Dizziness and low pulse ox since Covid when using CPAP

[JenB]

I have a Resmed set on 12 and I have been using CPAP for about 15 years with no issues until recently. I had a breakthrough case of delta in late August, and ever since then I feel dizzy whenever I use my CPAP. I thought it might be vertigo, which is an inner ear problem, but I was also concerned about possible heart damage. So I went to a cardiologist who said my ekg was good and he doubts there is any heart damage, and he was not concerned about my dizziness using CPAP. He said it takes 6 months for covid patients to fully recover and I should just be patient. I made an appointment with an ENT who does Inspire to see if I am a candidate for that, in case I need it. That appointment is next week.

Recently, I got a pulse oximeter and performed a test. Sitting up and awake with the pulse oximeter on my finger, my pulse ox is in the high 90s (97,98,99). If I put on my CPAP and turn it on, my pulse ox drops rapidly into the high 80s (87,88,89), while still sitting up and awake, and I get very dizzy.

Has anyone else had this problem and, if so, was it temporary? How long did it last? I feel like I’m deteriorating and it takes longer and longer to get going in the mornings. I have to sit for several hours upon waking and breathe without the CPAP before I feel like I can get up and move around.

[Miss Emerita]

Please see your primary care physician, taking your CPAP machine and with you so you can show him/her what happens to your O2 levels when you're using the machine.

Also, do you have any night-time readings from your oximeter?

[palerider]

If I put on my CPAP and turn it on, my pulse ox drops rapidly into the high 80s (87,88,89), while still sitting up and awake, and I get very dizzy.

Has anyone else had this problem and, if so, was it temporary? How long did it last? I feel like I’m deteriorating and it takes longer and longer to get going in the mornings. I have to sit for several hours upon waking and breathe without the CPAP before I feel like I can get up and move around.

The standard response by a RT in the ER when your oxygenation is low is to increase your EPAP,or resting pressure when giving a patient a bilevel breathing treatment.

You don't mention what your settings are, or what kind of machine you have, so... ?

[zonker]

I have a Resmed set on 12....

welcome to the zoo!

could you please let us know which resmed machine?

i'm sorry if you filled this out when you joined the forum, but there is a bug in the system and it no longer displays for anyone.

here is a list-

https://www.resmed.com/en-us/healthcare ... t/devices/

good luck!

[KrisCrossed]

Post-COVID symptoms can include lingering inflammation in the lungs. Is it plausible that the small airways might be narrowed by inflammation and exhaling CO2 is less successful against the CPAP pressure? (Similar to having a more severe case of asthma and trying to use CPAP when BiPAP is needed). If you can get in to see your doctor, as Miss Emerita posted, there could be some effective supportive treatments available--without waiting 6 months for it to resolve.

[JenB]

I think it is an S9.

[chunkyfrog]

S9---WHAT?
Autoset, Elite, or (horrors) Escape?

[JenB]

It’s an elite.

I also have my late husband’s dreamstation. It says DreamStnAutoCPAPHumHTcell. I think he used it in an auto mode.

Can either of these be programmed to operate like a bipap or decrease the pressure on exhale?

[Pugsy]

Can either of these be programmed to operate like a bipap or decrease the pressure on exhale?

They both can be programmed to operate like a bilevel with a drop during exhale by utilizing the exhale relief features.
On the ResMed the exhale relief feature is called EPR and you can set it so there is either a 1, 2 or 3 cm drop during exhale.
The Respironics exhale relief is called AFlex and it won't quite give you a 3 cm drop at the setting of 3 because the actual drop is based on your own forceful breathing.

Please note that EPR can only drop to the minimum machine setting of 4 cm...so if your pressure setting is say 6 cm..the setting of 3 can only drop to 4.
If your setting is 7 cm or higher your can get the full 3 cm drop during exhale with the setting of 3 for EPR.

You may have to go to the clinical setup menu area of the machine to turn on EPR and set it.

ResMed's EPR for exhale relief is superior to Respironics AFlex IMHO. It's more dramatic and you have more control over it instead of relying on how forceful you breathe.

[JenB]

Thanks. I’ll try to set my resmed as suggested.

The ENT told me I’m not a candidate for inspire because my bmi is above 35. He thinks I may need a bipap as suggested above. He prescribed an inhaler and a sinus regimen and referred me to a pulmonologist who does CPAP. Any other surgical options will depend on the results of my sleep study and sinus regimen.

[JenB]

I was able to set my resmed as suggested. I think it is helping my pulse ox as I’m not dizzy once the rhythm gets going, but I’m waking up sometimes struggling to take a breath.

I still don’t have the inhaler. Insurance wouldn’t cover the one called in and the doctor’s office made me call the insurance company and find out what was covered. Finally got a new one called in today but the pharmacy has to order it.

The pulmonologist can’t see me until mid January. They didn’t call me yet so I got the info and called them before the holiday delays things even more.