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[CPAP] Dizzy head, foggy brain after using CAP
#1
Dizzy head, foggy brain after using CAP
Hi all,
I started using CPAP machine (with a headgear) two days ago, and had the experience of two nights. Sleeps were basically good (though with some minor problems in adaption to CPAP). In the mornings, my energy was good, but I felt a bit lightheaded, and also a bit bad sense of balance (feeling your feet a bit lighter than usual, and walking a bit groggy). In the meantime, my brain seemed a bit foggy (or fuzzy?).  No other obvious discomforts.

My pressure was set by the clinic: minimum 5; maximum: no idea (but can check after this post). Two checks during nights are 10.5 and 12.5.

Is it a common thing at the beginning of using CPAP?

Thanks!
Have a lovely day!
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#2
RE: Dizzy head, foggy brain after using CAP
Welcome to Apnea Board tasboy111

I know that some experience brain fog and grogginess in the morning when first starting out.  
Hopefully, that will pass as you adapt to therapy.

I suspect your minimum pressure to be too low.  Would love to look at your data to better advise.  
I recommend that you download the free OSCAR software.  
(Be sure your machine has an SD card in it.)

Follow the directions in the links below in my signature line.  This will guide you in how to organize a graph, take a screenshot, and post some data here.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Dizzy head, foggy brain after using CAP
Also, want to add that if the brain fog and grogginess continue, you may want to ask your doctor to monitor your Oxygen levels.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Dizzy head, foggy brain after using CAP
Welcome to the club.

OSCAR will help us help you so much. It can provide details down to the breath by breath level when needed.

Starting pressures being too low is a very common problem that we see.

Setting your min pressure to 7 and EPR on full-time and set to 2. This leaves your exhale pressure at 5 min and your inhale at 7 which should be more comfortable.

As far as how well it is working for you we will need to see your OSCAR charts
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#5
RE: Dizzy head, foggy brain after using CAP
Hi Bonjour, OpalRose, and all,
Greetings from Tasmania, Australia, where we could see Aurora!

My machine is ResMed AirSense 10 AutoSet; min pressure: 5; max pressure: 20; ERP: 2.

Based on your suggestion, I asked the DME (the sleep clinic I visited in Tasmania) if they could tune up the minimal pressure to 7, and they did it conservatively by resetting it as 6. I used this setting for one night (28 Aug 2019) and slept for more than 9 hours (a good sleep, I think); but the next day (29 Aug 2019), I felt much more dizzy (though not a level that cause falling over). Then I manually set the minimal pressure back to 5 again on the night (29 Aug 2019), because I worried that the dizziness and walking grogginess might be caused by more pressure in the middle/inner ears.

So far, I still have the dizziness problem: head dizzy & foggy; walking a bit groggy; sometimes, ear a bit popping and slightly ear/headache (endurable). Brain fogginess and sudden dizzines/bad sense of balance (several seconds when coming, but not predictable) make me not confident in driving. Thus, I stopped driving recently.

I finally had some time today to install OSCAR and play with the software. Also carefully read the related documents and instructions. Seems that I also have some knowledge now about the auto-algorithms in the machine (ResMed AirSense 10 AutoSet) - which make me believe the machine itself is not so high-tech: algorithm design + some programming skills here.

I attached the OSCAR snapshots of 11 nights from 22 Aug 2019 to 1 Sep 2019 (I will have to use another two "reply"s to attach all the pictures because seems that I am only able to attach 5 pics in each reply).

Could you please have a close look at the data of these 11 nights (note that on 28 Aug 2019, I used minimum pressure of 6), and give me some suggestions about possible parameter settings? When proposing your suggestion, could you please keep in mind that I doubt my symptoms might be caused by pressure in middle/inner ears. When you suggest a higher minimal pressure like 7, directly raise my setting from 5 to 7 will cause more severe dizziness?

