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Extreme fatigue and lightheadedness after use
#1
Extreme fatigue and lightheadedness after use
I was prescribed an APAP machine (Dreamstation w/ humidifier/heater set to 4-20; ResMed AirFit P10 for her mask) 4 days ago.  I have barely been able to get out of bed since the first day after the first use.  I am having extreme fatigue and lightheadedness/tingling in my head and face.  If I try to get up and walk around, I have no strength.  My knees want to buckle and my whole body just wants to collapse.  It feels as if I had been given a very large amount of oxygen and it is making me about to pass out.  I realize that it "takes time to get used to the APAP machine," but this is well beyond discomfort.  If I don't feel better by Monday, I will have to contact my doctor.  In the meantime, I am wondering if there is every a physiological reason for having the gravest level of fatigue and tingling in my head and face while feeling totally lightheaded.  

I attached my screenshots from the first two numbers, but these numbers are like Chinese to me, unfortunately.  If anyone has any suggestions, I would really appreciate it. Thank you!


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#2
RE: Extreme fatigue and lightheadedness after use
I don't know anywhere near as much as the guy's here do but I know what you mean. Sleep is a mysterious thing. Being able to breath freely and easily is just 1 aspect of it. My personal theory on this (from my own experience) is your brain has to adjust to the change in sleeping patterns. Your brain was used to the way it 'was' and now even though your sleeping pattern has changed for the better as far as being able to breath better, it's not used to that. So everything gets jumbled up in your brain, it's like a sick jet lag feeling. 

You could try easing into using your therapy, sleep part of the night with and without the mask. It might take a week or longer for you to adjust to it. I'm adjusting to a new machine right now and feel pretty weird, though I know I'm sleeping more deeply and longer. It takes time, to adjust. Hope this helps.
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#3
RE: Extreme fatigue and lightheadedness after use
I think you are right, Jeremy.  It's 2:30 a.m. and I haven't been able to sleep from feeling so unwell.  I forgot to mention that the best way to describe this feeling is as if someone told you to take a very deep breath, as deep as you can.  Then, another.  And another, and keep going without stopping. After a short while, you would be dizzy and lightheaded.  That's exactly how I feel.  In addition, several times today, my entire inside of my body felt like it was pulsating on the inside, in my torso.  When I lay down to sleep or take a nap with the APAP machine, my body is "forced" to take these deeper breaths.  My breaths are longer when I am on the machine, and at the later point in the inhale, as I am drawing in the air, the machine doesn't seem to push the air, as if it was on the exhale cycle, so I would be trying to breath in air, but nothing comes in.  No matter how deep a breath I take, it still feels like I am not getting oxygen, so I'm drawing an even deeper breath, only to exasperate myself to dizziness.  I think I am also struggling to exhale through the small vents of the nose pillow.  

Whatever it is, I cannot take this any more.  It's been 4 days of total physical exhaustion.  I am going to take your advice and stop the madness.  I hope you can ramp up to your new machine faster than my acclimation!
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#4
RE: Extreme fatigue and lightheadedness after use
I tried the auto cpap, and sent it back. It increased the pressure way to much. If you have a doctor of some kind with this, maybe look into a cpap instead, with set pressures. If and when you can get a real sleep study done, would not be a bad idea. 

It sounds to me like the pressure gets to high , normal breathing in and out is not happening. These days doctors just say get an auto machine. It's a quick easy way out. But I should let the experts here help you. Just want to let you know your not the only one experiencing the 'weirdness' and there is a adjustment  that effects every aspect of your life that is not always an easy one to make. If all else fails, you could stop using the machine, find other ways to improve the quality of your sleep. 

BTW, what are the pressures telling you on your machine? The auto apap I used started at 4 and ended up at 9, I could not breath. Don't like the apaps.
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#5
RE: Extreme fatigue and lightheadedness after use
Amiru, you need to increase the minimum pressure from 4.0 to 7.0 for starters. This will prevent the feeling of starving for air and will start to stabilize your pressure closer to your optimum therapy needs. Trust me on this. Increase the pressure and you will have a whole different and better experience. Do you know how to access the settings?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Organize your OSCAR Charts
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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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#6
RE: Extreme fatigue and lightheadedness after use
Amiru, Sleeprider's advice is very important.  It sounds as though you may be hyperventilating, and if you are, that very low starting pressure may be setting it off.  The general stress of starting CPAP use may also be a contributing culprit.

