HELP DIZZY AND FATIGUE SINCE CPAP

[quiescence at last]

The PR machines use Aflex if it is an APAP, and Cflex if it is a CPAP. The same thing happens with both. It is not the same action that EPR does on the ResMed.

EPR sets the distance between inhale pressure and exhale pressure to 1, 2 or 3 cm H2O.

The correlation to the PR machines is - All PR machines that are basic APAP have a set pressure relief of 2 cm H2O (equals EPR of 2). If set as a CPAP, it has no pressure relief (equals EPR turned off).

Aflex and Cflex only affect the beginning of the exhale. The pressure is relieved briefly, but the levels of relief are not 1, 2,and 3 cm H2O, they are smaller increments, and I doubt the relief is much more than 1.5 at an Aflex of 3.

I decided I did not want any Aflex. In order to do that, I actually had to change the settings to make it what they call Auto CPAP. In this setting I get no flex, but additionally I get no pressure relief (equal to EPR off).

I hope this is clearer than mud.
QAL

[TorontoCPAPguy]

My observations and comments based on experience. I am NOT an MD.

When was the last time you had a physical? Is the bloated head and dizziness consistent and if so please comment on exactly when it occurs and how long it last for.

I have the same issues but believe them to be from a different source although now that I have YOUR experience under my belt I am going to investigate further. What you and I are experiencing should be setting off alarm bells to be blunt. Doh. I have Atrial Fibrillation (which can be difficult... very difficult to ascertain if it is intermittent, etc.). I was started on a drug called TIKOSYN which put me in Normal Sinus Rhythm supposedly (but remember it is hard to detect as the AFIB can last only minutes or hours and be almost asymptomatic). I have been thinking that I have been suffering side effects of TIKOSYN as they are well known and published; fatigue, shortness of breath, insomnia, dizziness and 'balloon head' are all on the list. Get thee to a cardiologist. My AFIB was found quite by accident... wife said I was short of breath. GP took an EKG and saw nothing but sent it to a cardiologist. Cardiologist saw nothing but to cover his butt put me on an event monitor for a few days and PRESTO! Diagnosed with Atrial Fibrillation. After he messed me around for a while I asked for a referral to one of the best electrophysiologists in North America and on arrival discovered my heart was enlarging rapidly. What took one year to produce (left atrium enlargement) took FOUR YEARS to reverse while in NSR. I am now booked for a catheter ablation which will resolve the problem and get me off the nasty, nasty medications. Get thee to a doctor. What you might be experiencing is a lack of oxygenation of the vital organs. You need to find out. BTW, my balloon head occurs from about 5:30 a.m. on awakening and continues to 10 - 11 a.m. Every day. Same times and situations and CPAP or no CPAP makes little difference if any.

Have you tracked and examined your other vital signs during and after sleeping? For example, a recording of your SpO2 (blood oxygen) during sleep and during the day. If you get a Contec CMS50EW it will do just what you need and will also record your pulse rate. If your SpO2 is dropping below 90%ish you are in respiratory distress - it will probably be accompanied by a spike in pulse rate. (And a spike in BP as well). These are great precursors to a stroke. I am not suggesting you have had a stroke by any means, just that your vital organs have not been oxygenated perhaps.

In any event, you have to be your own advocate in these matters as once you start down the path you will find, with a due respect, that the MD's tend to pass the 'busy' cases off. If you think that a test needs to be done you need to be able to say so and back that up with solid knowledge and experience.

Good luck. I am sure that you can find your path and conclusions along the way. DO NOT give up and DO NOT take no for an answer if you feel that a test needs to be done in order to assist or in order to rule out certain conditions.

Good luck to you and always remember that you are your own best advocate. GO FOR IT!

Regards,
Murray L.

[dizzy1]

Just checked my sleep study report and my Central Apneas were only 0.3 per hour.
There is no mention of any pressure settings for cpap.

Good; OSA is easier to treat than CA

EPR is expiratory pressure relief. Resmed uses EPR; Respironics calls it Flex (can't remember aflex or cflex) but in anycase it is a lower pressure when you exhale. Making sure you only swallow after exhale is another ear health tip.