(See my more replies for more OSCAR snapshots)

Many thanks again!
Warm regards,
Tasboy111

===================================22 Aug 2019==========================
   
===================================23 Aug 2019==========================
   
===================================24 Aug 2019==========================
   
===================================25 Aug 2019==========================
   
===================================26 Aug 2019==========================
   
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#6
RE: Dizzy head, foggy brain after using CAP
===================================27 Aug 2019==========================
   
===================================28 Aug 2019: min pressure 6 for one night========
   
===================================29 Aug 2019==========================
   
===================================30 Aug 2019==========================
   
===================================31 Aug 2019==========================
   

===================================1 Sep 2019==========================
   
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#7
RE: Dizzy head, foggy brain after using CAP
tasboy111,
You state that the dizziness, brain fog, ears popping and headaches are a problem for you regardless of the pressure setting.  Normally, these early feelings dissipate as you get used to using the Cpap.

Looking at your charts, there is not a lot of difference between them as far as AHI results.

What I do see is that for at least half of the night, your pressure hovers around 10 and higher. 
The pressure reaches that number simply because the machine is doing it’s job to tackle the
Obstructive events.  

So your biggest complaint is about how you are feeling.  Having to stop driving because of dizziness isn’t normal.  One thing is to check the humidity setting.  Too much humidity can cause symptoms like congestion and may affect the ears too.  
Have you been to a doctor, either your regular doctor or an ENT specialist?

I do feel you should be at a higher minimum pressure.  And remember, it takes time to get used to the feel of pressure.  Raise the pressure slowly, about .5cm at a time.  Watch your numbers, make note of how you feel.
The minimum should be around your median pressure number.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Dizzy head, foggy brain after using CAP
I see little difference between the chart from the 28th and the others. In every case the min pressure is increasing to 10-12 and not dropping below 8 for the entire night. So in spite of your min settings of 5-6 your actual min pressure for most of the night is 8 or more due to the response of your machine.. Raising the min pressure to 7 0r 8 should make no difference since it is running at that pressure or higher for for the entire night. Please replace the mask pressure graph with the flow limit graph and delete the pie chart (see link below for organizing charts). Have you seen an ENT Dr. about your dizziness? It may be unrelated to CPAP use. There a number of ear conditions including Meniere's disease that causes significant dizziness.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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#9
RE: Dizzy head, foggy brain after using CAP
Another consideration to support OpalRose's pressure increase recommendation is you have a pressure swing of over 10cm. This can cause some of your problems, as well as, sleep disturbance. Raising your starting pressure closer to a treatment pressure will go a long way in helping. It will feel difficult at first but if you stick with it, you will adapt to the pressure within a few minutes.

Finally, a good mindset will go a long way in your success. I could quote a half dozen inspirational sayings but I'll let you pick your own.

Good luck!
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Dizzy head, foggy brain after using CAP
Hi tasboy111,

I think most people with sleep apnea are strongly affected by sleep position: sleeping on our side versus on our back, and the angle of our neck, etc.  You may be able to greatly reduce your pressure needs by avoiding certain positions.

The totally excessive dizziness you are experiencing might be caused by PAP therapy, and you may find it more important to limit the Max Pressure rather than the Minimum Pressure. For example, you may find you are usually less dizzy if the Max Pressure is limited to 15 or 12 or whatever.

The reason the AutoSet algorithm is raising the pressure so high is you have been needing high pressures to minimize obstructive events. But you may need to compromise your therapy by allowing worse/more obstructive events in order to avoid high pressures. Or, if you’re lucky, you may be able to find ways to limit your sleep positions so that pressures do not need to go as high.

Our pressure needs do change hour-to-hour, night-to-night and throughout the week.  To avoid being misled by normal daily variation, we may need to keep the settings unchanged for a week or longer between changes, before we can make a reliable/repeatable observation regarding whether, on average, dizziness is better or worse for a given set of therapy settings.

For example, you might consider setting Min and Max pressures each to 13 for a week, and then keep the Max at 13 but lower the Min to 10 for a week. If dizziness is no better, then perhaps try both Min and Max set to 10 for a week. And so on.

In the meantime, of course work with your doctors to see if they can find a root cause for the dizziness.

Take care,
— Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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