I think you would benefit from using your mask and machine during the day and evening for an hour or two at a time, while you do something relaxing and diverting, like reading or watching TV.  This will speed up your adaptation to the new experience.  

Here is some general advice from a trusted web source about calming down hyperventilation:

Breathing techniques
  • Breathe through pursed lips, as if you are whistling, or pinch one nostril and breathe through your nose. It is harder to hyperventilate when you breathe through your nose or pursed lips, because you can't move as much air.
  • Slow your breathing to 1 breath every 5 seconds, or slow enough that symptoms gradually go away.
  • Try belly-breathing, which fills your lungs fully, slows your breathing rate, and helps you relax.
    • Place one hand on your belly just below the ribs. Place the other hand on your chest. You can do this while standing, but it may be more comfortable while you are lying on the floor with your knees bent.
    • Take a deep breath through your nose. As you inhale, let your belly push your hand out. Keep your chest still.
    • As you exhale through pursed lips, feel your hand go down. Use the hand on your belly to help you push all the air out. Take your time exhaling.
    • Repeat these steps 3 to 10 times. Take your time with each breath.
Always try measures to control your breathing or belly-breathe first. If these techniques don't work and you don't have other health problems, you might try breathing in and out of a paper bag that covers your nose and mouth.
Using a paper bag
  • Use a paper bag to control your breathing. Take 6 to 12 easy, natural breaths, with a small paper bag held over your mouth and nose. Then remove the bag from your nose and mouth and take easy, natural breaths.
  • Next, try belly-breathing (diaphragmatic breathing).
  • Alternate these techniques until your hyperventilation stops.
Keep us posted, would you?
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#7
RE: Extreme fatigue and lightheadedness after use
The machine is set to auto-hover between 4 and 20.  According to the Oscar app, it stays mostly in the 4-7.6 range, but it did spike a few times per night in the 10.6 range.  I did have a one-night, at-home sleep study done last year, and it showed that the AHI was 9.7, which is in the mild sleep apnea range.  The 4 days of the Oscar data is very similar to the sleep study.  The reason I suspect that my brain has to do with this total failure is because I actually have more clear airway apneas than obstructive apneas, so it's not a matter of my tongue slouching back into the airway at night, it has to do with my brain sending the wrong signal.  Last night, when I did go back to sleep, I took your advice and ditched the APAP machine and slept better again.  I also think that the nasal pillow mask I chose was a mistake.  I think the way it forces the air up the nose is just too aggressive for my dumb brain that insists on being the boss.  I might have to buy a different mask, a full face or at least full nose mask to see if my brain can be fooled.
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#8
RE: Extreme fatigue and lightheadedness after use
You may be wrong for all I know, but you may be right Turn off the auto pressure, use CPAP mode and try a pressure of 7. It will stop your sleep fragmentation, give you effective therapy for any obstructive events, and we will see what is real. As long as your therapy looks like this it's simply chaos.

[Image: attachment.php?aid=29531]
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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#9
RE: Extreme fatigue and lightheadedness after use
Welcome to Apnea Board,

I'd agree. We can see by the data on the left side that EPAP wants to go up towards 7ish plus. What this change in settings would do is make the machine start where it senses pressure starts to support your apnea. Unfortunate but your Philips PAP is a bit slow to get there and lets quite a few events pass as not treated. If you bring that 4 up to 7, it gives the PAP a head start and becomes better able to combat the apnea, allowing fewer to sneak past. And that is the goal of a well tuned PAP machine, not allowing events past and then to provide therapy that's comfortable and easier to sleep.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Extreme fatigue and lightheadedness after use
Thank you so much for the support and advice.  I found online the tip for changing the settings and changed the measurements to 7.  It shocks me that I was prescribed this machine without a word of counseling.  Welcome to our health insurance system, I guess!  We have the know-how and technology to have fancy devices like this Dreamstation, but we cannot afford to counsel the patients on it.  I cannot tell you all how ill I felt after two nights of hyperventillating.  Thank you, again, for the advice, I'll send an update with the new charts with -- hopefully -- improvement.
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