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[Symptoms] Headache Chestpain and Leaks
#1
Headache Chestpain and Leaks
I'm up to a month using now and am having a harder time now then when I started.  When I started I was suprised how extremly silent the machine was and also how comfortable  the mask/hose was, even my constant rolling side to side wasnt an issue. I've read a lot here and made a few changes. On Christmas I changed to a full mask because even though I'm not normally a mouth breather I found I was opening my mouth to breath every so often. At that time the constant burping all night long went away but now I wake up in the morning with a chest full of air that is quite painful, After I get up and perform some massive burps for the next 10 minutes the pressure is mostly gone but the chest is still "sore" untill the afternoon- also the last few days I now get a bad headache begining midway through the night and lasting an hour after waking. I'm not one to get headaches - Maybe a small one 1-2 a year. And finally after a few hours the mask starts leaking giving me the "impression" of too much pressure, What I started doing was jamming a finger under the bottom of the mask and letting a lot of air out, or even waiting until the machine autoshuts off before removing my finger. Then I'm good again for usually another few hours or if it happens around my usual bathroom break I'll do that instead of releasing the pressure. - I have worn a Oximeter a few nights and my O2 seems to be fine ( stays above 90 averiging 93%ish)  while using the cpap, if I take CPAP off during the night O2 goes back to old levels with intermittent drops to 87ish for short periods 
progressive Screenshots attached


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#2
RE: Headache Chestpain and Leaks
I do not have an answer to your headache, I use oxygen and when my O2 is down I do get headaches when I first get up - so no real help.  You do have problems with Hypopnea.  You have a lot and also your low pressure is not helping you.  I think we can help you with those problems.  Your low pressure should be about 9.  We will need to see if any adjustments are needed after seeing how you do at 9.  Your flow limits are also high (they are also apnea only smaller and not timed) see the bottom of this post to see how they assign what type of apnea you are having.  To help with the flow limits we would move the EPR from off to 2.  As you noted you do have some leaks but they are not to bad and should not effect your therapy overall.  Do what you can to limit them as we all do.

If you look at the chart for Hypopnea - some appear to be positional apnea.  Which means you are cutting off your own airway.  Your machine can NOT help positional apnea no matter the pressure set. That come many times from back sleeping or to high a pillow.  What ever the reason we need to stop getting into that position.  Many Many times that position is from "chin tucking" and if changing the pillow height or side sleeping does not work, many people have found they can but a collar (around 15$) to relieve it.  Again see my signature at the bottom on collar.  Before doing that try to eliminate the flow limits by pillows and side sleeping.  Your 3rd night did not show much positional apnea so I think you can control it without a collar but we will need to see.

So changes would be:

EPAP 9
EPR 2

Post another night with these setting.  Thing will get better.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Headache Chestpain and Leaks
I think the answer to your aerophagia and other issues is EPR. Your flow limit is relatively high, and that is what drives your pressure upward. Adding EPR will support inspiration, provide lower pressure during exhale, and reduce the flow limits. Your overall pressure will be lower and comfort should be much better.

Increase minimum pressure to 8.0 (7 if you are worried about it) and turn on EPR full-time at 3.
Sleeprider
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.
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#4
RE: Headache Chestpain and Leaks
I see this as the common issuing a CPAP to the patient at default settings and expect things to magically be correct. EPR should be used to combat the flow limits like Sleeprider mentions. Your default wide open settings are very far from optimal and are not going to treat you. Again, Sleeprider addresses that by suggesting an increase in Min from 4 to 8. I'm quite sure better numbers tailored to you specifically will help address all the symptom/complaints you mentioned.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Headache Chestpain and Leaks
Thanks for all the suggestions. I set EPR to 3 from 2 as thats the highest setting.  My Min Pressure was 6.4 so I upped that to 9, Is that the setting you were talking about? I ask becasue I see in the stats EPAP min is 4.4 even though pressure was at 6.4.  Is that maybe an average including earlier numbers before I set it to 6.4?

As far as my sleep position, I sleep strictly on my sides with my arm up and a max pillow of 3" or 4" thick on my shoulder/arm, so head is pretty much straight from my spine with a slight chin tuck which I will work on stopping.
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#6
RE: Headache Chestpain and Leaks
Yes, you got it. I'm certain your pressure will end up lower with these settings. If not, we can do more to cap the maximum pressure and lower minimum to 8.0. Give this a try, then let us know. This will actually start your pressure at 9.0/6.0 (inhale/exhale), and you will feel that as lower pressure than the CPAP pressure which had a median of 9.45 to 11.0 and maximum up to 16.0. I think your pressure won't increase much from these minimum settings.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#7
RE: Headache Chestpain and Leaks
Your 6.4 with a EPR of 2 takes the exhale pressure (Min) to 4.4.  If you set the EPAP (exhale pressure) to nine then with a EPR of 3 your low would be 6.  EPR is set so your exhale is not as hard as it is at full min pressure.  And the EPR helps treat upper airway...  It should reduce your flow limits.  Hope I explained it well enough - if not someone will be by to address it better.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#8
RE: Headache Chestpain and Leaks
Got it.. Thank You!!
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#9
RE: Headache Chestpain and Leaks
Yep, if you're setting EPR to 3 and Min to 9, that pressure stat that shows 4.4 should read 6 with these new settings. Post an OSCAR after use and tell us if it helps make things better.

On aerophagia, I've had some a bit in the past. I found that raising the torso/head area of the bed or mattress a few degrees and sleeping on the left side helps lessen this air swallowing.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Headache Chestpain and Leaks
Its been about 2 weeks since my last Chart. I think things are better looking at the new chart, but I really didnt think the old one was that bad.. My Chest pain is much less and headaches are gone.

2 things since then.  

1st I do catch myself not breathing when falling asleep, Not bad as far as I can tell, just I sense I need to breath and take a deep breath ( not gasping) then all is fine, I dont continue with heavy breathing. I dont really see that in oscar - probably because I dont know how to read it, should it show? ( I'll add a screen shot including respitory also) - I dont notice this happening during sleep.

2nd - I'm having an awful time with Moisture in the mask, to the extend that I often just remove it for a few hours. When I take the mask off my entire face under the mask is quite damp. I'm a side sleeper and often through the night I take my finger under the lower side of the mask ( depending which side I'm on) and swipe out a good amoung of moisture- I'm not sure if its humidifier or drool ( and I do drool a good amount more than I ever thought I did) - I did just turn the humidifier totaly off which i'm not sure about because somehow I also get drymouth, How that happens while drooling is beyond me. - also I think this is the reason I'm getting a light mask shaped "wind burn" on my cheeks and chin and I dont have sensitive skin.

Any more suggestions?


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