[Symptoms] Persistent headaches, nothing seems to fix

[Crimson Nape]

Seeing that you are using the P30, check the diffusers on the exhaust ports for proper flow.  I've had and heard of others experiencing headaches due to oxygen desaturation by CO₂ buildup from the mask's exhaust membrane being occluded.

- Red

[TechieHippie]

Given how many other things you've tried, it might be worth investing in an oxygen monitor. My personal preference is the SleepU. Monitor at night and maybe during the day also, it's possible something at night is making the oxygen drop in the day though it seems unlikely.... But maybe your respiratory muscles tire and then get lazy in the day.

I assume liquid intake is the same? You aren't drinking less to not have to get up in the night?

Jaw, head and neck tension as well as teeth clenching are worth thinking about thigh you've probably already thought of that.

Hope you find it soon.

[haikuclue]

Thanks so much, I will actually try this... in a weird way, though quite a bummer, it has been good for me to realize that sans machine I am not actually getting better sleep, just not having headaches. 

I will resume using myself as the test subject and up my pressure again. 

One of the things I am hoping to get clarity on is the oxygen/CO2 conundrum, which I have a hard time grasping. What I have uploaded in my screenshots are examples of rampant (what could be read as, but not sure) hypopneas, almost like a see saw of deep breaths to shallow in long periods of waves. 

My intuition though is that it is not oxygen and CO2 per se... that would make sense intuitively for me to have a headache while waking... but all day headaches... it seems like my sinuses just suddenly decided in the last year that they really dislike the pressure at all. 

anyways, I will keep this thread active with what i find out, thank you so much for your input!!!!!

[haikuclue]

I might get an oxygen monitor for sure. I have an apple watch (which I naively bought for this purpose) but have figured out that it only measures when I'm in a perfect position, so it's not telling the whole story (i'm guessing)

liquid intake is healthy. i will say that mouth taping discourages me from drinking as much water as I used to, but since the headaches started before mouth taping and since the water intake doesn't "fix" things during the day, I don't think that's it. 

I have, yet another thing I forgot to add to my list of things: mouth guard, check. Have used and not used. Doesn't seem to be the cause.

Cheers and thank you so much I really appreciate you taking the time!

---

Seeing that you are using the P30, check the diffusers on the exhaust ports for proper flow.  I've had and heard of others experiencing headaches due to oxygen desaturation by CO₂ buildup from the mask's exhaust membrane being occluded.

- Red

Red thank you I hadn't heard about that. I will check. Not to be annoying, just to be useful for future headache havers, I will say that I actually got a new frame during this whole saga,  so I doubt that is the issue BUT I will check it out for sure.

---

As of now I am going to try the pressure increase.

While I hate to add two variables at the same time, I also will be moving to my full face mask N20i... my intuition tells me it is directly pressure based, and if there is any way to allow my sinuses a break then I have to try that.

Will keep posting here, thanks to everyone for your thoughtful replies

[Crimson Nape]

I should have pointed out that the diffuser mesh is so fine, any moisture will stop it up. Having a humidifier set high enough can cause this condition.

- Red

[haikuclue]

Checking in to keep this thread alive. Unfortunately today I am back in headache hell.

I upped my pressure slightly (up to 10) and lowered my humidity (down to 2).

It's so weird the pattern:

One night with full face mask (n20i): fine
Next night with full face mask: so much leaking that almost no sleep. Not a headache night, but unbearably uncomfortable, not reasonable etc

So, switch masks, back to my usual p30

One night with nasal pillows: fine, surprising, exciting even
Next night with nasal pillows: woke up with a headache forming already at 1:30am (2.5 hours into sleep)... took mask off finally at 3am. now 12 hours after that I still have a dull headache that is very noticeable on both sides of my head and behind my eyes. I feel awful, not great that Valentine's day is kind of ruined.

The feeling is in my body too. If you were to tell me that it was because of not enough oxygen or too much CO2 I would believe that. Intuitively that feels true-ish... it feels, not to be melodramatic, but like a poison almost.

I don't know y'all. I have a doctor's appointment next week, but I kind of know that at best they'll basically tell me to keep titrating, or suggest a sleep study, which, I honestly don't see how two+ years later would really help.

