CPAP causing vertigo symptoms??

I would look for a professional in my town from this web site:

http://www.vestibular.org/vestibular-di ... atment.php

If its a routine Vertigo it would take less than 10 min to dislodge the Otoconia in your ear. These days there are special goggles that you wear and which indicate the exact location of those stones. After a couple of maneuvers by the specialist, the stones should be gone to their right place in the ear and you would be free of the Vertigo. Most ENTs are not familiar with it = waste of money.

A CPAP has nothing to do with it. But many of those who have Sleep Disorders also have Positional Vertigo.

Even if treated most likely that it will come back. So get someone for long term.



Dislodging otoconia using
the Epley maneuver
Credit: NIDCD

I started using a cpap machine about 10 months ago but just starting to use it six hours a night. before that it was only about 3 hours. for about 2 months I have experienced dizzy spells at all hours of the day. when I look up or lean over is the worst but also get dizzy when I stand from a sitting position. My doctor said it would pass and gave me motion sickness pills which didn't help. I went to an ENT at the same time I started a Sleep study and he put a tube in my ear and removed a polyp and removed cartilage but my vertigo started later. My machine was set at 16 but I had it reduced to 14.

I think we blower users have made excursions into sleep deprivation that most people have never experienced. Most of us have probably become somewhat adapted to sleep deprivation and probably also physiologically adapted in our circulatory systems to expect lower SPO2 and possibly higher CO2 levels. According to my respiratory therapist, it can take six months to a year to reset those physiological changes. Consequently, its easy for us to be careless and allow ourselves to get sleep deprived again.

So, I suggest that maybe you are experiencing vertigo because you are just now well rested enough to perceive vertigo. Before, you were so sleep deprived that you were numb to that perception.

Here is some supporting evidence from my experience...

Hmmm, A couple of years ago, I told my doctor I was experiencing vertigo, and odd perceptions that the room dimensions were shifting when I was not looking. It would usually happen when I was standing up, which I am all day long in our lab. I would go to turn slightly and there would be the vertigo. I was also complaining of tingling in my feet. So, we did the whole nine yards. I saw an ENT specialist, then the neurologist who additionally did a nerve conduction test, then an opthamologist. Conclusion, could not find a cause. Around a year later....

In the fall of 2009 I got new cats two kittens who disturbed my sleep quite a bit. I became nearly sleepless just exhausted. I reported to my doctor with symptoms of whole body numbness, extreme lethargy, depression, and vertigo. Another round with my MD and the neurologist who advised me that there was nothing wrong that a little exercise would not cure (I made a point of dropping off a copy of my sleep study later). Well, this gradually passed. Then, finally in fall of 2010 the final crisis of sleep apnea came on with crushing thoroughness and there was no doubt in my mind that I was not sleeping.

My thought, is that all these have an underlying cause, that my sleep efficiency was gradually slipping. When I finally got my ASV it was just in time. I told my sleep tech I had just the day before getting off the parkway stopped in a left turn lane at a traffic light. I closed my eyes just for an instant and fell totally asleep. I woke up in a panic, the turn arrow was green. Nobody was behind me. But for a moment I had no idea how long I had been asleep. It freaked me out but good.

Anyway I felt like I got a weeks worth of sleep in 1.5 hours that I slept in my ASV titration and got my ASV a week later. It was a horrible night falling asleep, but I did. I woke feeling great and then spent the next several months with both insomnia and feeling super tired. I think I had to get enough sleep just to realize how very very sleep deprived I had been. Then I had to overcome the problem that 4 hours of ASV sleep was probably twice what I had been getting prior to therapy (24% sleep efficiency) even if it was not totally restful sleep. Now I cannot really say that I went through a vertigo stage in getting better. But I do get a little tipsy on my feet when I stay up too late. The numbness however, does reoccur. If I have a cold or for whatever reason get less than 4 hours a night on my ASV for say three nights, then I start feeling the numbness in my arms and face. So that is my ding ding alarm that I need to pay attention and get more sleep.

The first few months of CPAP I experienced dizziness/vertigo, I felt it was due to the fact that I only slept on my side due to the
mask because before i'd toss & turn all night. Exhaustion didn't help either but it eventually went away as my sleep improved.

