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Severe side effects from CPAP

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Severe side effects from CPAP

Postby lisa40 » Fri Sep 29, 2006 11:44 pm

My husband used his CPAP machine for the first time this week, with pressure set at 16. When he woke up in the morning, he started vomiting violently, had a severe headache and severe vertigo. He was in such distress that I called an ambulance. The hospital did a CAT scan and spinal tap to rule out a ruptured aniurism in his brain. The tests were normal. I asked the doctor if the pressure from the CPAP could have caused an inner ear imbalance that caused the vertigo, vomiting, etc. He said he had never heard of that happening, but said 16 was a pretty high pressure. He suggested that maybe my husband should have been told to "work up to" 16. When I asked the Sleep Center, they also were suprised and skeptical that this was the problem. However, they said to stop for a couple days and then start at 6 and work his way up.
I really think the CPAP caused this to happen. He only used it one night and has not used it since. He has had no other problems since that first (and only) night.
Anyone out there know of any similar experiences?
Thanks for your help!
lisa40
 

Re: Severe side effects from CPAP

Postby Daniel » Sat Sep 30, 2006 4:16 am

lisa40 wrote:My husband used his CPAP machine for the first time this week, with pressure set at 16. When he woke up in the morning, he started vomiting violently, had a severe headache and severe vertigo. He was in such distress that I called an ambulance. The hospital did a CAT scan and spinal tap to rule out a ruptured aniurism in his brain. The tests were normal. I asked the doctor if the pressure from the CPAP could have caused an inner ear imbalance that caused the vertigo, vomiting, etc. He said he had never heard of that happening, but said 16 was a pretty high pressure. He suggested that maybe my husband should have been told to "work up to" 16. When I asked the Sleep Center, they also were suprised and skeptical that this was the problem. However, they said to stop for a couple days and then start at 6 and work his way up.
I really think the CPAP caused this to happen. He only used it one night and has not used it since. He has had no other problems since that first (and only) night.
Anyone out there know of any similar experiences?
Thanks for your help!


I have never heard of this type of reaction, that is not to say that it couldn't happen.

Was your husband in any way agitated or concerned about using cpap ? Does he have any other conditions ? What type of equipment is he using (make of machine, type of mask etc). Swallowing a lot of air (if using a nasal mask) MIGHT bring on vomiting...........severe vomiting MIGHT upset balance etc. I'm only clutching at straws here. Please post back with more details.

While pressure setting of 16 is highish.......there are people here with pressures of 20 +, and manage OK.

Please post back.

Daniel.
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Postby lynn321 » Sat Sep 30, 2006 4:05 pm

I think he should try it with the lower pressure to see what happens
an allergy to the plastic of the mask is a remote possibility
but why didnt the problems happen while he was using it?

if his mask covers the nose only, a common problem is breathing thru his mouth when asleep you could check him for this
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Severe side effects from CPAP

Postby lisa40 » Mon Oct 02, 2006 9:05 am

We are now on Day 5 of the vertigo, nausea, and pain. My husband cannot stay upright for more than a few minutes before the vertigo and nausea set in. I have set up an appointment with an Ear, Nose, and Throat Doc tomorrow for evaluation.

His machine is a REMstarPLUS, M series. It adds humidity and the pressure eases when he breathes out. That's all I know about the machine. He was not nervous about using it. In fact he was very excited about the prospect of getting a good night's sleep for once. He even went to bed earlier than usual so he could get started.

Thanks for your comments.
lisa40
 

Postby Gunnyman » Mon Oct 02, 2006 9:19 am

This sounds very much like the pressure is messing with his middle ear. I'd contact your pulmonologist TODAY.
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Postby painless » Tue Oct 03, 2006 6:00 pm

I think I'd discuss with the Dr. about a Tympanogram (a test on the ear drum to see if it is working well) and also about some of the other middle ear conditions (Labarynthitis, etc.) which might contribute to some of the symptoms you discuss. There might also be a Eustation Tube Dysfunction (the tube running from the middle ear to the throat to equalize pressure) that if it is blocked up, might cause the symptoms. If it is the cause, then the Dr. might suggest PE Tubes (like kids get for middle ear infections) to equalize the pressure.

Keep us posted.

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Postby Artie » Tue Oct 03, 2006 8:19 pm

I had dizziness and headaches in the morning after using BIPAP after 1-2 hours of waking up and some generalized weaknes as well. I know this is definitely from the CPAP/BIPAP use cause I never had them before; caused by sinus congestion and allergies affecting the ears.
However, I continued to use the machine every day, and afer about 5 weeks it got less severe and also had some good days as well.
Mucinex, Nasal Sprays and Allergy pills could be helpful. It takes time to get used with the machine and all other related details. We have to be patient.
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Postby RPSGT88 » Tue Oct 03, 2006 8:22 pm

lisa40,

What did the ENT doc say?
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ENT visit