I feel stuck between a rock (CPAP) and hard place (Sleep Apnea). It makes night time not that fun.

Anyways. Thanks for all the suggestions

@red: does anyone know what oxygen desaturation might look like in OSCAR? I'm attaching a couple images of last night's unmarked "events", and I'm wondering if it seems "obvious" that I'm getting not enough oxygen in them?

   
   

[TechieHippie]

I'm sorry, headaches really have a big impact on quality of life.

I don't think you can tell what's going on with your oxygen without an actual monitor. I think the Sleep U runs about $160, likely cheaper than another sleep test, repeatable,  it will likely last for years and is helpful to lend to family and friends.

It really feels to me like this is not a one-to-one correlation with the machine, but instead something the machine is changing that interacts with other health issues or your environment.  Here's another long shot (but that's where you are I guess) to consider. I had headaches and migraines infrequently for years. Then at one point after eating out, I had an ocular migraine, and after that it never seem to go fully away for long. My headaches got very frequent. I discovered I was extremely sensitive to glutamate, not just MSG but other free glutamic acid: yeast extract, carrageenan, hydrolyzed protein, protein isolate, malt extract, and others. But unfortunately the headache usually comes the next day so it's hard to pin it down. Sometimes in the middle of the night, and with a big exposure a few hours later. Luckily I haven't had one for a year or two.

There are lots of associations between glutamate imbalance and OSA. Here's a very old thread that talks about it.  It could be plausible that using the CPAP changes the GABA/ glutamate balance in your brain and interacts with food in your diet. 

The interesting thing is that I and most people only react to free and highly processed glutamic acid. One researcher found that bombarding proteins with heat or acid produced stereoisomers of l--glutamate in a way that regular cooking did not and speculated that that was why, but who knows. I know it's all a little controversial. I just know what works for me. (Live yeast in breads is fine, yeast used as a flavor additive is not, for example.) It took me ages to figure it out but It's been extremely predictable since then. Let me know if you want more info about a low glutamate diet. Unfortunately, it's quite restrictive until you figure out what foods you can substitute. But even a one to two week trial off the major suspects would let you know if it's worth considering further.

(Now that I think about it, I had carrageenan once since starting CPAP therapy and I didn't get a headache which very much surprised me. A friend brought me a soy milk latte and I drink about a third of it before I thought to check the ingredients.... If using pap therapy allowed me to eat a wider diet again, that would be pretty big for me. I'll have to experiment once I've been on it longer.) 

Do you ever take ibuprofen? I know you said it did nothing for the headache and I wouldn't expect it to with a glutamate headache after it started. But you might try taking 2-3 ibuprofen the night before and seeing if you see any impact. Ibuprofen is actually a pretty powerful glutamate blocker for small amounts or for those who are less sensitive but it tends to work better before or with the offending food,  and not very much taken after. For me, once the headache starts the pattern is already set and nothing OTC will fix it. 

I really hope you solve this mystery!

[Yujiyun]

Have you found a solution? I have the same symptoms. At some point, when I use cpap, I have severe brain fog and headaches all day long. It usually lasts about 12 hours. I'm expecting a co2 problem, but I can't understand all of this

[SarcasticDave94]

An interesting bit of info, not sure if this makes any difference, OP haikuclue makes mention of the mask N20i and saying full face. This isn't full face but nasal as signified by this N in the model name. It probably means nothing, but could this mistake mean OP is setting this as full mask on the CPAP? Again it probably means nothing to the issue.

As for headaches after CPAP use, this sounds very much like my own, which are/were oxygen deprived as best as I could find out. Getting a compatible with OSCAR recording oximeter would give data to help find out about oxygen levels while asleep, whether or not you're using CPAP.

[TechieHippie]

This is a different situation, but perhaps worth mentioning. I'm helping a friend with CPAP. She has had very low oxygen at night and even during the day for a long time. I've seen her drop to low 80s sitting and high 70s moving.

We got her a used Vauto. We tested with the mask and she was jumping to 98 and PS 4 in Vauto mode seemed most comfortable. She started using it for naps but was getting headaches behind her temples. Decreasing pressure support to 2.8 and trigger medium and pressure lower helped. The doc agreed that it probably was oxygenating her too quickly.