You said you have inner ear issues - getting the pressure high enough to abate your OSA without further damaging the inner ear will be your goal.

Thanks again. Much appreciated. I paid a little extra for the cpap I have as it has a feature which adapts to breathing when you exhale. So they say.
That said it is still one of the cheapest cpap's I could find and seems popular over here. It is made by a US company. Link below.

http://www.eu-pap.co.uk/sleepcube-autoad...ocpap.html

[dizzy1]

Just checked my sleep study report and my Central Apneas were only 0.3 per hour.
There is no mention of any pressure settings for cpap.

Good; OSA is easier to treat than CA

EPR is expiratory pressure relief. Resmed uses EPR; Respironics calls it Flex (can't remember aflex or cflex) but in anycase it is a lower pressure when you exhale. Making sure you only swallow after exhale is another ear health tip.

You said you have inner ear issues - getting the pressure high enough to abate your OSA without further damaging the inner ear will be your goal.

Thanks again. Much appreciated. I paid a little extra for the cpap I have as it has a feature which adapts to breathing when you exhale. So they say.
That said it is still one of the cheapest cpap's I could find and seems popular over here. It is made by a US company. Link below.

http://www.eu-pap.co.uk/sleepcube-autoad...ocpap.html

This company have been great when purchasing cpap and looked at my 90 day report a few weeks ago but only picked up on the amount of leaks I was having and gave advice on how to correct this. Turns out I just had to tighten my full face mask. I loosened it after getting marks on my face and funny looks from the post man when I woke to answer the front door in the mornings. Told him I wear a gimp mask to bed

[dizzy1]

My observations and comments based on experience. I am NOT an MD.

When was the last time you had a physical? Is the bloated head and dizziness consistent and if so please comment on exactly when it occurs and how long it last for.

I have the same issues but believe them to be from a different source although now that I have YOUR experience under my belt I am going to investigate further. What you and I are experiencing should be setting off alarm bells to be blunt. Doh. I have Atrial Fibrillation (which can be difficult... very difficult to ascertain if it is intermittent, etc.). I was started on a drug called TIKOSYN which put me in Normal Sinus Rhythm supposedly (but remember it is hard to detect as the AFIB can last only minutes or hours and be almost asymptomatic). I have been thinking that I have been suffering side effects of TIKOSYN as they are well known and published; fatigue, shortness of breath, insomnia, dizziness and 'balloon head' are all on the list. Get thee to a cardiologist. My AFIB was found quite by accident... wife said I was short of breath. GP took an EKG and saw nothing but sent it to a cardiologist. Cardiologist saw nothing but to cover his butt put me on an event monitor for a few days and PRESTO! Diagnosed with Atrial Fibrillation. After he messed me around for a while I asked for a referral to one of the best electrophysiologists in North America and on arrival discovered my heart was enlarging rapidly. What took one year to produce (left atrium enlargement) took FOUR YEARS to reverse while in NSR. I am now booked for a catheter ablation which will resolve the problem and get me off the nasty, nasty medications. Get thee to a doctor. What you might be experiencing is a lack of oxygenation of the vital organs. You need to find out. BTW, my balloon head occurs from about 5:30 a.m. on awakening and continues to 10 - 11 a.m. Every day. Same times and situations and CPAP or no CPAP makes little difference if any.

Have you tracked and examined your other vital signs during and after sleeping? For example, a recording of your SpO2 (blood oxygen) during sleep and during the day. If you get a Contec CMS50EW it will do just what you need and will also record your pulse rate. If your SpO2 is dropping below 90%ish you are in respiratory distress - it will probably be accompanied by a spike in pulse rate. (And a spike in BP as well). These are great precursors to a stroke. I am not suggesting you have had a stroke by any means, just that your vital organs have not been oxygenated perhaps.

In any event, you have to be your own advocate in these matters as once you start down the path you will find, with a due respect, that the MD's tend to pass the 'busy' cases off. If you think that a test needs to be done you need to be able to say so and back that up with solid knowledge and experience.

Good luck. I am sure that you can find your path and conclusions along the way. DO NOT give up and DO NOT take no for an answer if you feel that a test needs to be done in order to assist or in order to rule out certain conditions.

