Gasping for breath

[ruby0080]

Hi,

I'm actually writing on behalf of my husband who got diagnosed with OSA last summer. He scored 70.

He's been given a Respironic Remstar Auto M series with C-Flex. I don't know what the mask is but it's one that fits under his chin and over his nose.

The first few days the machine was going up to 12cm but he would wake up bloated with stomach cramps so he went back to the hospital where they looked at the data and saw that the ideal pressure for him is 9cm and the lady set the max on the machine a 9. She also lowered the pressure for when he breathes out.
The problem now is that he sleeps with the machine on for 2 to 2.5 hours but wakes up like out of breath where he needs to take some deep breaths without the machine. He usually gives up at that point because he feels too tired and wants to sleep.

Anyone experienced this and managed to get over it? Is a problem with the settings again?

Thanks for any help.

[Joe McManus]

Hi Ruby, welcome to the forums!

A couple of questions come to mind in a bid to find out why this happens.

Does he exercise at all? His lung capacity could leave room for improvement. Perhaps he's also naturally a shallow breather. Deep breathing exercises during the day could help expand his lung capacity.

Does he suffer from GERD/acid reflux? Many CPAPers who report bloating suffer from these issues too. Aerophagia it's called I believe. Some report this product helps. I could ony find it on eBay in the UK.

Also check the mask doesn't leak as that may cause the machine to overcompensate and ramp up the pressure.

[ruby0080]

Hi and thank you for welcome,

No he doesn't exercise much (he has a rest whenever he's not working as he is quite tired). Would he feel like he's suffocating because the CPAP machine is blowing too much air in his lungs?

He doesn't suffer from GERD/acide reflux no. Lowering to 9cm actually helped on the bloating problem.
As for leaks I don't think it does - the lady at the hospital said his mask leaked for 5 minutes in a week which can be explained by adjustments during the night etc.

[Joe McManus]

Would he feel like he's suffocating because the CPAP machine is blowing too much air in his lungs?

Rather than seeing it as "too much air" it sounds more like "his lungs aren't capable right now of normal amounts of air". The pressure settings you mention aren't anything out of the ordinary, the average OSA patient should be able to handle those types of pressures comfortably.

Breathing exercises alone should help him build some lung capacity and 'valve strength' to guide the air in the right direction.

Does he sleep on his back or side? Chest and belly weight, when sleeping on your back, can almost crush lungs in some cases, making it hard for the lungs to fill up so the air would try and go somewhere else (stomach in this case). Try finding out if it's better when sleeping on the side (some people sew tennis balls into the back of their PJs to enforce side sleeping).

Just some ideas. Would be interesting to hear what a doc would recommend.

[puffin]

Joe, that anti gas product contains pepper mint, worst thing you can take if you have reflux. I have suffered acid for 20 odd years. See a specialist gastro Doctor, who will prescribe the correct pills. Normal cause will be a weakened or non existent valve between gullet and stomach, in the area of the diaphragm. Operations don't work, just keep take the pills.

[ruby0080]

Well a few months on and it's not much better. They experimented with the pressure and even at 7 (his ideal pressure is 9) he can't keep the mask on all night.
He averages 1.5 hours but then wakes up and he feels like he's suffocating and said the air inside the mask is hot and he can't breathe. So he can't really keep it on.

He's got a humidifier on but will try without it tonight.

Has anyone got the same problem? ANy advice would be greatly appreciated.

[chelseauk]

A couple of thoughts..

Firstly i sometimes feel like i have issues breathing - but i stop take some deep breaths - and then realise i am breathing and i calm down and things work better again.

I don't have a humidfier - and i'm not sure i need one - so it's worth ago.

Finally - i have mine set to 14.5 (any higher and my lungs get hurt) - but i do need it high - the interesting thing is i find the higher 10+ pressure more reasuring than lower than 8 - as you can really feel it working.

[ruby0080]

He started at 11 and could average 2.5 hours then but he'd wake up with his stomach full of air and needed to "release" it because of the pain.

He then had it dropped at 9 + humidifier and the length of use went down. Maybe the humidifier really is the problem.

[chelseauk]

Found this (may be worth a try).

I'd guess it's Aerophagia.

Air in the stomach. Occasionally, a CPAP user will experience air trapping in the stomach and awaken with stomach pain or gas. Sometimes simply making sure that you sleep with your head aligned with your body can help with this . If you want to elevate your head in bed you should do that with a wedge pillow or with bricks under the headboard. If you sleep with several pillows it may cause your head to tilt forward and block your airway. Lowering the CPAP pressure can help but your sleep specialist may not want to do this if it reduces the effectiveness of your treatment. Switching to bilevel pressure or C-Flex may be very helpful in these cases.

Also the americans seem to rate Gas-X which contains Simethicone - which seems to be in WindEze in the UK.

[ruby0080]

An update in case someone else has this problem.

A day after I posted the last message my husband removed the humidifier for a try and within days he was averaging over 5 hours a night (although not all in one go)
We've been back to the hospital where they were impressed by the sudden and vaste improvement. The pressure has been put back up to 9 and despite a set back caused by a bad cold he's back to 5.5 hours average over the last week.

The last thing to tackle now is removing the mask in his sleep.

[retsyo]

I had my best nights sleep last night and found on waking this morning I had not put water in the humidifier so tonight I will try without the humidifier.

[acebass]

Worth a try, I was never offered a humidifier and so far, have not found the need for one....