Using Cpap during a Vertigo attack

[Dori]

I've been using cpap for about 4 years. I experienced for the first time, a spinning episode of vertigo a little over 2 weeks ago while sleeping. I went to ER, had CT scan, EKG. Scan showed mucosal thickening of bilateral sphenoid sinuses and ethmoid air cells and mucous retention cysts in both maxillary sinuses. I've continued to use my machine every night since, but I'm still having residual dizziness and balance issues and yesterday I had another spinning episode, it was brief but was so off balance I had to have help to walk to bathroom and bed and still need help today. Should I continue to use my cpap, or could the air blowing through be worsening the problem? Also, if anyone has suffered from vertigo or bppv, do you have any suggestions as how to cope, or what steps to take next? This is so scary and debilitating.

[Julie]

You should be referred to a neurologist, pref. one with some sleep disorders experience... we're not doctors and I think it would be irresponsible to guess at things here, even if someone's had a similar experience.

[Dori]

Thank you for your reply. I've tried to schedule an appointment with a neurologist and also an ENT, but in my area, due to covid, there is a 4 month waiting list to get in. I was hoping for some suggestions and information in the meantime while I'm waiting. I apologize if I've come to the wrong group for help. I've seen many helpful answers to questions here.

[Julie]

No, no, not wrong, just maybe not quite up on some things, but some have also been in similar situations and I'm sure they'll share when they see your note... I just wanted to be careful for you... and the ENT is a good idea.

[Pugsy]

I have had BPPV pretty much all my life. OSA and cpap the last 11 years.
Sometimes are worse than others but using cpap really hasn't seemed to make it better or worse.
It all depends on what is causing the vertigo.
If it's just BPPV...then cpap is unlikely to impact things but if it is something else then of course a maybe.
Let your body make your decision. If the vertigo is worse with cpap use then stop it for a while.
For me it never made the vertigo worse or better. Time was my only healer.

[Dori]

Thank you, Pugsy. Cpap hasnt seemed to make it worse. I felt not quite as off balance when I got up this morning so maybe that means it's not affecting it in an adverse way. I'm sorry you have this too. It's a nightmare for the short time I've had it, and I cant even imagine suffering with it for years. I admire your courage. I'm trying to navigate it and figure out how to try an get things done, such as showering, simple meals, dishes, etc. Its overwhelming, especially after 2 weeks I thought I was getting better, and then another attack, so I feel I'm back to square one. But I'll keep using my cpap unless I start to feel worse in the mornings...thanks Pugsy.

[Pugsy]

While I have had the vertigo off an on all these years it is mostly "off" as opposed to on but when it is "on" it's really bad and I totally understand it.
The first time it hit me I was 15 and rolled over in bed and threw up...and I was in bed for 2 weeks.
The last time I had it was early this past summer and it hit me as I was just laying down in bed. I thought maybe I could sleep it off but I wasn't that lucky and it took me over an hour to snake/crawl out of bed to get to the living room where my phone was to call for help.
I couldn't hold my head an inch off the floor without the room spinning 100 mph. I was in bad shape for 2 days that time.

Just be careful. It takes time for those rocks to quit moving around and get back into place and sometimes all it takes is just laying down in bed to move them out of place and all hell breaks loose.

Move slowly and deliberately and if you get dizzy....sit down and rest a bit. Don't try to drive because you never know when you will have to move your head quickly.

[Dori]

Pugsy, I've been reading about the rocks getting out of place in the ears and I think that's the type of vertigo I have, bppv, because when it first hit, I rolled onto my left side in bed, and everything started spinning. But it seems it's my right side that's affected because I cant lie on that side without becoming dizzy. I can lie on my left side with no problem. I cant look down or up. I will take it slow and easy and hopefully those rocks will fall back into place on their own. I've been reading about maneuvers to help that happen, but read that unless you know which canals the rocks are out of, you can do more harm, so I've not tried any of those. Thank you Pugsy, I appreciate your help more than I can say.

[Pugsy]

The maneuvers to put the crystals/rocks back in place are tricky and you do have to know which side seems to be the problem and it isn't always easy to know....plus it isn't so easy to do the maneuvers yourself anyway. I have never been able to master it myself despite reading a lot about them. The other thing was I just didn't have the guts to try it on my own just in case I really screwed myself up. It involves sudden movement and when I am in the middle of one of these attacks...sudden movement is the last thing I want to do.
I just haven't had the guts to to try it.

I get the severe BPPV thing...maybe once every couple of years. Usually lasts 3 to 7 days for me with gradual improvement each day.
The first couple of days are always the worst though.
Now in between the severe attacks I might get short intermittent bouts of the vertigo but they are very brief. Like when I bend over and raise up suddenly. They pass quickly.

If you still have a lot of dizziness tomorrow call your primary care doctor. There are some meds that might help shorten the time frame and make you more comfortable while it is passing. This last one early this summer I had some residual dizziness for about 6 weeks that was annoying and my doc gave me some prednisone (one of those decreasing burst packets) and I think it helped a bit.

