I have been on the CPAP for a month now.  I have severe sleep apnea at
the rate of 135 events per hour.  I had gradually gotten worse and
worse until I could not even stay awake to drink my morning coffee.  I
could barely function at work, and I was a danger on the roads to
myself and others.

I loved CPAP!  It gave me my life back!  I knew that other people did
not fall off to sleep anywhere and everywhere as I did, but until I
got better using my CPAP machine, I had no idea exactly how bad off I
was.  I did not mind the machine for a second, and got used to it
within days.

Now I can't sleep through the night because my chest gets sore when I
use the CPAP.  The pain is so intense that it wakes me up after about
two hours.  I then have to sit up for one to two hours before it
subsides enough to let me lay down again.  My setting was 15, and my
sleep doctor had me get it lowered to 12.  I was relieved and
confident that would work, but it did not.  It did not improve things
one little bit.  I constantly have the sneezes and a runny nose, but I
could live with that.  It would be a price I would be willing to pay
in order to be able to function.

But now the chest pain is interrupting my sleep, and I can feel myself
slipping backwards again.  I am so upset.  I cannot face going back to
feeling the way I did before.  Before I did not know how bad off I
was.  But after feeling well (and practically dancing with joy to feel
that good after such a long time), I would know the difference.  I am
so depressed.  It was all I could do to get through work today without
breaking into tears.

Thankfully I see my sleep specialist on Tuesday.  I hope he can give
me some options.  For the next two nights I am going off CPAP.  My
chest pain used to go away during the day, but now it is not and it
hurts all the time.  I hope two days is enough, and that on Monday
night I'll be able to use it again so I'll be fit enough to make the
two hour drive to see my sleep specialist.

My family physician says that my chest muscles can't handle breathing
out against the pressure of the CPAP machine, and that there is
nothing wrong with my heart or lungs.  Has anyone else had this
problem?  A setting lower than 12 would not do me much good at all.
Any suggestions?

Deeply depressed and desperate to find a way to keep using my CPAP.

My husband read your post - he's been on a CPAP machine at a setting of
15 for several months and is doing really great, sleeping comfortably
all night. He also has heart trouble (has had bypass surgery) and goes
to a cardiologist as well as a sleep specialist at a very good sleep
disorder clinic.  He says it takes BOTH doctors, because he has two
problems, and it sounds like you might be the same way.

He suggests you get a cardiac specialist to check you out PDQ!

Best,
Mary (and Bill)

I will bet hard cash that if you press the issue, you can get your
Doctor to put you on a BiLevel device at a lower pressure and still feel
as good as you did on 15 of CPAP.

BillsCPAP in Seattle

ROGER

I re-read my Tranquility Quest manual, and according to it, it is
supposed to reduce pressure when I am exhaling, but it does not say by
how much.

Anyway, after being off the CPAP for two nights, I still have the same
problem.  The idea was that perhaps being off of it would give my
chest muscles a chance to recover and heal a little, and hopefully
when I went back on at a reduced setting of 12, the problem would not
be there or would not be so bad.

Now I am re-thinking this.  If I have the same problem--waking up with
severe chest pain, mostly in the back but sometimes around the sides
and in front--maybe the problem is NOT my CPAP machine!  During the
day the pain subsides quite a lot, but it does not go away completely
and sometimes I have mild chest pain in front.

I know I have had sleep apnea for several years (probably most of my
life--I have always snored).  I am also very overweight, and I have
had an ongoing problem with edema (swelling of feet and ankles) for
about three years.  So now I am starting to wonder if I have damaged
my heart over the years.  However, I am only 41 and my family
physician is holding fast to the idea that the pain is coming from my
chest muscles.  

I see my sleep specialist tomorrow.  He is a neurologist, and I will
ask for his opinion and possibly for him to refer me to a
cardiologist.  He might be easier to sway than my family physician.
(I have to be referred for our Canadian healthcare system to cover it;
I just can't refer myself.)

Tell me, are these symptoms you think I should be concerned about?  I
am wondering about congestive heart failure myself, but I do not know
a lot about that.  Do you know what the symptoms of congestive heart
failure are?

Thanks for your response.

In article <53mh7k$...@gollum.kingston.net>, gri...@adan.kingston.net

Note that there can be a whole sequence of problems using CPAP,
which has little to do with the CPAP itself (except indirectly).

They all boil down to "if you can't breath through your nose,
CPAP won't work for/with you".

1) many people have problems with their nasal cavities drying out.
This causes nasal congestion.  In my case, I both need to humidify
the air, and heat the humidifier, particularly in the winter.
I just use a heating pad on lowest setting under the humidifier.
This helped.