Good luck to you and always remember that you are your own best advocate. GO FOR IT!

Regards,
Murray L.

Hi. sorry to hear that you have been suffering these symptoms. My dizziness has been constant for a year now among other symptoms. The migraine or headaches are on and off but most days. My head is always very strained and I can feel my whole brain in my head. I have not had a full physical but if blood tests, blood pressure and eye test means a physical then I have had one. My blood pressure has been a little high on and off and my thyroid is a little low but improving now.

[dizzy1]

My observations and comments based on experience. I am NOT an MD.

When was the last time you had a physical? Is the bloated head and dizziness consistent and if so please comment on exactly when it occurs and how long it last for.

I have the same issues but believe them to be from a different source although now that I have YOUR experience under my belt I am going to investigate further. What you and I are experiencing should be setting off alarm bells to be blunt. Doh. I have Atrial Fibrillation (which can be difficult... very difficult to ascertain if it is intermittent, etc.). I was started on a drug called TIKOSYN which put me in Normal Sinus Rhythm supposedly (but remember it is hard to detect as the AFIB can last only minutes or hours and be almost asymptomatic). I have been thinking that I have been suffering side effects of TIKOSYN as they are well known and published; fatigue, shortness of breath, insomnia, dizziness and 'balloon head' are all on the list. Get thee to a cardiologist. My AFIB was found quite by accident... wife said I was short of breath. GP took an EKG and saw nothing but sent it to a cardiologist. Cardiologist saw nothing but to cover his butt put me on an event monitor for a few days and PRESTO! Diagnosed with Atrial Fibrillation. After he messed me around for a while I asked for a referral to one of the best electrophysiologists in North America and on arrival discovered my heart was enlarging rapidly. What took one year to produce (left atrium enlargement) took FOUR YEARS to reverse while in NSR. I am now booked for a catheter ablation which will resolve the problem and get me off the nasty, nasty medications. Get thee to a doctor. What you might be experiencing is a lack of oxygenation of the vital organs. You need to find out. BTW, my balloon head occurs from about 5:30 a.m. on awakening and continues to 10 - 11 a.m. Every day. Same times and situations and CPAP or no CPAP makes little difference if any.

Have you tracked and examined your other vital signs during and after sleeping? For example, a recording of your SpO2 (blood oxygen) during sleep and during the day. If you get a Contec CMS50EW it will do just what you need and will also record your pulse rate. If your SpO2 is dropping below 90%ish you are in respiratory distress - it will probably be accompanied by a spike in pulse rate. (And a spike in BP as well). These are great precursors to a stroke. I am not suggesting you have had a stroke by any means, just that your vital organs have not been oxygenated perhaps.

In any event, you have to be your own advocate in these matters as once you start down the path you will find, with a due respect, that the MD's tend to pass the 'busy' cases off. If you think that a test needs to be done you need to be able to say so and back that up with solid knowledge and experience.

Good luck. I am sure that you can find your path and conclusions along the way. DO NOT give up and DO NOT take no for an answer if you feel that a test needs to be done in order to assist or in order to rule out certain conditions.

Good luck to you and always remember that you are your own best advocate. GO FOR IT!

Regards,
Murray L.

Hi. sorry to hear that you have been suffering these symptoms. My dizziness has been constant for a year now among other symptoms. The migraine or headaches are on and off but most days. My head is always very strained and I can feel my whole brain in my head. I have not had a full physical but if blood tests, blood pressure and eye test means a physical then I have had one. My blood pressure has been a little high on and off and my thyroid is a little low but improving now.

I was only looking on ebay at oximetery meters the other week. There are cheaper options available with usb and software which look exactly the same as the Contec for around £30.

A copy of my sleep study is below including Oximetery:



[attachment=1263]

[dizzy1]

My observations and comments based on experience. I am NOT an MD.

When was the last time you had a physical? Is the bloated head and dizziness consistent and if so please comment on exactly when it occurs and how long it last for.

