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[CPAP] Dizzy head, foggy brain after using CAP
#11
RE: Dizzy head, foggy brain after using CAP
I don't buy the suggestion that your oxygen levels are low when using the machine.  If you have sleep apnea, your oxygen levels are lower when you're not using the machine.

You should know that Resmed's machines send pulses whenever you experience an apnea, starting at 3 second into the apnea and continuing until you start breathing again.  Those pulses are designed to determine if your apnea is central or obstructive.

.  Notably, when you do an in-lab sleep study, even with a Resmed machine, the machine doesn't send FOT pulses, and so the lab does not test you to see if the pulses disrupt your sleep.  My experience, and the experience of several other users here, is that those pulses disrupt sleep without necessarily waking you up.  If you are one of the Resmed users who get an AHI of 0.0, you they won't occur and they won't be an issue.  But, if you have periodic breathing and/or central apneas, those pulses can disrupt your sleep worse than sleeping without the machine.  That could be why you are having "brain fog" when you wake up.  

If you don't adapt to them, you may wish to try to get a machine that doesn't send them.  Fisher Paykel's machines don't send them at all.  The AirSense 10 CPAP (not Elite, not APAP) and AirStart 10 CPAP won't send them at all.  The ResMed AirCurve 10 VAUTO won't send them when you turn easy-breathe off.

Respironics machines send a different pulse, which can actually be more disruptive to sleep 10 seconds into an apnea.

Regarding your dizziness, you might also want to try the epley manuever (google it).  I found that helpful, especially when I first started on CPAP.  But, dizziness can also be caused by disrupted sleep.
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#12
RE: Dizzy head, foggy brain after using CAP
Started CPAP therapy in July and had brain fog during the first few weeks but I felt fine during the day. Didn't have any daytime sleepiness anymore which plagued me before CPAP and generally felt rested.

I don't experience brain fog anymore but then I am now using a different mask from what I started with and I have dialed in my settings based on the advice of the wonderful people on this board. So I can't really say for sure if the reason why I don't have brain fog anymore is simply because I've gotten used to the therapy or because of the changes that I have made in my settings.
hearsay73
Hosehead padawan 
Repaying my sleep debt, 1 night at a time...
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#13
RE: Dizzy head, foggy brain after using CAP
Hi all,
Many thanks for your patience, encouragement, knowledge, suggestions, and experience sharing. 

Today, I went to my sleep centre for the first appointment after using CPAP (usually the first appointment is at the two weeks after using CPAP, and the second at the one month after using CPAP). But the appointment is not with the doctor, but an assistant who looks after the parameter setting. Through her ResView software, I saw the median value of my pressure is 11, and the 95% percentile is 14.1. She said the treatment pressure is the usually the 95% percentile value (14 in my case). She reset my pressure from auto to a fixed value (14: my treatment value) --- the machine pressure will start from 6 and then go up to 14 during my sleep and stay at this value, which means there will be no "swing" any more. She was quite helpful: she suggested trying this for two weeks, and ringing her once there is a big discomfort; she said, if the head dizziness and brain fogginess does not dissipate after some time, she would arrange an appointment for me with the doctor in the clinic.

Today, I also got an nasal pillow (though it is pink for me a man:-)), and will try the nasal pillow along with my current nasal mask. Not sure if I can endure the air at pressure 14 with the nasal pillow.

I will make note and update my experience on the forum. If the experience is not good, will also post the data on the forum to seek your suggestions.

Have a lovely day, friend from US (apparently, US guys are more active in this forum. Where are Australian guys? :-))!

Tasboy111
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#14
RE: Dizzy head, foggy brain after using CAP
(09-03-2019, 02:02 AM)Reznik Wrote: I don't buy the suggestion that your oxygen levels are low when using the machine.  If you have sleep apnea, your oxygen levels are lower when you're not using the machine.

You should know that Resmed's machines send pulses whenever you experience an apnea, starting at 3 second into the apnea and continuing until you start breathing again.  Those pulses are designed to determine if your apnea is central or obstructive.

