Choosing correct mask, Septum questions, Nasal Cycle

[beetee]

Hi all, 

I have an appointment next week to collect my first CPAP machine from the hospital and meet the experts/techicans to discuss it's use and presumably choose a mask.

I have 3 questions relating to this, i hope some of you could kindly help

1. My nose periodically switches nostril for breathing and becomes blocked on one side while open on the other and then randomly swaps throughout the day and/ or night. I still don't understand if this means i have a deviated septum or nasal polyps, and i'm not aware of any way to be able to check this to differentiate between the two.
  I have read online that if you have a deviated septum, when you are with your clinician choosing your mask you should not be choosing the pillow or nasal option and instead only be consiering the full face mask option to compensate for having a deviated septum.
  Yet when i search and read more online, I found conflicting views on this, with other people saying that if you do have a deviated septum it isn't an issue or a reason to avoid the pillow or nasal masks and they will both be just as effective as the full face mask.

Could anyone please help to clarify this?

2. I have suffered previously with acid reflux (though i now have it under control) & also Irritable bowel syndrome, bloating and general stomach sensitivity, I'm worried about these reports of aerophagia, and I'm reading that using any of the nasal masks reduce the chance of getting aerophagia drastically vs a full face mask.

Is this true?

3. I tend to turn from side to side when i sleep (or at least i think i do) Is it important i use a mask that has the air inlet at the top of head, or is it still possible to wear a mask with the inlet at your mouth, if you frequently turn postions during the night.

Also, other than the above is there anything else besides comfort that needs to be taken into consideration?

Thanks 

[Sleeprider]

As long as you can control CPAP pressure in your airway without mouth leaks, a nasal interface is much easier to tolerate. Nasal pillows will apply pressure directly to the nares or the nostrils, and this often helps to stent the nasal airway to prevent the nasal cycle that affects you. This stent would be less effective with a nasal or full face mask. Nasal cycling is a physiological congestion of the nasal conchae, also called the nasal turbinates, due to selective activation of one half of the autonomic nervous system by the hypothalamus. It should not be confused with pathological nasal congestion, so it may not respond to decongestants, however some people find Flonase (fluticasone propionate) can reduce the inflammation that may accompany the periodic congestion.

Another member "Lucid" recently posted an article https://www.apneaboard.com/forums/Thread...#pid491087
Here is an older thread discussing the nasal cycle, where I mostly got it wrong https://www.apneaboard.com/forums/Thread-Great-Insight
I made a minor change to the title of your thread to include "Nasal Cycle" to hopefully help with future searches on this topic.

[SleepyDawg]

I use a AirTouch F20 which has the air inlet opposite my nose. I tend to move from one side to another and on my back throughout the night, mostly due to arthritis in my hips.
I have a hose holder that keeps my air tube above my head and helps with the turning. It was under $20.

[PeaceLoveAndPizza]

We have a number of things in common as I have similar nasal turbinate and congestion issues, plus have IBS-D and GERD. 

I can use nasal pillows with no issues as my nostrils are blocked on one side or the other, particularly during allergy season, which is year-round here in the American South. GERD/IBS is fairly well managed with smart food choices and some OTC meds, but when it flares it buggers up everything. 

My take is you have nothing to be concerned with using CPAP related to either condition. Hose in front or above your head will make no difference in therapy. Use what is comfortable for you. I primarily use nasal pillows (Resmed P10), but will switch to a full-face mask (F&P Evora) on occasion. I change sides frequently during the night due to shoulder issues and have no problems with mask or hose management. You will learn to manage it.

Aerophagia affects some, not all. For me the key is relaxation and breathing with the machine. When I fight the machine, I end up swallowing air, and end up with aerophagia. I do not think it is pressure related as it can happen at low or high pressure. Some complain about it whether at low or high pressure, and invariably it turns out they are fighting the machine. Take a moment and count to zen.

My suggestion is do not get too far ahead of yourself and worry about things that may never happen with CPAP. Get the machine, learn how to adjust the settings, and follow the instructions in my signature on downloading OSCAR and formatting OSCAR charts. Many here can help find the best settings for you.

[beetee]

Thanks what made you choose to use that full mask?

---

Thanks for your reply


I primarily use nasal pillows (Resmed P10), but will switch to a full-face mask (F&P Evora) on occasion.

Why do you swap on occasion from pillows to full-face, any particular reason?

[PeaceLoveAndPizza]

I switch from pillow to FFM when my allergies are not being managed by OTC meds. After a few days of mouth breathing I go back to pillows when the allergies have subsided.

[HalfAsleep]

I had a nasal mask (P10) and a blocked nostril. Didn’t work for me at all. I could never get enough air.

I had a septoplasty and several other surgical tweaks. I have an F40. It’s a minimalistic FFM, and I love it; I will never go back to a nasal mask.

I wouldn't worry about any of the potential responses to therapy until they happen. They aren’t inevitable, by any means, and may be short-lived. Instead, focus on getting used to the machine, managing leaks, and analyzing your Oscars to dial down settings. You can train discomfort or stuff like breathing at cross purposes to the machine (which may cause you to eat air) by reading or watching TV with your equipment on. With that experience under your belt, it will be easier to assess issues, if there are any.

[beetee]

I had a nasal mask (P10) and a blocked nostril. Didn’t work for me at all. I could never get enough air.

I had a septoplasty and several other surgical tweaks. I have an F40. It’s a minimalistic FFM, and I love it; I will never go back to a nasal mask.

I wouldn't worry about any of the potential responses to therapy until they happen. They aren’t inevitable, by any means, and may be short-lived. Instead, focus on getting used to the machine, managing leaks, and analyzing your Oscars to dial down settings. You can train discomfort or stuff like breathing at cross purposes to the machine (which may cause you to eat air) by reading or watching TV  with your equipment on. With that experience under your belt, it will be easier to assess issues, if there are any.

[robbob2112]

Sleeping left side down is good for the acid reflux - stomach valve is on the right so it helps with the reflux - Right side down tends to make it worse.

The aerophagia can be an issue with higher pressures. And they are made worse by chin tucking, if you get them a soft cervcal collar can help. The collar also helps just keeping the mouth shut and you can use just a nasal mask.

I am currently on the F20 or the F&P evora FFM. The F30 pinches my nose and the Evora doesn't. I am going to have the DME send me a F40 next time I am due a full mask just to try since I have a backlog of cushions for the F20 I loose nothing.

I went through 9 different masks before I found one that worked consistently and didn't rub or leave me with other issues.

IF your nose gets dry inside use something called Aquegel (that isn't a mis-spelling) - you can get it on amazon. It is made for people using oxygen and it causes them to dry out. I also use it on contact points if a mask is rubbing my nose or face causing an issue. DON'T use vasaline - it drys out the nose

[beetee]

My diagnosis was using a device sent to my home called the (Watch Pat Device).
The device was only run on one night, and i didnt get a particularly good night sleep that night. I haven't slept in the overnight sleep lab. When i spoke to the consultant he told me that the Watch Pat Device is very accurate, (even though the results were just for one night) and therefore presumably i wouldn't be staying overnight in there lab.

Is the Watch Pat Device accurate enough to diagnose sleep apnea for just one night sleep study, to therefore prescribe cpap for life, I guess it is as when i pushed the consultant on this, he said it was more than enough sufficent for them to determine as such.