I have the same issues but believe them to be from a different source although now that I have YOUR experience under my belt I am going to investigate further. What you and I are experiencing should be setting off alarm bells to be blunt. Doh. I have Atrial Fibrillation (which can be difficult... very difficult to ascertain if it is intermittent, etc.). I was started on a drug called TIKOSYN which put me in Normal Sinus Rhythm supposedly (but remember it is hard to detect as the AFIB can last only minutes or hours and be almost asymptomatic). I have been thinking that I have been suffering side effects of TIKOSYN as they are well known and published; fatigue, shortness of breath, insomnia, dizziness and 'balloon head' are all on the list. Get thee to a cardiologist. My AFIB was found quite by accident... wife said I was short of breath. GP took an EKG and saw nothing but sent it to a cardiologist. Cardiologist saw nothing but to cover his butt put me on an event monitor for a few days and PRESTO! Diagnosed with Atrial Fibrillation. After he messed me around for a while I asked for a referral to one of the best electrophysiologists in North America and on arrival discovered my heart was enlarging rapidly. What took one year to produce (left atrium enlargement) took FOUR YEARS to reverse while in NSR. I am now booked for a catheter ablation which will resolve the problem and get me off the nasty, nasty medications. Get thee to a doctor. What you might be experiencing is a lack of oxygenation of the vital organs. You need to find out. BTW, my balloon head occurs from about 5:30 a.m. on awakening and continues to 10 - 11 a.m. Every day. Same times and situations and CPAP or no CPAP makes little difference if any.

Have you tracked and examined your other vital signs during and after sleeping? For example, a recording of your SpO2 (blood oxygen) during sleep and during the day. If you get a Contec CMS50EW it will do just what you need and will also record your pulse rate. If your SpO2 is dropping below 90%ish you are in respiratory distress - it will probably be accompanied by a spike in pulse rate. (And a spike in BP as well). These are great precursors to a stroke. I am not suggesting you have had a stroke by any means, just that your vital organs have not been oxygenated perhaps.

In any event, you have to be your own advocate in these matters as once you start down the path you will find, with a due respect, that the MD's tend to pass the 'busy' cases off. If you think that a test needs to be done you need to be able to say so and back that up with solid knowledge and experience.

Good luck. I am sure that you can find your path and conclusions along the way. DO NOT give up and DO NOT take no for an answer if you feel that a test needs to be done in order to assist or in order to rule out certain conditions.

Good luck to you and always remember that you are your own best advocate. GO FOR IT!

Regards,
Murray L.

Hi. sorry to hear that you have been suffering these symptoms. My dizziness has been constant for a year now among other symptoms. The migraine or headaches are on and off but most days. My head is always very strained and I can feel my whole brain in my head. I have not had a full physical but if blood tests, blood pressure and eye test means a physical then I have had one. My blood pressure has been a little high on and off and my thyroid is a little low but improving now.

I was only looking on ebay at oximetery meters the other week. There are cheaper options available with usb and software which look exactly the same as the Contec for around £30.

A copy of my sleep study is below including Oximetery:

Cheaper Contec model below do you think is is worth purchasing?

http://www.ebay.co.uk/itm/Finger-pulse-o...4182dcd796

[TorontoCPAPguy]

I had a look at your sleep study and I am surprised that they did not discuss oxygen infusion into the airline with you with the number and extent of desat's that you are showing. Again, remember that anything under 90% SpO2 is considered respiratory distress and, for instance, paramedics will give you oxygen as soon as they see this until it can be further analyzed.

The sleep study is generally set up to try and differentiate between centrals and OSA event. However, if you have a blower that does NOT have data features, you will not be able to follow along on a long term basis.

I would think that you want to investigate your SpO2 (blood oxygen level) through the night, recording same and laying it against the data which you don't have.... but at least you will see the ongoing picture of your SpO2 and if you have drops below 90% through the night you want to head straight back to your sleep doc and ask some questions. BIG questions.

What will happen without infused O2 to keep your SpO2 above 90% is that (I suspect) as you approach REM sleep and your breathing becomes shallow, your SpO2 is dipping (diving?) and your body is being aroused by your autonomic nervous system. Bingo. No REM sleep. Or... little REM sleep. Do you happen to recall vivid dreams when you awaken? And do you awaken with a start? Or in the middle of a good dream? Do you ever awaken in a sweat or gasping? Your sleep study shows all too many desats for my own personal comfort and I know that in my personal situation, supplementary oxygen infused into the air line from the blower at a rate of about 4L/m increased the oxygen in the air from 21% to about 30-32% and it made all the difference in the world to me. I started sleeping through the night much better asides from the pit stops, etc.