2) I've had cronic nasal congestion for years, without really being
aware of it.  Once aware of it, I talked to my pulmonary person,
and she prescribed a nasal steroid spray (the over the counter
sprays should not be used for more than a few days at a time, or
they will cause more problems than they are worth.  In my case,
I started using beconase, and now use flonase.  This helped
the congestion during the day (always able to breath freely), but
I noticed slowly that I tended to get congested at night.

3) Go get yourself tested for allergies, sooner rather than later.
From your description of sneezes and a runny nose, you may have a
serious allergy problem.  In my case, when I finally went and got
tested this last summer (16 months after starting CPAP), I tested
off scale for dust mites, which, you guessed it, love to live
in your bed (they live off of dead skin and other things that
humans give off, and therefore love beds more than anywhere else).
I've now just started getting injections for the allergy as well.

Note that congesion problems may have been cronic for you for as
long or longer than Apnea, and you may therefore have become used
to them as well.

--
Jim Gettys

I am new to all this but during my research on the subject, I did hear
about a "bi-pap" capability......according to the sleep disorder
technician, this is a cpap that has two levels of pressure one for inhale
and a second lower level for exhale........you could ask about whether or
not this could benefit you.
again, i am a novice so be sure to get some expert advice.  The
technician at the sleep lab I attended was very knowledgeable and worked
closelly with my physician and has made herself available to answer my
questions.  your
technician should be able to help you too

Jan in FL..

Is it possible you are getting congestion in your lungs due to
excessive nasal congestion?

Valerie,

In article <53ugfs$...@gollum.kingston.net>, gri...@adan.kingston.net

As you suggest, medical literature reports that years of sleep apnea can
have cardiovascular effects.  However, from what I have read specifically
regarding heart failure (which you mention), CPAP has  been shown to be
effective at reversing heart failure symptoms in several groups of
patients.  Here are some references:
Takasaki et al, Am Rev Respir Dis 130:1578-1584, 1989.
Malone et al, Lancet 338:480-484, 1991.
Bradley at al. Am Rev Respir Dis 145:377-382, 1992.

It would be cool if you could see a cardiologist who believes in the
cardiovascular effects of sleep apnea.  I get the idea that not all of
them are converts, yet.

Someone wrote earlier suggesting BiPAP instead of CPAP, and my
semi-educated bet would be, that's going to be your answer.

You sound like a smart medical consumer, so I'm sure you'll work your way
to a solution that works for you.

Best wishes,
Sally in Seattle
JSo...@aol.com

Whenever I travel and sleep on a new matress I have problems similar to
what you describe, but not so sever.  Before you jump to the worst case,
(heart probelms) do explore all the other possible areas, such as a
different matress, lower pressure, higher pressure, Bipap, Dipap etc.
There is an answer.  Hang in there.

Bill

For some information on the relationship between apnea and heart
disease, see the articles on the Phantom Sleep Page at
www.newtechpub.com/phantom

Hi Valerie. I also tried the CPAP (and BPAP) and was unable to breath
against the pressure. I have now used a DPAP for over a year and it works
great for me. It is a "demand" PAP which has a base level set at about 5
and then only responds when you have an apnea, ramps up, then gradually
ramps down if you are breathing again. It does this all night long and
causes alot less stress on the lungs and heart. If you want more info,
send me email and I'll put you in contact with the manufacturer who can
send you a brochure.
Chris
--

Sally, I did not see the original post re CV problems as a result of OSA
but you are correct that it can have a serious  affect in terms of  
causing secondary pulmonary hypertension and possibly an enlarged heart.  
 The symptoms are often  swollen ankles and edema  and especially
shortness of breath .  The danger of course  is  congestive heart failure.
  Certainly, someone with these symptoms should immediately see a
pulmonary specialist.     Usually, diagnosis is achieved  after a
flueroscopy and/or an echocardiogram and sometimes a heart catherization.
and a sleep study to see.if OSA is the culprit...........again , to
valerie  .....get thee to a physician.

Jan in Fl.

In article <55bg93$1...@usenetw1.news.prodigy.com>, WEJH...@prodigy.com

However, I would certainly opt for a sleep test FIRST, before undergoing
heart catheterization or any other invasive procedure.  It would be easy
enough to screen patients at that point by asking them (and their partne,
for accuracy) about snoring, stopping breathing during sleep, and daytime
sleepiness.  If the answers are yes, get thee to a sleep specialist.

Sally