Trach tube and CPAP?

[Lulu54]

Dr. Park,

Tonight I was talking with Shadowsister and she is having trouble with nighttime sleeping - she is having MS spasm problems with her tracheotomy and the tube has become clogged and has also been ejected by the spasms.  This is the first these problems have happened in the approx. 20 years she has had a trach.

Sleep is worrisome to her because of this problem, and she mentioned that she was going to ask her doctor for a CPAP machine to use to help keep her airway open.  Her problem is not sleep apnea, and we discussed that.  

This started us wondering  about a general question - can CPAP be used by someone with a  trach tube?  

Thanks in advance for sharing your expertise,
Laura
MS forum

[Steven Y Park, MD]

Laura,

It sounds like Shadowsister is having tracheotomy tube maintenance issues, and CPAP won't help. She needs to address the mucous plugging and spasms instead.

In rare situations, CPAP can be used through a tracheotomy tube if there's severe collapse of the trachea or bronchi. A  servo-ventilator PAP machine can be used as a ventilator as well.

[Lulu54]

Thanks for the information - I will pass it on to her for discussion with her doctor.  I didn't think the CPAP was the right approach.