Dizziness from Sleep Apnea: Causes and Solutions

Dizziness caused by sleep apnea?

Hello, doctor.
I have been experiencing dizziness for over a year since February of last year.
Initially, I thought it was due to a cold, but after more than a month, I realized something was wrong and went to see a doctor.
At first, the doctor believed it was caused by my obesity (116 kg) and high blood pressure (155/101 at the time).
After taking blood pressure medication for three days, I experienced numbness in my head and limbs, which led me to the emergency room.
The emergency physician attributed it to a side effect of the medication.
The next day, I saw my doctor again, who discontinued my blood pressure medication.
I underwent numerous tests and consulted various doctors, but there were no significant issues, just mild fatty liver and small bone spurs in my cervical spine (not compressing any nerves).
Later, a doctor asked if I had been tested for sleep apnea.
I mentioned that I had undergone testing about seven years ago (when I weighed 109 kg) and was diagnosed with severe sleep apnea, which required me to use a CPAP machine.
However, I gave up after a month due to discomfort and subsequently gained more weight.
This doctor recommended that I retake the test, so I underwent another sleep study at the end of June last year.
This time, I was diagnosed with severe sleep apnea (AHI: 54) and had a blood oxygen level of 48%.
Due to my fear of being ill, I had lost 18 kg over two months and weighed 96 kg during the sleep study.
In September of last year, I purchased a new CPAP machine with a pressure setting of 5 and underwent another sleep study, which showed a blood oxygen level of 90% and an AHI of less than 5.
However, by mid-January of this year, my dizziness worsened, and I began to feel like I was swaying up and down, similar to being on a boat.
At times, I experienced numbness in my left hand and foot, along with gastrointestinal discomfort.
The doctor informed me that my sleep apnea likely caused long-term oxygen deprivation to my brain, leading to autonomic nervous system dysfunction.
I was advised to wait for my nerves to heal gradually, to maintain exercise, and to continue using the CPAP machine.
Doctor, is it true that my autonomic nervous system dysfunction, caused by sleep apnea, is responsible for my daily dizziness over the past year? My family and friends do not notice it and tell me not to overthink it.
Due to the worsening dizziness, I had to resign from my job in March.
Will this get better?

Alvin, 40~49 year old female. Ask Date: 2017/05/31

Dr. Li Jiaxuan reply Otolaryngology

Dizziness can have many other causes such as inner ear imbalance, vascular constriction, or heart problems.
It is recommended to consult an otolaryngologist, neurologist, and cardiologist to rule out other causes of dizziness before proceeding with treatment.
Wishing you good health!

Reply Date: 2017/05/31

More Info

Dizziness can be a troubling symptom, and in your case, it appears to be linked to obstructive sleep apnea (OSA), a condition that can significantly impact your overall health. Given your history of severe sleep apnea, as indicated by your apnea-hypopnea index (AHI) of 54, and the associated low blood oxygen levels, it is understandable that you are experiencing persistent dizziness and other symptoms.

Understanding the Connection Between Sleep Apnea and Dizziness
Obstructive sleep apnea occurs when the muscles in the throat relax excessively during sleep, leading to repeated interruptions in breathing. This can result in fragmented sleep and reduced oxygen supply to the brain, which may contribute to various neurological symptoms, including dizziness. The long-term effects of untreated sleep apnea can lead to complications such as high blood pressure, heart disease, and even cognitive decline.

In your case, the dizziness you are experiencing may be attributed to several factors:
1. Chronic Hypoxia: The episodes of low oxygen levels during sleep can lead to chronic hypoxia, which may affect brain function and contribute to feelings of dizziness or lightheadedness.

2. Autonomic Nervous System Dysfunction: Sleep apnea can disrupt the autonomic nervous system, which controls involuntary bodily functions. This disruption can lead to symptoms such as dizziness, especially when changing positions or standing up.

3. Weight and Health Changes: Your weight loss and changes in health status can also play a role. Rapid weight loss can sometimes lead to electrolyte imbalances or changes in blood pressure regulation, which may contribute to dizziness.

4. Medication Side Effects: If you have been prescribed medications for blood pressure or other conditions, these could also contribute to your symptoms. It’s essential to discuss any side effects with your healthcare provider.

Recommendations for Management
1. Continuous Positive Airway Pressure (CPAP) Therapy: It is crucial to continue using your CPAP machine as prescribed. This device helps keep your airway open during sleep, improving oxygenation and reducing the frequency of apnea episodes. Consistent use can significantly improve your symptoms over time.

2. Follow-Up Sleep Studies: Given your history and the changes in your condition, it may be beneficial to have follow-up sleep studies to assess the effectiveness of your CPAP therapy and monitor your sleep apnea status.

3. Lifestyle Modifications: Maintaining a healthy weight is vital. Continue with regular physical activity, as it can improve overall health and may help alleviate some dizziness symptoms. Additionally, a balanced diet can support your recovery.

4. Hydration and Nutrition: Ensure you are adequately hydrated and consuming a balanced diet rich in vitamins and minerals, as deficiencies can contribute to dizziness.

5. Neurological Evaluation: If your dizziness persists despite adherence to CPAP therapy and lifestyle changes, consider consulting a neurologist. They can evaluate for other potential causes of dizziness and recommend further testing if necessary.

6. Stress Management: Since stress and anxiety can exacerbate dizziness, consider incorporating relaxation techniques such as mindfulness, yoga, or meditation into your routine.

Conclusion
While your symptoms are concerning, it is essential to remain hopeful. With consistent management of your sleep apnea and lifestyle adjustments, many individuals experience significant improvements in their symptoms over time. Regular follow-ups with your healthcare provider will be crucial in monitoring your progress and making necessary adjustments to your treatment plan. Remember, recovery can take time, and it’s important to be patient with yourself as you navigate this journey.

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