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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
spareohs
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Headaches getting worse with BiPAP

Postby spareohs on Sat Apr 15, 2017 4:59 pm

Hello everyone. I just found this forum and wanted to ask a question since I've just recently been diagnosed with sleep apnea.

I've been waking up with morning headaches for as long as I can remember. I just started using a machine three nights ago and I've been waking up with headaches far worse than my typical headaches and they seem to be lasting all day as opposed to just a few hours in the morning.

I will admit the past three nights I've taken the mask off around 6am and gone back to sleep for 1-2 hours without it- not sure if that's causing the more severe headaches or if anyone else experienced worsening symptoms after starting treatment. It also seems really weird to me that during my sleep study my AHI was only 9 and since starting with the machine it has reported 84.4, 70.3, and 68.8 events per hour which seems way too high and inaccurate. As far as I can tell I'm getting a good seal on my mask but I've been constantly waking up throughout the night which is why I've ended up taking it off every morning and sneaking in a couple extra hours without it.

My machine is a ResMed AirCurve 10, mask is ResMed Quattro FX, and my pressures are 4-16 cm.

If anyone has any insight or advice it would be greatly appreciated! Thank you :)

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Re: Headaches getting worse with BiPAP

Postby prodigyplace on Sat Apr 15, 2017 5:45 pm

You mention frequent headaches. Have you been examined by a neurologist? The headaches may be unrelated to any sleep issue.
I know because my wife has been suffering from chronic migraines fir years, apparently triggered by a severe infection a number of years ago, causing nerve damage in the brain.

Be sure to get a thorough medical exam rather than guess at issues.

Have you looked at Sleepyhead software? Without data, it is very difficult to provide any helpful advice.

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Re: Headaches getting worse with BiPAP

Postby ajack on Sat Apr 15, 2017 5:45 pm

Having a desat in o2 for 2 hours before you wake/get up could be the reason? Did you have a headache when you took the mask off?

As to the events, if you download the sleepyhead program, it shows everything breath by breath. The guys who know, will help you go over your results, It sounds like something is wrong.

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Re: Headaches getting worse with BiPAP

Postby Guest on Sat Apr 15, 2017 5:53 pm

All excellent ideas... seeing a doc and using Sleepyhead - FREE software to check your events.
spareohs wrote: It also seems really weird to me that during my sleep study my AHI was only 9 and since starting with the machine it has reported 84.4, 70.3, and 68.8 events per hour which seems way too high and inaccurate.
This concerns me and could be the reason for feeling worse - I am sure it would make me feel worse for sure.

DL Sleepyhead today and check what data is already on your cpap - hopefully it is a fully data capable cpap.

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Re: Headaches getting worse with BiPAP

Postby spareohs on Sat Apr 15, 2017 6:37 pm

Thanks for the software suggestion... just downloaded it and now trying to make sense of all this. It seems like the majority of the events are clear airway apneas?
As for the headaches I've mentioned them to the dr. when discussing how tired I feel after waking up but was never referred to a neurologist. When I found out I had sleep apnea I just assumed the two were related but probably worth getting it checked out on its own.

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Re: Headaches getting worse with BiPAP

Postby spareohs on Sat Apr 15, 2017 6:48 pm

ajack wrote:Having a desat in o2 for 2 hours before you wake/get up could be the reason? Did you have a headache when you took the mask off?

As to the events, if you download the sleepyhead program, it shows everything breath by breath. The guys who know, will help you go over your results, It sounds like something is wrong.

I can't remember if I had a headache when I took the mask off but I will make sure to pay attention tomorrow morning and I am determined to NOT let myself fall back asleep without the mask!

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Re: Headaches getting worse with BiPAP

Postby Guest on Sat Apr 15, 2017 6:58 pm

spareohs wrote:As for the headaches I've mentioned them to the dr. when discussing how tired I feel after waking up but was never referred to a neurologist. When I found out I had sleep apnea I just assumed the two were related but probably worth getting it checked out on its own.

They very well could be related. Did your sleep study reveal any centrals? What are your current pressure settings and at what pressure are you seeing the CA's?

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Re: Headaches getting worse with BiPAP

Postby TheDuke on Sat Apr 15, 2017 9:26 pm

My own experience is the reverse of your problem. Before diagnosis and CPAP/BIPAP use I woke with headaces every morning. Since Beginning treatment (Now 29 years ago) I absolutely never experience headaches.
TheDuke

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Re: Headaches getting worse with BiPAP

Postby Pugsy on Sun Apr 16, 2017 12:24 am

What are your pressure settings?

Can you post an image of a daily detailed report from SleepyHead?

How to post images
https://sleep.tnet.com/reference/tips/imgur

Thread with some examples of what we like to see....don't need all those graphs that you see.
viewtopic/t103468/Need-help-with-screen-shots.html

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Re: Headaches getting worse with BiPAP

Postby spareohs on Sun Apr 16, 2017 5:26 pm

Guest wrote:They very well could be related. Did your sleep study reveal any centrals? What are your current pressure settings and at what pressure are you seeing the CA's?

I'm not sure how to tell; the only things I see on the SleepyHead results are clear airway, obstructive, unclassified, and hypopnea. Almost all of mine are showing as "clear airway."

edit: never mind I see now you're asking about the actual sleep study. Yes looking now it says there were some central apneas noted while at 16 cm of water pressure. Also looking back it seems my AHI was 9 during the first sleep study and increased to 16 during the second sleep study with the CPAP. This is all so confusing to me!

Pugsy wrote:What are your pressure settings?

Can you post an image of a daily detailed report from SleepyHead?