.  Notably, when you do an in-lab sleep study, even with a Resmed machine, the machine doesn't send FOT pulses, and so the lab does not test you to see if the pulses disrupt your sleep.  My experience, and the experience of several other users here, is that those pulses disrupt sleep without necessarily waking you up.  If you are one of the Resmed users who get an AHI of 0.0, you they won't occur and they won't be an issue.  But, if you have periodic breathing and/or central apneas, those pulses can disrupt your sleep worse than sleeping without the machine.  That could be why you are having "brain fog" when you wake up.  

If you don't adapt to them, you may wish to try to get a machine that doesn't send them.  Fisher Paykel's machines don't send them at all.  The AirSense 10 CPAP (not Elite, not APAP) and AirStart 10 CPAP won't send them at all.  The ResMed AirCurve 10 VAUTO won't send them when you turn easy-breathe off.

Respironics machines send a different pulse, which can actually be more disruptive to sleep 10 seconds into an apnea.

Regarding your dizziness, you might also want to try the epley manuever (google it).  I found that helpful, especially when I first started on CPAP.  But, dizziness can also be caused by disrupted sleep.

It is a piece of new knowledge to me. I will make note as a point possibly discussing with my doctor. From your words, seems that ResMed machine would blow the air to open up your airway once an obstructive event is detected (reactive to events)? Previously, I only know that the algorithm is "proactive": it predicted the possibility of events and proactively increase pressure in order to avoid future events. If they use a reactive event, identification of an event in a timely manner would be a treaky part.
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#15
RE: Dizzy head, foggy brain after using CAP
tasboy111 Wrote:It is a piece of new knowledge to me. I will make note as a point possibly discussing with my doctor. From your words, seems that ResMed machine would blow the air to open up your airway once an obstructive event is detected (reactive to events)? Previously, I only know that the algorithm is "proactive": it predicted the possibility of events and proactively increase pressure in order to avoid future events. If they use a reactive event, identification of an event in a timely manner would be a treaky part.

No, you've misunderstood what Reznik is saying. He's referring to the "forced oscillation technique" (FOT) that Resmed machines use to determine if an apnea is central or obstructive. It is not intended to treat the apnea, only diagnose it. The pressure oscillations are very small and very few people are even aware of them. There is a description of the method as well as a lot of other interesting stuff on this page: https://www.resmed.com/au/en/healthcare-...ology.html Scroll down to "central apnea detection".

I should also mention that most of the machines that don't have FOT are basic machines with limited or no data capability and are not recommended.

Coming back to your dizziness, if it persists you should definitely see a GP. It could be something completely unrelated to apnea, such as benign paroxysmal positional vertigo. I had this once and it was frankly terrifying - I got up to answer the call of nature and next thing I was flat on my face. It's easily treated using repositioning manoeuvres. Read about it at Wikipedia. https://en.wikipedia.org/wiki/Benign_par...al_vertigo
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#16
RE: Dizzy head, foggy brain after using CAP
Fixed pressure is often helpful to people that get disrupted sleep with numerous pressure changes. I'd like to go back to your original charts and suggest your pressure is rising not on events, but on persistent flow limitation which routinely shows up at 0.15 as the 95% frequency. Your charts did not include the flow limitation chart, but I'm fairly certain taht most of your obstructive events, as well as high pressure arise out of flow limitation. We have found that higher EPR can help limit FL, so I think you would benefit from changing your EPR setting from 2 to 3. It won't make a lot of difference, but may make your higher pressure more comfortable, as well as helping with flow limits. The idea is, if you solve the flow limits, pressure won't rise as high. If you really want to see what flow limitation looks like, zoom in on your flow rate to a 2-minute segment where the respiratory wave-form is clearly visible, and look for the flat-topped inspiration wave.

For fixed pressure, I agree that a setting around 14 looks pretty good, however I would have approached it by slowly narrowing the range, rather than jumping to a fixed pressure all at once. I would have started with a range of 10-16 with EPR 3, and tried to arrive at an optimal pressure after observation. Let be be clear, I don't disagree with your therapist, I just would have approached it differently. Good luck with the fixed pressure, and please continue to share your progress going forward.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#17
RE: Dizzy head, foggy brain after using CAP
Hi all,
Update: I have been using the fixed pressure "14" set by the therapist since 5 Sept 2019, because the therapist said they usually use 95% percentile as the treatment pressure (my data when I saw them on 5 Sept 2019: median: 11; 95 percentile: 14.1).  The data charts from 8 Sept to 12 Sep 2019 are attached below, FYI.