This topic is very interesting to me. I am in the beginning stages of Menieres. My left ear is the one affected and since using CPAP the weird tingeling that I feel has come back after not having it for a while. It also itches and I feel slightly clogged. Clogged is bad for Meniers, and since I know that ENT are all conncected I am concerned that the CPAP may cause episodes. I am going to so some goggling on this one...

Mr Bill wrote: I suggest that maybe you are experiencing vertigo because you are just now well rested enough to perceive vertigo. Before, you were so sleep deprived that you were numb to that perception.

Thanks for sharing your experience, I found it useful. But, with all respect, the vertigo I experienced was so severe that I'm sure I'd have perceived it whether rested or not. By comparison, after reducing my pressure from 13 to 12, I awoke well rested today and have had no vertigo symptoms at all. I realize that my reasoning is post hoc ergo propter hoc, but as a practical matter it has worked - my vertigo is gone and I got restorative sleep.

At a pressure of 12 my AHI is about 12, and at a pressure of 13 my AHI is reduced to about 8. So, admittedly, my sleep is a little better at a pressure of 13. However, the reduction in AHI from 12 down to 8 doesn't feel worth the vertigo compromise to me. If I get courageous (and if I get a day when I don't need to be able to work, walk, read, or eat), then perhaps I'll raise the pressure back to 13 and see what happens. The vertigo was a pretty rough ride though, and I'm not eager to make myself into my own guinea pig just yet

Thanks!

The more I glance at above posts the more I am convinced that most are related to Vestibular System disorders, including sleep apnea. A year ago I came down with Peripheral Neuropathy (numbness in the soles of the feet or other parts of the body ) and that started the chain of events of my Vestibular System malfunction, including OSA. A neurological clinic including staff in Vestibular System rehab and Sleep Medicine helped me a lot.


Specific Vestibular Disorders

Some specific vestibular disorders include the following:

■Benign Paroxysmal Positional Vertigo (BPPV)
■Meniere's Disease
■Secondary Endolymphatic Hydrops
■Labyrinthitis & Vestibular Neuritis
■Perilymph Fistula
■Acoustic Neuroma
■Ototoxicity
■Vestibular Migraine
■Mal de Debarquement
■Pediatric Vestibular Disorders
■Aging, Dizziness, & Balance
■Cervicogenic Dizziness
■Otosclerosis
■Cholesteatoma
■Enlarged Vestibular Aqueduct Syndrome
■Vestibular Hyperacusis
■Autoimmune Inner Ear Disease
■Superior Canal Dehiscence

Source: http://www.vestibular.org/vestibular-di ... orders.php

And:



Thanks Dr Edie

As a scuba diver I learned that differing pressures in the Eustachian tube can cause vertigo. I had it happen when changing depth, usually when ascending a little and having more pressure in one tube than the other when the air in the tubes escaped at a different rate.

Last year I also had vertigo two or three mornings when my Eustachian tubes were slightly inflamed. When I turned the CPAP off, apparently the air bled out of one tube and not the other. It would last for 10 minutes or so and stop when the pressure equalized.

DIZZINESS DEFINITELY RELATED TO CPAP PRESSURE

Maybe my post will help. I am a 68 year old retired physician so
should have credibility.

Due to sleep apnea, I have been on APAP for a few years. I have
had no problems. I have residences in FL and KY. This June,
the humidifier went out on the APAP. Since
I was traveling to KY for a couple months,
I ordered a travel CPAP preset to 9. My
APAP usually was between 8 and 10 as a high
so I thought this would be an average.

The first day after sleeping with the travel
CPAP (set at 9 and not adjustable), I had
severe vertigo. This has persisted since. I
have used meclizine (Antivert) which helps
with the dizziness, but like most antihistamines,
it really drags one down.

Even though I am a physician, I have gone
through the same frustrations: contacting the
Apnea specialist; he said (of course) that
the CPAP was unlikely to be the cause (completely
ignoring that I had not had the symptom prior
to using the CPAP pressure 9 machine). Of course
the ENT found "nothing wrong."

I tried to go without CPAP/APAP and actually made
it for 4 nights. The frequent awakenings (up to
6 per hour) left me completely fatigued.

I have used a new APAP with new humidifer (about
$1600 out of pocket as it was "not time" to have
it taken care of by Humana-Medicare) now for 4
weeks, still the vertigo persists. It may be
about 15% better, but I am not positive this is
because I want it to be better so badly.