[Dori]

Pugsy, same here about those maneuvers, the last thing I want to do is make myself dizzier on purpose and afraid of the same thing as you said, messing myself up worse. I dont have the guts to try it either. My episode was spinning for a day, then really bad off balance and dizzy with head movements for these past 2 weeks. I was ok while sitting or lying down on my left side an looking straight ahead. Then yesterday, I was trying to order something on my phone, didnt think I turned my head but I was stressing and concentrating hard and everything started to spin again. I will take your suggestion and call my PCP tomorrow and see if she will call me in some meds. The only med the ER gave me was meclizine. I took one when I got home that night but I had weird vivid dreams that night and haven't taken any more. The prednisone sounds like a much better choice. I feel so much better after talking to you. Like I just might make it through this! I hope your last episode this summer was your last and that neither of us has to struggle with it any more than we have.

[Miss Emerita]

Dori, if you're sure you have benign paroxysmal positional vertigo (BPPV), you can get those otoliths back where they belong via the Epley Maneuver. Google it; you can do it at home, though from experience I would say it helps a LOT to have someone with you to coach you from a printed set of directions that you've gone over together. But your primary care doctor can also do it, if that would work better for you.

Fair warning: the Epley can induce vertigo in the first and last positions, and you may need to do it several times to get the ongoing vertigo licked.

Residual dizziness is common and can be pretty severe. I can remember clutching the walls to get around the house. It general subsides on its own within a couple of weeks.

There's another after-effect, I found out. Your balance systems can stop working seamlessly together, leaving you feeling off balance, briefly confused when you turn your head, etc. This is different from residual dizziness, which is an ear thing. For the balance-system coordination, there is specialized physical therapy that I found incredibly helpful. I was skeptical that it could make a difference, but it really did. Worth checking out, though I know it's hard in the COVID times.

Good luck with it -- I really feel for you.

[Movieman]

I am a new CPAP user (started two weeks ago) and I have also suffered with BPPV on and off for about six years. The Epley maneuver always seems to work on the vertigo followed with physical therapy for my residual balance issues. I also cannot seem to successfully do the maneuver myself. I always need to go to physical therapy for it to work!

It’s been about six months since my last vertigo attack and I too was wondering if CPAP usage could make it worse. I’m glad to read that CPAP treatment doesn’t seem to worsen BPPV.

Good luck Dori; hopefully you just have the BPPV. It’s a miserable thing, but it can be treated.

[Dori]

Thanks Movieman and Miss Emerita. Both of your posts have been helpful. Both mention physical therapy as a means to help the balance issues, which is a big problem for me. Residual dizziness as well. My PCP recommends I only do telephone visits due to covid, being I'm over 60 and have several preexisting health conditions. But I'm going to have to go if this doesn't get better soon. Theres a 4 month waiting list now to get in and I'll know more by then.

[JLROhio]

I don't know if this is helpful but just wanted to share an experience I had with helping someone with Vertigo.

After accompanying a friend to the hospital and watching a doc help gets the "rocks back in place"...the same friend called me a year later when it occurred again. (BTW, both times, the episodes started when they were in the shower).

We did some research online and watched a few YouTube videos from neurologists and physical therapists explaining the whole "rocks" thing as well as some animations which helped really explain things. Then they also covered how they go about tossing, turning, etc to figure out how to find out what side the rocks are not in the right place. They then went through 3-4 different maneuvers one could do (most you'll need an assistant) to help get the rocks back in place.

Once we did a few maneuvers, my friend felt fine again and the dizzyness went away.

My friend says that they do the exercise/maneuvers every now and then just to keep the rocks in the right place and that they have not had any episodes since.

Bottom line - there are some great explanation videos on YouTube that some might find educational and possibly a relief to their Vertigo - and if nothing else, to really understand what's going on so that they can work with their doctor collectively on a treatment plan.

[Slartybartfast]

You've been given some good advice: Run this all by your doc. However, for some perspective, I had several bouts of vertigo a few years ago. Bouts seemed to correspond to movements of my head. The worst one I had was when I lay down in bed. Suddenly the room began spinning, and though I knew, intellectually, what was happening, my inner ear was telling me the bed was going to dump me on the floor. Scary as heck! I held on with my fingers digging into the sheets until it subsided. I was very unsteady on my feet the next day. My wife is an RN and said it will likely pass, so I got back to my routine.

Thereafter, I had fewer, and less severe bouts, usually when I was making large movements of my head, such as in the shower, while washing my hair, or suddenly looking straight up at a hawk or an eagle flying overhead. But, while I now grab something solid when I look straight up, the sensation is not so bad that I might fall down. I expect it's hereditary to some extent. My father complained of vertigo in his later years. I guess he got it from me.

I mentioned it to my GP at my last appointment, and he said it's common, sometimes caused by a transient low-grade infection in the sinuses, and as long as it doesn't last long, expect that it will go away. As a precaution, I no longer work on ladders without being very cautious. I've had no serious bouts in the last year or so, just mild dizziness from time to time, almost always when I suddenly turn my head. A couple very minor ones while I have been driving, which dissipated by the time I got to the side of the road.

So what my GP told me was correct (for me). However I know people for whom vertigo is a chronic problem. So your mileage may vary, as they say.

I don't think my CPAP use had anything to do with the events.