Sierra

I have noticed something like this, but not exactly the same. What I have experienced is a dizzy feeling about 1 hour after I get up. It goes away in about another hour. I did some searching on this issue and came up with an article about Otic Barotrama Resulting from CPAP Treatment. This sounds quite a bit more serious than what I was experiencing as there was a significant hearing loss with this individual. What it does indicate however is that spending significant hours on a CPAP every day can cause a pressurization of the middle ear. That article is very technical and I don't pretend to understand all the physiology of it. But, what needs to be kept in mind is that while it is a bit similar to flying in an airplane or going up and down a mountain, it is in one essential part different. In the airplane situation you get a pressure change on the outside of the ear, and eventually on the inside of the ear after things equalize. However with a CPAP there is no equalization until the time you get up and take away the pressure. The pressure acts inside your nasal passages all night, while the pressure outside of the ear remains unchanged. So while it kind of like the airplane experience, the pressure differential lasts for hours, instead of being equalized by chewing gum or swallowing in the plane situation. Also the individual in the article had increased treatment pressure up to 20 cm. I maintain 12 cm. But many do treat at 20 cm and some up to 25 cm.

My thoughts would be to ask for a referral to an eye, ear, and nose specialist to get their opinion. I am monitoring my symptoms and have resolved that if there are no lasting effects more than an hour or so, I am not going to worry about it. I do strongly suspect that it is a pressure issue in the ear, and it slowly resolves itself each day after I get up.

I've tried 4 different chin straps: one home made with Tensor bandage and some sewing, one an on line generic that sells for $10 or less, one that I bought locally at 2 for $6 (hole cut out for the ear), and most recently the Breathewear Halo. It is probably the most secure of them all. For me putting the chin strap on last works the best. You could try taping the straps with some paper type medical or first aid tape (3M Nexcare). I use it to tape my mouth shut. It is not too hard on the skin.

Does the Respironics bipap machines have the equivalent of ResMed's Triggering and Cycling adjustments; TiControl and Rise Time?

The amount of purge air they use to keep the mask high in oxygen and low in CO2 is based on the dead volume of the mask. A larger volume mask needs more purge flow. They can't of course get rid of all the CO2, but most of it. The other issue is that the purge flow changes with mask pressure. If you use a high mask pressure you get more purge flow than if you use a low pressure. The OP seems to be using a fixed pressure of 6 cm which is very low, so the purge flow will be low as well.

The other issue if it is an APAP or auto machine is the minimum pressure. If the minimum pressure is set too low, and the machine backs off the pressure to minimum in the night you can wake up feeling short of air. It would be very helpful if you could tell us what brand and model of machine you have.

I believe the other difference in the two methods is that the Flex methods use a timed predictive technique in the switching between the two pressure levels. The EPR method is based on flow. It tries to follow what you want to do. There are pros and cons to each method.

Yes, Auto CPAP and APAP are generally the same thing. It means they adjust the pressure during the night in response to obstructive apnea events, hypopnea, snoring, and flow limitations. You set a maximum pressure that you will allow the machine to go to, and you also set a minimum pressure that the machine is not allowed to go below. When first using them, it is normal to set a wide range between the two. For example max could be 20 cm, and min could be 7 cm. Then after you use it, and look at the results as to where the pressure goes in response to your events, then it is normal to reduce the maximum and increase the minimum. A well tuned machine will likely have a fairly narrow range between the minimum and maximum. If you give us the manufacturer and model name of your machine we can tell you what type it is.

My CPAP pressure does not seem to be affected by congestion. I use a nasal pillow mask and if anything that seems to keep my nasal passages clear, if I get them clear before I put the mask on.

You should ask to get a copy of your sleep study report. One of the most important factors in the report beside the total AHI number is the portion of the total that is obstructive apnea and the portion that is central apnea. Ask for these numbers. Standard CPAP machines are very effective in treating obstructive apnea, but not so effective in treating central apnea. If you have a high proportion of central apnea you may need a different type of machine. If you have basic obstructive apnea and have any choice in the machine, I would select a ResMed AirSense 10 AutoSet For Her (even if you are male). It has the best features.

Masks are difficult. I have tried 5 masks so far, 2 full face, 1 nasal, and 2 nasal pillow types. For me, I find the nasal pillow masks to be the most comfortable. Of the two I tried, I prefer the ResMed AirFit P10 over the F&P Brevida. But everyone is different. Ask to try different masks to see what works for you, if that is possible. The common problem with a nasal, or nasal pillow mask is that you open your mouth in your sleep and air escapes out. Some learn not to do it, and others use a chin strap to help keep your mouth closed. The other option is a full face mask, but that tends to have more trouble with leaks, and some find it claustrophobic.

Hope that helps some. Any questions just post...

What is the manufacturer and model name of your machine?