Connection of OSA to Rhinitis, and Sinusitis

[ac555]

Yes, it made little difference.

Have you tried a daily neti pot rinse?

[TBMx]

is it possible that you simply have UARS and not OSA?
I'm a little bit astonished that they made a turbinate reduction with NAR ... I always thought that makes it definitely worse.
It's a crap-advice but maybe you should start mouth-breathing while doing sports. (It's a really crappy advice - I know - but no sports at all is also not a good option^^)

[gman5200]

I have many of the same sinus related issues- clog up when lying down to sleep and a runny nose most all of the day. This has been going on for several years, and like others I have tried nasal sprays and had limited success. I have enormous bags under my eyes, particularly on the right side. One OTC remedy called D-Hist has provided some relief to the nasal congestion, but it gets expensive as the loading dose is 6 per day for 7-10 days and then drop to 2 a day after that. After 2 weeks I did get relief(not a total cure) from the stuffy head but was afraid to go lower than 4 per day since the relief was welcomed. The last 3 days I have taken one of the -D claritinish 24 hour tablets and my nose has been perfectly clear throughout the last nights, and I do feel better. Is that a long term solution to the chronic stuffiness while sleeping? Time will tell.
But, I do believe that at a minimum rhinitis in any form will make OSA worse if not bring it on. I have had nights where I wake up and my head is stopped up and I have clearly been snoring with my mouth wide open. I sleep with a contour pillow ON TOP of a nice big pillow that is firm as a concrete block after wife put it in washing machine. All of this in an effort to get rid of the stuffy head which is certainly making a good night's rest via breathing through the nose very difficult/impossible. The stuffy head along with fatigue and frequent nighttime urination have been my major complaints that I am hoping OSA treatment will benefit- and it has so far to a certain extent, but I'm only a few months in.

[ac555]

I'm about to run out the door. I didn't hear about UARS, but I just glanced over a couple things. This does sound more like what I have, but I do snore a little. I don't know if that falls under UARS at all, but I am leaning towards it as my condition. It blows my mind even more that after 7 years, none of the ENT doctors even mentioned this.

The open mouth thing I am already doing. Doesn't work for running, but helps with most other stuff.

Thanks!

is it possible that you simply have UARS and not OSA?
I'm a little bit astonished that they made a turbinate reduction with NAR ... I always thought that makes it definitely worse.
It's a crap-advice but maybe you should start mouth-breathing while doing sports. (It's a really crappy advice - I know - but no sports at all is also not a good option^^)

[Beej]

Have you read about vasomotor rhinitis? Basically, the vasculature is trigger happy and will constrict or expand with triggers, such as changes in temperature, humidity, light (does it get worse going between 2 very different light levels?), and pressure (like lying down from vertical to horizontal, maybe?)

[Mosquitobait]

Ac55, have you also been evaluated for symptom-less acid reflux? That can cause chronic post nasal drip which in turn can cause issues with rhinitis, although not so much with sinus. Probably all the doctors know about the acid reflux-post nasal drip thing now, but they didn't 6 or 7 years ago.

[mrkdilkington]

I'm about to run out the door. I didn't hear about UARS, but I just glanced over a couple things. This does sound more like what I have, but I do snore a little. I don't know if that falls under UARS at all, but I am leaning towards it as my condition. It blows my mind even more that after 7 years, none of the ENT doctors even mentioned this.

The open mouth thing I am already doing. Doesn't work for running, but helps with most other stuff.

Thanks!

is it possible that you simply have UARS and not OSA?
I'm a little bit astonished that they made a turbinate reduction with NAR ... I always thought that makes it definitely worse.
It's a crap-advice but maybe you should start mouth-breathing while doing sports. (It's a really crappy advice - I know - but no sports at all is also not a good option^^)

Were the ENT's specialized in sleep surgery, or garden variety? Did they do a sleep endoscopy? You've been to ENT's but have you been to a orthognathic/maxillofacial surgeon (i.e. jaw surgeon) with specialization in sleep surgery? Their branch of sleep & airway surgeries and tests are vastly different from what otolaryngologists (ENT's) do. If possible I'd visit Stanford University as well; they have one of the best collections of sleep surgeons in the world (including the father of UARS).

[ac555]

Have you read about vasomotor rhinitis? Basically, the vasculature is trigger happy and will constrict or expand with triggers, such as changes in temperature, humidity, light (does it get worse going between 2 very different light levels?), and pressure (like lying down from vertical to horizontal, maybe?)

I heard of it, but I had mostly looked at non-allergic rhinitis as a whole. Light, humidity, and temperature don't seem to have a noticeable effect. Laying down does was my primary complaint. From 2008-2015 I only had it laying down. After the turbinate reduction surgery, I started getting it while standing up. I'll research into it more.

I guess Nonallergic rhinopathy is the new name for vasomotor rhinits now. Just came across it researching.

[ac555]

Ac55, have you also been evaluated for symptom-less acid reflux? That can cause chronic post nasal drip which in turn can cause issues with rhinitis, although not so much with sinus. Probably all the doctors know about the acid reflux-post nasal drip thing now, but they didn't 6 or 7 years ago.

No, never had any type of acid reflux issues. I have seen drawings of what you are referring too though.

Were the ENT's specialized in sleep surgery, or garden variety? Did they do a sleep endoscopy? You've been to ENT's but have you been to a orthognathic/maxillofacial surgeon (i.e. jaw surgeon) with specialization in sleep surgery? Their branch of sleep & airway surgeries and tests are vastly different from what otolaryngologists (ENT's) do. If possible I'd visit Stanford University as well; they have one of the best collections of sleep surgeons in the world (including the father of UARS).

Honestly, I just started digging into everything about ENT after 7 years without success. I know 8 times more now about ENT related issues than I did back 3 months ago at my last ENT appointment. So I didn't think to look into much of that.

I'm going to say they were the garden variety. There was one VA ENT surgeon I saw when I had my turbinate reduction. I only talked to him before, and he seemed pretty knowledgeable. I never saw him again though.

Oh, you're going to love this. My primary complaint is that the symptoms are when I am laying down. Not once have they ever checked me laying down (other than MRI). No sleep endoscopy, in fact the allergy clinic did one while I was up and awake. I asked the Doctor if he wanted to do it while I lay down. "No, because if it blocks up, I can't see..." While he is 'looking for blockage' to determine the problem.

No, I've never been to a jaw surgeon. Now that you mention that, I have heard connections of the two. Right after I had my turbinate reduction surgery, I started getting pain in my jaw. That pain you get after chewing on gum way too long. I'd get that after about 3 minutes, and it would just randomly hurt. I've constantly complained about it for over a year to the ENT Doctors, but they just act like it's not related.

The main issue is trying to get something from an actual doctor to establish that their is possibly a connection between my sleep apnea, rhinitis, sinusitis, and now jaw pain. The VA refuses to acknowledge it, and as I mentioned in my original post it seems 50/50 with Doctors. The way insurance and Doctors are now days, I can't afford to go to 10 different outside Doctors until I find one who was smart enough to have done his research. I really need one locally in Tampa, FL as travelling around to somewhere else is difficult with my work.

[Queen Celeste]

I find a daily sinus rinse very helpful but not a total answer.  Recommendo a daily rinse.