COPD and CPAP

[Katmacd]

I have COPD with air trapping. I have had my machine for 4 months and during that time I haven't been able to get off steroids. Now I have diabetes.
The other night I fell asleep without my CPAP and woke up in less respiratory distress than ever! I am not using it and have been able to start weaning the steroid. Don't need 6 to 10 nebulizer treatments per day just to be able to sit in a chair!
I believe the CPAP was over inflating my lungs. I also started to get pitting edema which is resolving without the CPAP.
My problem is that I woke up with that apnea headache yesterday.

Is there a way to make the CPAP pressure stop so I can fully exhale and then have it sense my inhalation and give me the CPAP at that time?

Thanks
Kathy

[zonk]

Is there a way to make the CPAP pressure stop so I can fully exhale and then have it sense my inhalation and give me the CPAP at that time?

Thanks
Kathy

Welcome to the forum, Kathy
Your machine have C-Flex pressure relief, works by reducing pressure at the beginning of exhalation and returning to therapeutic pressure just before inhalation http://cflex.respironics.com/

C-Flex 1 gives the least reduction in exhalation pressure
C-Flex 2 gives more reduction in exhalation pressure
C-Flex 3 gives the most reduction


what machine do you have?

Sorry, I cannot offer any help with the other issues that you have raised, others would chime in when had their snooze

[vsheline]

My problem is that I woke up with that apnea headache yesterday.

Is there a way to make the CPAP pressure stop so I can fully exhale and then have it sense my inhalation and give me the CPAP at that time?

Hi Katmacd, welcome to the forum!

Three things.

What is "air trapping"?

A bi-level auto machine like the Philips Respironics System One BiPAP Auto with heated hose can minimize the exhale pressure while at the same time increasing when needed the inhale pressure to optimize treatment. I suggest you ask your doctor for a change in machines.

The treatment pressure on your machine likely was based on your pressure needs while sleeping on your back and dreaming. (This is usually the worst case combination for Obstructive Sleep Apnea.). If you can ensure that you will never be sleeping on your back, your pressure needs will likely be lower. I wear a teeshirt with a couple tennis balls in pockets sewn along my spine between the shoulder blades, so that when I roll onto my back I awaken enough to keep rolling until I am on my other side. Doing something similar would likely allow the pressure to be lowered on your present fixed-pressure machine.

Take care,
--- Vaughn.

[Katmacd]

Hi
Air trapping is just that when I exhale, I don't completely exhale all the air so that when I inhale I don't get a full breath.

I never sleep on my back. Only on my left side.

I saw that the c flex can be set to lower the pressure during inhalation. I haven't tried setting it to 3 yet. It was set at 1 when they set it up. I wonder if 3 would be close enough to no pressure?

Thanks for the ideas so far! Thanks for the warm welcome to the group

Kathy

[trish6hundred]

Hi Katmacd,
WELCOME! to the forum.!
I wouldn't totally do without CPAP therapy. You might talk to your doc about your situation and see what he/she says.
Hang in there for more suggestions and best of luck to you.

[justMongo]

I believe this is where a bilevel machine is useful. Bilevel permits a greater pressure split between IPAP and EPAP pressures -- permitting one to exhale more fully.

BTW -- steroids can raise blood sugars levels. If you can successfully reduce or get off steroids, you might see an improvement in blood glucose levels.

Take this with a grain of salt -- I am not a doctor.

[retired_guy]

I have COPD with air trapping. I have had my machine for 4 months and during that time I haven't been able to get off steroids. Now I have diabetes.
The other night I fell asleep without my CPAP and woke up in less respiratory distress than ever! I am not using it and have been able to start weaning the steroid. Don't need 6 to 10 nebulizer treatments per day just to be able to sit in a chair!
I believe the CPAP was over inflating my lungs. I also started to get pitting edema which is resolving without the CPAP.
My problem is that I woke up with that apnea headache yesterday.

Is there a way to make the CPAP pressure stop so I can fully exhale and then have it sense my inhalation and give me the CPAP at that time?

Thanks
Kathy

"Air trapping" is sort of what COPD is all about. I have emphysema. At my appointment last week it was pointed out to me that I have 26 percent of "normal" lung function. But I chug along pretty good, without oxygen and so forth. Because, I feel, I do not allow myself to give into the thing. I focus on breathing exercises to get rid of the trapped air when I'm in trouble, and I stay very committed to using the cpap therapy at night.

There are some interesting studies you can google up. At Mayo, a test was done on critical COPD ICU patients. Normally they were immediately strapped up to oxygen. But in this case they were put on CPAP. The mortality dropped significantly. What exactly does that mean? Well, I don't know, except I think our body is a lot more capable of fixing itself than is often given credit.

About the albuterol thing.... I have learned the worst thing I can do is overuse the nebulizer treatments (no longer allowed in the house). They're great to use when you're in distress once in awhile. But in my case I found that the more I used them, the more times I would end up in distress. That's true of the rescue inhalers as well.

Manage the diabetes, but don't worry too much about it. It probably will go away once you defeat the prednisone. As you no doubt know, lowering prednisone can be very tricky and take considerable time.

I assume with your copd they have you on one of the steroidal inhalers? If not, you certainly should.

Now, as to the CPAP stuff, you certainly want to continue using it. The guys more familiar with your machine can advise you better than I as to what tweaks you can make to get better comfort. Sleeping on your side is a biggie for you.

[Katmacd]

Hi all

Forgive me while I learn the ins and outs of being on a message board. As a general reply to all who have tried to help, I will be seeing my doctor this week and will discuss this with him. Until that time I am not going to use the machine because I wake up completely breathless and it doesn't go away. The prednisone issue began when I got the machine but I also had surgery at the same time and a bout of tonsillitis so we all thought I couldn't wean the steroid because of that. I am a nurse (but a NICU nurse). I don't know much about adult issues but I do know that the CPAP has caused the long term prednisone use as well as a trip to the hospital for IV steroids!
I take symbicort and tudorza and duoneb for the management of the COPD along with oxygen therapy.

I look forward to see what the doc says.

The diabetes may or may not go away when I get off the prednisone, according to the docs. But I just want to be able to breath and leave my house and take a short walk. All of which I can't do since March.

Again thanks for your ideas. That is sometimes the best way to solve problems right?

Kat

[retired_guy]

Good luck to you Kat.

[woozie38]

I have COPD with air trapping.

Don't know if this would be of any help Kate, but for my COPD I nebulise 40 ml of 3% saline (as in intravenous drip bag) solution, three to four times per day or "as needed" Rx from my doc.