Seems that the problems of head dizziness and walking grogginess become better (sense of balance is quite good now): I am not sure if it has 100% disappeared, but obviously it almost disappeared, and this happened immediately from the day time (6 Sept 2019) starting using the fixed pressure - thus, I reckon the head dizziness and sense of balance were probably, to the largest extent, caused by the wrong pressure settings (previously: min-5; max-20). [note: I am 100% sure: before using CPAP, I never got head dizziness and walking grogginess, except when I did not eat for 7 hours and blood sugar got very low]

However, the problem of brain fogginess is still here, and this did not become better at all (seems that during evening and night, my brain works better) - brain fogginess makes me still thinking much slowly than normal, and sometimes, I am a bit struggling in choosing the suitable words during speaking (English is my second language): luckily, my students could endure this. I still chose not to drive now. [note: I am 100% sure: before using CPAP, my brain never got foggy. I turned to CPAP not because of feeling sleepy in office or driving, but only because of snoring problem]

Another problem worried me: sometimes, I felt that my heart beating was different from that before using CPAP machine (my heart beating was good before using CPAP). For instance, during the daytime of this Wednesday (lasting around 1 hour from around 11:30 am to 12:30 pm, 11 Sept 2019) and today (lasting around 1 hour from around 12:00 pm to 1:00 pm, 12 Sept 2019), I felt my heart sometimes were beating faster and harder, which was quite similar to the heart beating feeling that someone wake you up and your heart got beating faster; or to the feeling that you drink too litter water during a hot day and your heart beats faster. Today, to relieve this symptom, I drunk more water, though the weather was chilly. At around 1:00 pm, I sat in canteen and had lunch, but the symptom was still lasting. Thus, I went to see my GP directly and he measure my heart through ECG and also blood pressure, but both indicated that it was normal. He doubted that this might because of the low blood pressure caused by CPAP. He suggested me directly adjusting the fixed pressure to 12 (I did it by myself just now) and then sending an email to let my therapist know. He said, though he did not worry about this, he took it seriously - he also referred me to an blood test (done today), an 24-hour holter monitor (will do in next Tuesday and Wednesday), and an chest X-ray (done today). In this matter, to be honest, I am a very sensitive man and even my temperature jumps to 36.8 will make me alert for fever or something. I reckon someone else in my situation might not think it was an issue for him/herself. But here, I am also 100% sure, I have never experience this heart discomfort before using CPAP (except when I drunk too little water in a hot day).

I will update further once I have any new information. 

Any thoughts regarding the lasting foggy brain, and the slight heart discomfort? I am really sure these happened only after using CPAP. But I am not saying CPAP directly caused the problems - it might changed your blood pressure and also something/pressure in your brain, which then caused the problems here? Are there any conclusive theories that explain the foggy brain and slight heart discomfort issues after using CPAP treatment?

In the meantime, any good suggestions on the pressure setting? Seems that my GP is more encouraging in letting me listen to my own body and resetting the pressure by myself.

Many thanks, again!
Tasboy111



===========================8 Sept 2019================================
   
===========================9 Sept 2019================================
   
===========================10 Sept 2019================================
   
===========================11 Sept 2019================================
   
===========================12 Sept 2019================================
   
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#18
RE: Dizzy head, foggy brain after using CAP
It might be helpful to zoom in closer (2-minute segment) so we can see what respiration looks like. The general statistics and AHI look fine, but there seems to be some irregularity in the breathing flow rates. Your flow limitation 95% has improved significantly from the 0.15 we saw before to 0.02.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#19
RE: Dizzy head, foggy brain after using CAP
I also measured my pressure at home just now at around 8:30 pm. It was 114/77 Hg. Pul: 71.
Cheers,
Tasboy111
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#20
RE: Dizzy head, foggy brain after using CAP
Hi Sleeprider,
Thanks for the quick response. Could you give me a clear instruction on which 2-segment on which figure you prefer. 
Regards,
Tasboy111
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