The other thing that you need to know is that OSA/sleep apnea is closely associated with a host of other ailments, not the least of which is Atrial Fibrillation; and, AFIB is not at all pleasant and will give you some of the symptoms that you are complaining of. It is not all that easy to detect and you want to detect it in the early stages so that you can get the issue addressed and not have to mess around with it for five years like I have had to do. You have a couple of the top electrophysiologists (cardiologists all) in the world near at hand should you be diagnosed with AFIB.

But, I think the first question I would ask is why my (your) SpO2 has been permitted to drop so low and so often through the night without being addressed. It is easy to address. I bought an Everflo Q 5 litre/m oxygen concentrator and an inline nipple to infuse it. Problem solved.

The Contec CMS50EW should cost you no more that $125, is rechargeable and records up to 24 hours. Its accuracy is superb. If you get one use some green or blue masking tape, judiciously placed, to keep the unit affixed to your finer and steady. Best part is that if your computer has Bluetooth you can transmit the data wirelessly.. else they provide a data cable. Easy enough to use. And you will get an ongoing picture of your SpO2 situation at night and your pulse rate. And be assured, if your SpO2 is plummeting and your pulse rate is rising, your blood pressure is skyrocketing and placing you in danger of a stroke. And if you have AFIB, you want to know about it immediately so that it can be treated. The first thing they should be doing is putting you on Warfarin blood thinner to reduce the stroke risk. Don't take these other and newer blood thinners as they have no antidote in case of an accident and bleeding.... simple massive doses of Vitamin K reverse the thinning effect of Warfarin but do nothing for these others and trust me, you want an antidote at hand should you get cut or injured internally with bleeding involved. Ask me how I know. Trust me, I know. In real life.

The few extra dollars for a Contec CMS50EW is well worth the investment. I have three CMS50E series pulse oximeters (I believe in spares). The last was the CMS50EW which came right from China, purchased online for about $125 delivered. Worth every penny and they are all well built and reasonably rugged.

We happen to have a BP meter, same as the hospitals use (I am very serious about my health) and untreated sleep apnea is associated with several other afflictions including AFIB, Diabetes, hypertension, etc. They are all inter-related and I consider, in my case, that OSA was the seed that was planted and from which all of the others blossomed. I am fortunate in that I am managing to beat down ALL of these afflictions. They are making a slow but steady retreat and I expect that they will all have been beaten down in about a year from now. There is plenty of good information online... your job is to find it, read it, digest it and make use of it along with your medical helpers. BUT, as I always say... you must be and have a front line advocate. Be your own advocate. Have an advocate should you find you cannot advocate for yourself as I did in 2009. It is important.

[quiescence at last]

Cheaper Contec model below do you think is is worth purchasing?

http://www.ebay.co.uk/itm/Finger-pulse-o...4182dcd796

This is a fine unit, as it has data capabilities and is compatible with sleepyhead.

I picked the wrist one CMD-50F+ because of the finger sock being a bit more comfortable. I use it all the time, so I was willing to spend the extra cash.

It has basically the same data capabilities, but has an onboard clock as well. This is a helpful feature for me.

Good luck with you xPAP'g pursuits.

QAL

[quiescence at last]

...snip...
(I suspect) as you approach REM sleep and your breathing becomes shallow, your SpO2 is dipping (diving?) and your body is being aroused by your autonomic nervous system. Bingo. No REM sleep. Or... little REM sleep.
...snip...

loss of this sleep is unnerving to say the least.

my use of the oximeter actually confirmed that my treated condition results in consistent spO2 reading in mid 90s when I suspect I am in REM sleep (and all other periods). One episode in the past 3 months got me below 90%. nice! YMMV - your mileage may vary

case in point, I have a friend that does get disturbed right out of REM sleep as soon as it begins. crap crap crappy sleep but great AHI scores. not fair!

QAL