Morning Dizziness

[victormiller]

For the past 6 days when I've woken up in the morning I've been dizzy -- not falling over dizzy, but dizzy nonetheless. It usually lasts for about 4 hours after I get up. I've been using my new oral device instead of PAP (except for the night before last) for about 4 weeks. A home sleep test with the Medibyte Jr last week showed that I have an AHI of 2.3 using it, with no central apneas. I find that I feel that I've been sleeping more deeply with it, and haven't awoken in the middle of the night. Yet I still feel pretty tired in the morning (but that's status quo -- it's always been that way whether I use PAP or not). The night before last I decided to use my auto Bipap along with the oral device. I woke up after 3 1/2 hours, and removed the mask, and went back to sleep. When I looked at the numbers in the morning I found that I had an AHI of 13.2 of which 10.0 was central apnea, and 2.5 was Hypopnea. When I've been on my auto bipap since last November, by OA has always been less than 1, but starting in March the CA and H started creeping up to levels like the above. My (old) sleep doc tried raising the minimum pressure, but that only made things worse. Unfortunately I've come to the conclusion that PAP actually causes central apneas for me, which is not good.

In any case, has anyone experienced this morning dizziness? What did you do about it?

[Mary Z]

I have never experienced the morning dizziness you describe. It seems to last a long time. I normally would attribute such a thing to do with your ears or sinuses.
I wasn't sure from your post if you're using the dental device or the CPAP, or both. The data from the CPAP would not be reliable if it was not for a full night.
Since the dizziness could have many causes, some serious I would go in for a complete physical if it continues. Also I would use one mode of treatment consistently- the machine, the dental device, or both- but the same thing every night. Good luck, keep us posted.

Here is a post from BlackSpinner in regard to a sinus question (I hope this is ok, BlackSpinner)- it may apply to you.

There is more pressure on the sinuses with cpap. Some people get dizzy from the ear canals being impacted. You may want to see an ENT and get some scans(MRI) done to see what is happening in there. Sometimes going on cpap will illuminate other issues in your respiratory system. I have found a lot of my sinus issues have decreased dramatically over the last 2 years. That might be due to breathing clean filtered humid air for a 1/3 of 24 hours.

[Lizistired]

I have dizziness and double/blurred vision fter I have fallen asleep without my machine, on the couch or in the recliner. It's called oxygen deprivation.
If you are going to continue to experiment, I suggest you buy a recording oximeter and use the alarm feature for desats.

[victormiller]

I have dizziness and double/blurred vision fter I have fallen asleep without my machine, on the couch or in the recliner. It's called oxygen deprivation.
If you are going to continue to experiment, I suggest you buy a recording oximeter and use the alarm feature for desats.

I did use an oximeter last night. The readings were typical (which is as good or better than those when I'm using PAP):

[Lizistired]

That's good. If I had that much variation in my O2 levels, I would assume I was waking up alot. Maybe you didn't sleep as well as you thought. Or as posted above, you need to get checked out by your Dr in case it is something totally unrelated.
As for centrals, I didn't have any in my sleep study, but I do have a few on APAP. As long as there aren't many and are 10-13 seconds, I don't worry much about them.

[victormiller]

That's good. If I had that much variation in my O2 levels, I would assume I was waking up alot. Maybe you didn't sleep as well as you thought.

Really! Readings like that are as good or better than any that I've *ever* had (whether on PAP or not). Perhaps that's related to the fact that during my last sleep study, which was a titration study, (in the hospital) I had 78 arousals only 19 of which were breathing related.

Or as posted above, you need to get checked out by your Dr in case it is something totally unrelated.
As for centrals, I didn't have any in my sleep study, but I do have a few on APAP. As long as there aren't many and are 10-13 seconds, I don't worry much about them.

I hardly had any centrals in my titration study either, but now almost all the apneas that I'm having (when I'm using PAP) are centrals.

[Lizistired]

How many centrals are you having over the course of a night?
I had 300+ spontaneous arousals during my initial study. No wonder I was brain dead.
I sleep better and don't wake up not being able to get back to sleep with the machine.
I notice that there are many times throughout the day that I "don't breathe", to me this = centrals.
I feel like if they are of short duration and don't cause desats, I don't need to worry about them.
Maybe I'm dreaming and hold my breath during a dream.
I know hold my breath when I turn over or adjust my mask or hose...
When I have centrals but no OA's, I reduce my pressure because the machine is obviously doing it's job.
Right now I have an AHI of 0.2 and it is usually 50% OA & 50% CA's.

I would love to sleep without the machine.
This afternoon, I wanted a nap, I had my mask drying from cleaning the pillows this AM. So, I put on the finger pulse oximeter with the alarm at 87%. Recliner: alarm every time I started to doze. Loveseat, same thing.
I finally went and laid across the bed ON MY STOMACH, and the alarm never went off. Had a good hour nap.

I've been trying to get used to sleeping on my stomach with the mask. That's the way I used to sleep best, before apap.
So tonight I'm setting the alarm to 90% and try it again... with the mask.

[victormiller]

How many centrals are you having over the course of a night?
I had 300+ spontaneous arousals during my initial study. No wonder I was brain dead.
I sleep better and don't wake up not being able to get back to sleep with the machine.
I notice that there are many times throughout the day that I "don't breathe", to me this = centrals.
I feel like if they are of short duration and don't cause desats, I don't need to worry about them.
Maybe I'm dreaming and hold my breath during a dream.
I know hold my breath when I turn over or adjust my mask or hose...
When I have centrals but no OA's, I reduce my pressure because the machine is obviously doing it's job.
Right now I have an AHI of 0.2 and it is usually 50% OA & 50% CA's.

I would love to sleep without the machine.
This afternoon, I wanted a nap, I had my mask drying from cleaning the pillows this AM. So, I put on the finger pulse oximeter with the alarm at 87%. Recliner: alarm every time I started to doze. Loveseat, same thing.
I finally went and laid across the bed ON MY STOMACH, and the alarm never went off. Had a good hour nap.

I've been trying to get used to sleeping on my stomach with the mask. That's the way I used to sleep best, before apap.
So tonight I'm setting the alarm to 90% and try it again... with the mask.

Lately I've been getting 10-15 centrals per hour. The last in hospital study that I had was a titration study, so I was on PAP throughout the study. Nevertheless I still had 79 arousals (only 19 of which were breathing related). My previous 5 sleep studies were uniformly awful. I hardly slept at all.
Unlike you, I don't sleep better with the machine -- if anything I sleep worse. The machine does a good job at banishing my snoring and OA's (my OA level with the machine is rarely above 2). An AHI of 0.2 is an unattainable goal for me. The best AHI I've been able to get is about 2.5. Up until May, my AHI was averaging about 4. Suddenly things seemed to change. Since then I've gotten a replacement mask (a Swift LT) which is the same as the old mask. Nevertheless my AHI is creeping up -- the CA and H keep increasing. My sleep doc increased the minimum pressure -- if anything it made it worse.