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[split] CPAP triggering asthma/wheezing?
#1
[split] CPAP triggering asthma/wheezing?
I started using CPAP six nights ago and each day have been waking up with strange tightness in my chest and gradually worsening episodes where it’s hard to take a deep breath. I have very in frequent asthma related to exercise and occasional chest colds - Enough that I do have a rescue inhaler, But infrequent enough that I only use it a few times a year.

Each day since I started CPAP, my breathing symptoms during the daytime have been worse. And in the last two days I’ve had to use my inhaler several times each day. Today my breathing was so difficult that my inhaler wasn’t providing as much relief as I wushed and I thought for a while I’d need to go to urgent care. But then it settled down again. I don’t have seasonal allergies, I haven’t moved, I haven’t changed anything except starting CPAP. 

I talk to my sleep medicine doctor today and he told me I might want to adjust my temp and humidity settings. I tend to like my air as cold as possible so I’ve had the temperature set at 60 (lowest setting on my machine).  60 feels good when I breathe thru the mask and helps me feel less claustrophobic to fall asleep but I wonder if it might be too chilly for my lungs for the while night?  So on my doc’s advice I’ll increase to 70 and see how I do.  I also hate humid air so I had humidity on the lowest setting (1) as well. I’ll increase that to “medium” or 4 on my ResMed 10. 

My doctor said if I don’t feel better after a couple of nights trying new adjustments, to just stop the CPAP for several nights and see if it changes. That’s the only way will know whether or not it’s related to CPAP therapy or not.

I’m really hoping that my temperature and humidity may have been the problem and that if I push them both higher things will settle down. After six days, I’m finally getting used to the nasal pillow mask and sleeping a little better, so I’d hate to lose that progress. My sleep apnea is well-controlled on the machine according to my doctor, so I really hope I can find a way to live peacefully with it and my asthma too.  

It has helped me to read some of the accounts of others who had similar experiences up here, so I will report back after my adjustments about how well they did or did not work in case that is helpful to others.
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#2
RE: [split] CPAP triggering asthma/wheezing?
its normal to have chest tightness when you first start cpap. Continue monitoring o2%sat or start monitoring if you don't do it yet.
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#3
RE: [split] CPAP triggering asthma/wheezing?
The temperature setting is only part of the picture. Your humidifier in manual mode allows settings of 1-8 and temperatures from 60 to 86. It appears your humidity is essentially off, so you are not experiencing any significant pre-humidification. That could explain the problems you are describing. In Auto mode your humidity tries to maintain 85% humidity and 80 degrees. While that sounds warm, it is relatively cool compared to body temperature, but effectively reduces the discomfort that comes with dry, cool air that muat be conditioned by the airway passages.

In addition, your profile suggests you are using a wide range of pressure from 4 to 10, and we don't know if you are taking advatage of the exhale pressure relief feature (EPR). You really need to download OSCAR which is far easier to use and understand than Resscan, and post a chart on the forum so we can see if there are optimization strategies that might further relieve your discomfort. A minimum pressure of 4.0 is rarely effective, and can result in air starvation because the pressure is too low to meet most adult needs. You may be experiencing discomfort because the pressure is so low that you are expending respiratory effort just to overcome machine resistance. I think there is a lot of room for improvement in your therapy.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#4
RE: [split] CPAP triggering asthma/wheezing?
If you're brand new to CPAP, I'd caution you to give this more than a week before concluding a problem. For my first week on CPAP, my chest felt tight and sore... and I learned from here that it was because my chest muscles needed to get used to the constant (and purposeful and effective) breathing at night. After about a week, there was no more tightness or soreness.

I am asthmatic. So I get that there is a difference. And probably only you can perceive and discern that difference.
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