CPAP induced loss of balance / ataxia

[SeaPap]

I have been suffering from loss of balance since using a cpap machine to treat sleep apnea. The loss of balance improves when I stop using the cpap. I had some lightheadedness and loss of balance before starting CPAP for 1 month, but CPAP seemed to make it worse.

I have seen a neurologist. My MRIs were inconclusive. They did have a small number of very small WMHI's suggestive of 'ischemic changes'. The nuerologist said the WMHI's were not a completely abnormal finding and he did not think it was the cause of the loss of balance. I also has\d an MRA which was completely normal. He also stated that I'd not had a stroke and that MS was not a posibility (although I am not sure how he could know that for sure).

I do have blocked sinuses and nasal / sinus polyps according to a CT scan and the MRI's. I have had tests from an ENT dr and an audiologist. They have said I do not have an inner ear problem.

I can only tolerate cpap for 2.5 hour per night, but it was helping. My heart palpertiations had reduced and I felt more refreshed in the morning. However the loss of balance and light headedness was extremely distributing. I can't live with that.

I don't know what to do. Most doctors refuse to accept CPAP can cause loss of balance, but it seems obvious from a searching the internet that this can happen. Any suggestions would be welcome

[trish6hundred]

Hi SeaPap, First, WELCOME! to the forum.! I'm sorry you are having such a rough time with CPAP therapy. There are a few threads on this board that talk about this very thing. Hang in there, someone will be along shortly with a suggestion so keep checkin' back in to this forum. Best of luck to you with this problem and hopefully, you can get back to good sleeping with the CPAP machine since what little you were able to use it was helping you.

[PaulaO2]

MS can cause white spots on the brain to appear during an MRI. That and other signs are probably what the doctor used to rule it out.

What would be interesting is to have you wearing the mask, the machine on, and be examined while you are experiencing the problems. I would think the ENT would be the one to discuss this with. If you can duplicate the problem in a doctor's office, it may help.

Other problem might be POTS but I'm not sure how CPAP use would exacerbate that.

Are they going to be doing anything about the polyps and the congestion? Both of these combined may cause the same symptoms.

Doctors are becoming less and less able to think outside the box they want to force patients into. If a patient does not fit, they declare it not a problem they can fix and push you off onto someone else or, worse, tell you it is in your head.

[jfmusil]

The higher pressure at night opens the tubes to the ear and may be affecting you when you wake up.

[DocWils]

The type of doctor you want to talk to for this is a Neuro-otologist - they specialise in diagnosing this sort of problem.

[jeanette]

You mention you have blocked sinuses etc but that does not seem to worry you, that is my main problem with the nasal pillows, not the face mask, does anyone have this symptom? mine is severe.

[PaulaO2]

Blocked sinuses caused by the nasal pillows? Or blocked sinuses and nasal pillows?

I have exclusively used nasal pillows since about my 3rd or 4th month in. During that time, I have had severe allergies, bronchitis, pert-near pneumonia, asthma, etc etc. Only once was I not able to use the nasal pillows. Usually, about five minutes after putting them on, my nose clears and remains clear (although I have woken up to a phlegm filled mask) until about 3 seconds after I take off the mask. The one night I could not, it was before I started using nasal rinses. The pillows were actually pushing out of my nose, I was so blocked. I went one night without the mask, slept horribly, hit the internet for assistance, and started using the nasal rinses. Not had any issues since. I only use the rinses when I have an issue. I don't use it every night.

Did my nasal pillows cause any of that stuffiness? I would have thought so but they actually help. And it was my use of the CPAP that helped me get over the pert-near pneumonia late last year. The humid air it blew into my lungs really helped. After about five days of suffering, I thought DUH and went to get a small humidifier for my desk. Ahhhh.

[archangle]

Sometimes I think apnea is a bit like smoking, drinking, caffeine, or doing some legal or illegal drugs. Your body adapts to the low O2, stress, hormones, etc. from being strangled over and over again during the night. It pumps out adrenaline and other hormones and chemicals, adjusts many things about your blood chemistry and nervous system to try to compensate.

If you do CPAP and stop having apnea, your metabolism and the feedback system is out of whack because you aren't having the apnea. It can basically be like withdrawal symptoms.

How long have you been doing CPAP? Why can't you take more than 2.5 hours?

You say you're working with your doctors. Check with them, but I'm going to recommend you figure some way to only sleep with your CPAP.

Many people here have worked through their problems of using CPAP. Tell us what problems you're having.

Some people do feel screwy at first when doing CPAP, but it usually improves pretty quickly. It sounds like you have some serious problems without CPAP.

[SeaPap]

Archangle, thanks for your reply.

I can usually (not always) fall asleep with the mask on. However I wake up after about 2 hours and often remove it without realisiing. When I consciously leave it on, I will not fall back to sleep. I can not survive on two hours sleep, so I remove it.

I take your point about the body reacting to cpap, but I think the loss of balance / lightheadedness is a direct result of air being blown at high pressure (relative to a non cpap user) up the nose. This can apparently effect the inner ear / sinuses which can impact balance. Most doctors do not have sufficient training to understand the connection.

The loss of balance means I feel disorientated and can not walk in a straight line. The lightheadedness means I can not think at work. This reduces my quality of life even more than OSA. It's a not a small side effect I can live with. I have been having the problem ever since I started Cpap about 4 months ago, so I don't think it's transitory. If I use CPAP it's worse, if I stop it gets better. I can try cpap again and hope for a different outcome (but they say about the definition of madness is doing the same thing over and over again and hoping for a different outcome).

The problem doesnt just occur in the morning. In fact, its often worse later in the day. I think CPAP is just exacerbating a predisposition for inner ear problems. Because most people do not have this predisposition, the medical community is refusing to accept there is a connection.

I bought a positional device and I'm hoping this will work. A home sleep test suggested I only had OSA on my back.

[SeaPap]

MS can cause white spots on the brain to appear during an MRI. That and other signs are probably what the doctor used to rule it out.

I did have white spots (whmi's), but was told many normal people have these.

What would be interesting is to have you wearing the mask, the machine on, and be examined while you are experiencing the problems. I would think the ENT would be the one to discuss this with. If you can duplicate the problem in a doctor's office, it may help.

The problem does not occur while using the cpap, it's the day/s after. Nevertheless, this could be an interesting idea.

Other problem might be but I'm not sure how CPAP use would exacerbate that.

Its not positional. It's chronic and occurs when standing or walking.

Are they going to be doing anything about the polyps and the congestion? Both of these combined may cause the same symptoms.

You think this can cause balance / lightheadednes problems? I have not treated this issue, as I have almost no usual symptoms of sinusitis. The ent dr said I was 7 on a scale of 10 for blockness on my left side. I have several polyps about 1 to 1.5cm. I can not tolerate sinus meds as I get heart palpitations.

Doctors are becoming less and less able to think outside the box they want to force patients into. If a patient does not fit, they declare it not a problem they can fix and push you off onto someone else or, worse, tell you it is in your head.

Absolutely, it's fairly pathetic. Personally I think many Dr's just can't be bothered to deal with anything that is non standard. They have no incentive to.