up in mid-August, and will have to sleep on my back or sitting up or, preferably, in my new electric recliner for about 6 weeks. So the better I am at sleeping on my back, perhaps the better I'll be sleeping post-op. I had terrible sleep last year after a similar surgery.


"Perseverance, secret of all triumphs."
Victor Hugo
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#6
Using a chin strap or an FFM is not always an either/or situation. I use a FFM because I mouth leak and a chin strap was not enough to solve the mouth leaking even with practicing the tongue seal.

The full face mask solved the therapeutic problem but I found that I was still getting dry mouth due to mouth leaks. I was able to practice the tongue seal and get it to work well enough to solve the dry mouth problem for a while. Some may feel that the pressure inside a FFM is the same throughout so mouth leaks should not be a problem. This would be true if the pressure in the mask is steady and there is no air flow but this is not the case. The pressure in different areas of the mask is very dynamic due to the flow from the machine and your breathing.

With all of that said, I reached a point where, due to other health problems, the tongue seal was no longer working well enough for me so it was back to desert mouth. I now use a chin strap together with my FFM and no dry mouth (once I found the chin strap that works for me).

The moral of this story is that the FFM/chin strap decision is not always an either/or decision. There are times that both are needed.

Best Regards,

PaytonA
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#7
(06-25-2016, 11:37 AM)PaytonA Wrote: I now use a chin strap together with my FFM and no dry mouth (once I found the chin strap that works for me).

Thanks for the info, Payton. Can I ask what chin strap works for you? I got the ResMed one, and it seems that unless you clip it to your hair or attach it to something, the top strap just moves all over the place loosening it and allowing your chin to drop. That night I used it, I threaded it through the top of the braid of my hair at the top of my head. Might I be the first person to have done that, I wonder?

I was happily surprised that when I used the FFM I avoided desert mouth, for the most part, and hope it continues. I've been working on the tongue seal. Also, last night I did not use the chin strap, and took drinks a couple of times in the night, but the dry mouth was much better than before. Perhaps the tongue seal is working for me.
"Perseverance, secret of all triumphs."
Victor Hugo
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#8
Kris the Crone,
Keep working on that tongue seal. It will become second nature in time. I ditched my chin strap after getting that tongue seal down pat, but I know some have a hard time mastering it.

As far as dry mouth, try either Biotene or Act Total Care Dry Mouth rinse before bed.
It will help elimate the need to drink water during the night, which in itself can cause a whole other issue with bathroom breaks. Smile
OpalRose
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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.




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#9
(06-25-2016, 01:35 PM)OpalRose Wrote: As far as dry mouth, try either Biotene or Act Total Care Dry Mouth rinse before bed.
It will help elimate the need to drink water during the night, which in itself can cause a whole other issue with bathroom breaks. Smile

I have Biotene gel, and it's interesting stuff, tried it one night. When I was using the CPAP or APAP, I rarely had to get a drink. But when I need one, I have a good set-up on the night stand (perfected during ten months of desperately needing it), can drink it lying down, is unspillable, and only need a few sips to thoroughly moisten my mouth, and a bit to swallow. Usually, I don't even get up to use the bathroom when I wake to drink or moisten mouth.

Yes, the tongue seal seems to be helping me already. Will keep practicing it and hope it becomes second nature.
"Perseverance, secret of all triumphs."
Victor Hugo
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#10
Kris,

I can not remember the name or the manufacturer of the chin strap that I use. I think I just found it on Amazon. It is called "Premium white chin strap with extra support straps" It is made by AG Industries and costs all of $9. I need the extra support straps to keep it on my head. I have the same problem that you reported.

I use it a little differently. I route it under my jaw rather than around my chin. It works better for me that way.

Best Regards,

PaytonA
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