How to post images
https://sleep.tnet.com/reference/tips/imgur

Thread with some examples of what we like to see....don't need all those graphs that you see.
viewtopic/t103468/Need-help-with-screen-shots.html

Pressure settings are 4-16 cm. I avoided falling back to sleep without the mask this morning but currently have a headache similar to yesterday (though not quite as intense). I'm tempted to go a night without using the machine at all and compare how I feel. These are my results from last night but I can't make much sense of it.

Image

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Re: Headaches getting worse with BiPAP

Postby palerider on Sun Apr 16, 2017 6:34 pm

spareohs wrote:Pressure settings are 4-16 cm.

that's very likely your problem, you've got a machine that's set for 16/4, and it's hyperventilating the hell out of you, all night long, a pressure setting of 4-16 is a pressure range for a single pressure machine, not a machine that's set for 16cm inhale and 4 exhale, in other words, your machine is almost certainly set very very wrong.

either change the pressure settings to ipap 8, epap 6, (for a starting point) or don't use it. till someone can fix it for you.

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Re: Headaches getting worse with BiPAP

Postby Pugsy on Sun Apr 16, 2017 6:45 pm

How did they come up with 4 cm EPAP and 16 cm IPAP? Who came up with these settings? Were these the result of the titration sleep study where you used the mask and machine?

Clear Airway (Respironics term) and Centrals (ResMed term) for open airway cessation of breathing. SleepyHead was originally written for Respironics machines and ResMed compatibility came later but Clear Airway stuck for the centrals.

While a few centrals aren't normally a problem you are having way more than a few of them.
Get with your doctor and get the pressure changed (unless you are comfortable changing it yourself) immediately.

I agree with Palerider...your big difference between inhale and exhale is causing unstable breathing and very likely responsible for the central apneas you are seeing.
A difference of 12 cm between inhale and exhale is highly a highly unusual setting unless you have some sort of serious lung disease (like COPD) and normally the difference is between 4 to 6 cm for most health individuals.

I am not surprised you are having worse headaches...your oxygen levels are probably in the toilet.

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Re: Headaches getting worse with BiPAP

Postby spareohs on Sun Apr 16, 2017 7:26 pm

Okay I am definitely going to hold off on using the machine again until I can see my doctor.

The treatment recommendation from my sleep study says: "Home Automatic bilevel therapy set from 4 to 16 cm of water pressure with a pressure support of 4 cm while utilizing (mask brand etc) is recommended."

I was surprised when I started reading online that BiPAP seems to be used for people with COPD like you said or people who can't tolerate CPAP. I'm 28 years old, 125 lbs, and don't have any other pertinent health conditions. But this machine does feel much different than the one from the sleep study- I guess maybe that was a CPAP since I felt constant air pressure and maybe they thought I didn't take to it well?

The technician who gave me my machine last week actually told me that the machine he gave me is not the one I'm supposed to have but he wanted me to get started until they got the correct one in stock. I wonder if getting the correct machine will help or if it will still be a problem with the 4-16 cm settings.

Either way I'm relieved to know that maybe I'm not crazy and also looking forward to a (hopefully) better night's sleep tonight on my own! I've really been feeling awful these past few days. Thank you both for looking over the stats and for the helpful suggestions, I really appreciate it.

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Re: Headaches getting worse with BiPAP

Postby Pugsy on Sun Apr 16, 2017 7:47 pm

spareohs wrote:Home Automatic bilevel therapy set from 4 to 16 cm of water pressure with a pressure support of 4 cm


The RX is for auto adjusting bilevel pressure...you got a fixed pressure bilevel machine.
Not only did the supplier not supply you with what was ordered they totally screwed up the pressure settings.

The 4 to 16 range isn't supposed to be 4 EPAP and 16 IPAP with PS of 12.
It's supposed to be a range that auto adjusts as needed but with Pressure support (difference between inhale and exhale) of 4 cm.
So if using 4 EPAP then PS would be 4 and IPAP would be 8.....if the machine wanted to go to say 7 EPAP then IPAP would be 11...and the most IPAP would be would be 16 and that would mean EPAP of 12.

Either change the pressure to say....6 or 7 EPAP and IPAP of 10 or 11....which would give you PS of 4...or wait but
I would call the doctor and alert him/her to what this supplier has done. Totally screwed up and set the machine at potentially dangerous settings. They need a good ass chewing.

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Re: Headaches getting worse with BiPAP

Postby spareohs on Sun Apr 16, 2017 8:21 pm

Pugsy wrote:
spareohs wrote:Home Automatic bilevel therapy set from 4 to 16 cm of water pressure with a pressure support of 4 cm


The RX is for auto adjusting bilevel pressure...you got a fixed pressure bilevel machine.
Not only did the supplier not supply you with what was ordered they totally screwed up the pressure settings.

The 4 to 16 range isn't supposed to be 4 EPAP and 16 IPAP with PS of 12.
It's supposed to be a range that auto adjusts as needed but with Pressure support (difference between inhale and exhale) of 4 cm.
So if using 4 EPAP then PS would be 4 and IPAP would be 8.....if the machine wanted to go to say 7 EPAP then IPAP would be 11...and the most IPAP would be would be 16 and that would mean EPAP of 12.

Either change the pressure to say....6 or 7 EPAP and IPAP of 10 or 11....which would give you PS of 4...or wait but
I would call the doctor and alert him/her to what this supplier has done. Totally screwed up and set the machine at potentially dangerous settings. They need a good ass chewing.

Thank you so much for the explanation this is finally starting to make sense to me now. I'm very relieved that the settings are the problem; it makes me feel much more optimistic about getting started with the correct machine, but I am kind of angry I had to go through this for no reason! I did wonder why he was giving me a "temporary" machine but never imagined it could be so detrimental.

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