Postby lisa40 » Thu Oct 05, 2006 9:06 pm

Thanks for your responses.
I took my husband in this past Tuesday to the ENT. The doctor said that his problems were definitely from the CPAP. Apparently there was pressure build-up behind the cochlea, which caused the fluid to leak out when he sat or stood up. The doc said my husband is very lucky that he did not lose his hearing permanently! He prescribed complete bed-rest for a week(he's been on his back for a week already!), and said hearing loss is still a risk if he does not stay horizontal as much as possible. If time does not heal the injury then surgery is a possibility. I'm not sure what the surgery will entail...
The doc said this is an unusual occurence after using the CPAP, but not unheard of. If my husband wants to use it again, he would need tubes placed in his ears first. I don't think he is willing to do that at least for a while. He says he will try sleeping on his sides and stomach and maybe try the Breathe-Right strips. But first his inner ear needs to heal. Even tonight he got up to tuck in our son and started seeing double. I hope a week will do it!
Did most of you start on a particular pressure from the beginning or did you work up to it? I'm wondering if this would have been a better idea than starting at 16 right away.
Lisa
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Postby Gunnyman » Thu Oct 05, 2006 9:43 pm

Wow.
Looks like you got it checked out in the nick of time!
I started at 11 immediately. I am noticing nasal congestion and I had a headache my 1st couple of mornings. But after now only 7 nights, those are gone. I'm starting on flonase asap to deal with the congestion.
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Postby RPSGT88 » Thu Oct 05, 2006 10:15 pm

lisa40,

I don't believe his problem is anything at all related to "needing to work up to the pressure" [not an exact quote.] He obviously has some sort of physcial problem that is allowing the CPAP pressure to enter the inner ear. [It may be more complicated than the ENT realizes.] This is anything but normal. I would be very concerned about using CPAP at -any- pressure until the physical problem has been clearly understood and fixed.

A slightly different but relevant topic: One of the known contraindications for CPAP is a cerebrospinal fluid leak. This is caused by a small defect or very weak place in the meninges that a person can have for many years without knowing about it. One of the symptoms is unexplained headaches. If CPAP is applied in the presence of a CSF leak, bacteria can be forced into the defect causing meningoencephalitis.

I am Not saying your husband has meningoencephalitis. I am saying his problem is very rare and warrants expert consultation by a neurologist. Perhaps a 2nd opinion by a neurologist with MRI imaging studies before attempting to use CPAP again.
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Postby CrohnieToo » Thu Oct 05, 2006 11:59 pm

To assist your husband in training himself to sleep on his sides and stomach tie a knot or two in a pair of old socks and baste them to the back of his PJs. He may need 4 socks. Whatever it takes. This worked very well for me to train myself not to sleep on my tummy after a whiplash. That was 12 years ago. I still do not sleep on my tummy after all this time and I was a tummy sleeper my previous 52 years.
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Postby lisa40 » Tue Oct 10, 2006 9:31 pm

I'm the one lisa40 has been writing about. I saw the ENT today, and he allowed me to drive, as long as I can check my blind spots... I did ok, but am verrrry careful. I have some balance issues, due to the middle ear problems, and have to do physical therapy as a result. I don't know what it will be, but I will keep you posted. Lisa40 didn't tell you it took me two days to get used to going from a sea-level city to Keystone, Colorado, which is several thousand feet above Denver.

I have perpetual ringing in my ears, which the doc says may take a while. The headaches are down to occasional pains above my ears, which I am not sure I can't attribute to my children... I am still a little weak, but I can really notice the improvement. I have to say, that it was a very bad set of days for me.

As far as the CPAP is concerned, I am ready to lose the weight, sleep on my side, and any other thing, but my ENT said that a 16 or 18 on the machine indicates that I have some severe problems with sleep apnea. He is going to put tubes into my ears next month, and then we may try again. I can't remember exactly what he called my problem, but I will call my nurse for the exact words. He told me when I was not well, and I forgot to ask today. Thank you very much for your communications. More later.
lisa40
 

Postby RPSGT88 » Tue Oct 10, 2006 9:36 pm

Thanks for the update. I'm eager to know all about your condition because I may see future patients having the exact same thing.

Best Wishes

RPSGT88
Manager
AASM accredited Sleep Medicine Program
Raleigh Neurology Associates, P.A.
1540 Sunday Drive
Raleigh, NC 27607
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Re: Severe side effects from CPAP

Postby sandie » Thu Oct 12, 2006 5:50 pm

lisa40 wrote:My husband used his CPAP machine for the first time this week, with pressure set at 16. When he woke up in the morning, he started vomiting violently, had a severe headache and severe vertigo. He was in such distress that I called an ambulance. The hospital did a CAT scan and spinal tap to rule out a ruptured aniurism in his brain. The tests were normal. I asked the doctor if the pressure from the CPAP could have caused an inner ear imbalance that caused the vertigo, vomiting, etc. He said he had never heard of that happening, but said 16 was a pretty high pressure. He suggested that maybe my husband should have been told to "work up to" 16. When I asked the Sleep Center, they also were suprised and skeptical that this was the problem. However, they said to stop for a couple days and then start at 6 and work his way up.
I really think the CPAP caused this to happen. He only used it one night and has not used it since. He has had no other problems since that first (and only) night.
Anyone out there know of any similar experiences?
Thanks for your help!



trust your instincts
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