THERE IS NO DOUBT IN MY MIND THAT VERTIGO IS A
COMMON (AT LEAST 'NOT UNCOMMON') SIDE EFFECT OF
CPAP. I wish I had a CPAP that I could manually
set; I believe '5' would prevent 95%/all of the
apnea awakenings.

I am as frustrated as any; perhaps more so since
as a doctor, I know when I am being smeared with
BS.

rc0222 at yahoo

Hi, I hope you don't mind my questioning your post, but while I have no doubt that you experienced vertigo and that it was almost certainly related to your switching gears with your machine, why does that necessarily make it a 'common' side effect? I have not heard of it outside of a couple of people who've asked about it (and I've been on here a long time), and their experiences left room for other conditions to be incidentally involved. I have speculated that e.g. suddenly increasing your normal pressure by a lot (5-10 notches) might have a similar effect, and/or that people may have inadvertently blocked the CO2 vents with bedding on occasion, but by what physiologic path would Cpap necessarily cause vertigo otherwise? Thanks!

Julie wrote:by what physiologic path would Cpap necessarily cause vertigo otherwise?

The Eustachian tubes go from the nasopharynx to the middle ear. This is why ear infections often accompany upper respiratory infections.
Cpap pressures can cause a disturbance in the middle to inner ear and upset the balance sometimes. Often in maybe the fluid in the inner ear. Odd that drrch222 mentioned a travel cpap and I wonder if no humidifier was used and maybe the lack of normally added moisture played a contributing factor.

So while I don't agree with the statement that vertigo is a "common" side effect....it isn't a rare impossible side effect.
Ear pain is also a known side effect. It is also possible that the cpap pressure is maybe making a minor problem worse.

It would be an easy thing to test though....lower the cpap pressure to see if the vertigo subsides.

drrch222 wrote:DIZZINESS DEFINITELY RELATED TO CPAP PRESSURE

Maybe my post will help. I am a 68 year old retired physician so
should have credibility.

THERE IS NO DOUBT IN MY MIND THAT VERTIGO IS A
COMMON (AT LEAST 'NOT UNCOMMON') SIDE EFFECT OF
CPAP. I wish I had a CPAP that I could manually
set; I believe '5' would prevent 95%/all of the
apnea awakenings.

I am as frustrated as any; perhaps more so since
as a doctor, I know when I am being smeared with
BS.

rc0222 at yahoo

Considering how easy it is to adjust ones pressure and how easy it is to look at your data with software (assuming you didn't receive a brick), you do lack credibility.
If you are a retired medical professional, why aren't you taking control of your therapy?

BlackSpinner wrote: Considering how easy it is to adjust ones pressure and how easy it is to look at your data with software (assuming you didn't receive a brick), you do lack credibility.
If you are a retired medical professional, why aren't you taking control of your therapy?

Nice move Blackspinner, first you question drrch222's authenticity, ie. a rare in a blue-moon self-professed doctor who visits this site. Next you accuse him of possibly misrepresenting his position in the medical profession, simply because he doesn't want to self-adjust his machine? As a final insult, you suggest he has no place trusting the sleep professionals (doctors and techs) who are advising him. What would you suggest? That he take your vast reservoir of knowledge as law? Really, your attitude is quite beyond belief. No wonder so few doctors and medical professionals dare raise their heads on this site. Shame.

Last September, I awoke to severe vertigo and went to the emergency room. It returned a few days later, and I went to the ER again. I was not using cpap at that time.

I started cpap April 30 of this year. I have never had any ear problems. No vertigo. No ear pain, nothing. As somebody who grew up with ear infections, has a history of colds going to the ears, and vertigo last year, I think it is more about the individual's personal history. It is possible that the pressure may set off something that already exists. But I don't believe that cpap causes vertigo out of the blue. I should be at a higher risk of ear problems, and I have had none during cpap treatment.

drrch222 wrote:I have used a new APAP with new humidifer (about
$1600 out of pocket as it was "not time" to have
it taken care of by Humana-Medicare) now for 4
weeks, still the vertigo persists. It may be
about 15% better, but I am not positive this is
because I want it to be better so badly.

If you do not expect to get reimbursed for the machine, and are not yet committed to the purchase, consider shopping around. Many DMEs have highly inflated "list" prices compared to any of what the machines cost, what they would be reimbursed by an insurance company, or the market prices of the machines on the Internet.