Connection of OSA to Rhinitis, and Sinusitis

[Hockenberry]

I'm pretty new here, myself, and really don't have any information, to help with your question, but, I'd like to welcome you to the forum, and say thank you, for your service.

[xxyzx]

Hi, new to the forum. I searched through, and didn't see this brought up before.


Can Sleep Apnea be a secondary condition to Sinusitis/Rhinitis?

Weather is be from swelling of the nasal area causing sleep apnea to be worse than it would normally be? Mucosal inflammation, or just mucus from sinuses draining to throat?

Technically, OSA is when something is restricting or blocking your airway. Commonly caused by your tongue pushing on your soft palate. However, what if that were minor to the point where you didn't have sleep apnea, but inflammation commonly found in people with sinusitis and rhinitis restricted the airways further causing it to become mild OSA?

The reason I ask this is because it may seem pretty possible, and there are tons of doctors who have written about the connection. I have been to several ENT doctors, and they say it's impossible for there to be a connection. Even though my rhinitis was why they sent me to do a sleep study which found out I had mild OSA. Looking around, it seems there is a 50/50 split between Doctors of whether it's possible or not and wanted some more opinions from other people. Maybe someone else has gone through the same thing.


I can't post links since I'm new, and have less than 4 posts. There are plenty of articles online talking about the connections, and studies that have been done.

i believe congestion is responsible for some hypopnea but not apnea unless you are on a machine and it blocks the pressure from being enough to stop the OA

[Sleeprider]

Ac555, thank you for your service. Your post goes into a lot of detail, and my take-away is you may be suffering from Upper Airway Resistance Syndrome UARS. An easy internet search can tell you more about that than I can, however it is most responsive to bilevel PAP therapy (BiPAP / VPAP). In bilevel, a separate higher inhale pressure and lower exhale pressure are applied to overcome the upper airway resistance and to do part of the work of respiration. It can of course treat obstructive apnea and hypopnea as well.

I don't know if the VA will trial you on a bilevel machine like the Respironics Dreamstation BiPAP Auto or Resmed Aircurve 10 Vauto, but I suspect it would be a lot of help to you. If you have the money, a BiPAP can be purchased for $720 on Amazon, and combined with a nasal interface like the Resmed Airfit P10 nasal pillows. This combination would make nasal breathing fairly easy for you since the pressure assist would move past any chronic congestion and inflammation in your nose and sinuses. Anyway, take a look at UARS and it you think this might be a useful path to pursue, let's talk some more about how to make it happen.

[Greggory]

Nasal congestion or obstruction of any sort can lead to mouth breathing. It takes very little increase in nasal resistance before a person will "naturally" switch to mouth breathing. If the restriction persists, a bad habit develops. We're suppose to breath through our nose.

There are many, many benefits to using your nose over your mouth. One of them is that it promotes healthy micro-flora in the nasal cavities. You can begin reading about this by looking up the Buteyko breathing method.

Given this understanding, I'd say that yes there is a definite link between OSA and sinus issues. OSA by definition is a result of an upper airway obstruction. My suspicion is that a very high percentage of those with OSA/RERA/UARS are mouth breathers. I'm one of them and plan on doing exercises to break this bad habit and strengthen my upper airway - see myofunctional therapy.

I've just been diagnosed with sleep disordered breathing (mostly RERAs) and got clued into the connection to proper breathing and myofunctional therapy at the same time. I have protracted sinus infections. I plan on using PAP therapy along with embarking on a 1-year myofunctional program. It'll be interesting to see how much PAP therapy helps with clearing my chronic sinus infection and later, to see if myofunctional training reduces sleep events.

On a related note, you may also want to look into the connection between root canaled teeth as they tend to become infected and this can lead to sinus infections. Diet is also a big contributor. For example, many are "allergic" to lectins with one result being an increase in the production of mucus - see the work of Dr. Gundry

[BadGoodDeb]

Let us know if PAP therapy helps with your sinus issues. It hasn't done anything for mine.

This I certainly agree with: "It takes very little increase in nasal resistance before a person will "naturally" switch to mouth breathing.". My existing nasal resistance is so high that I need to poke holes in the nasal mask I'm on, so that its own resistance doesn't push me over that limit. With a few holes (making it similar to a Swift mask) I'm okay.

[Greggory]

My existing nasal resistance is so high that I need to poke holes in the nasal mask I'm on, so that its own resistance doesn't push me over that limit.  With a few holes (making it similar to a Swift mask)  I'm okay.

That sounds bad; I hope it get better.

I have a deep sinus infection called MARCoNS that can only be found when properly cultured. They say that this infection doesn't necessarily lead to added congestion. However, my experience is of having chronic post-nasal-drip and being unable to ever really clear my throat. Sometimes at night, it can be a real challenge to fall asleep with so much mucus at the back of my throat. I can't wait to get going on PAP therapy and send lots of air/oxygen up into my sinuses as I sleep - unlike without PAP where I do a lot of mouth breathing. Take that you damn MARCoNS.

[Queen Celeste]

I am a mouth breather with chronic sinus issues and LDR.  I have found nasal rinses very helpful, though not a cure.  The CPAP seems to be helping a bit in that direction, but has definitely helped other issues I wasn't even aware of.  I am interested in the Myofunctional Therapy and will check it out.  Thanks!

[Greggory]

I am a mouth breather with chronic sinus issues and LDR.

The interesting connection between Laryngopharyngeal Reflux Disease (LPRD) or Gastroesophageal Reflux Disease (GERD), chronic sinus infections, and obstructed breathing is made by Dr. Steven Park in his book "Sleep Interrupted" where he writes, “…LRPD is silent, the only symptoms being throat clearing, post-nasal drip, a lump sensation in the throat, hoarseness, cough, coughing, or difficulty swallowing.”

Dr. Park goes on to explain that LPRD/GERD can happen as a result of the suction that is created in the chest and stomach cavities during obstructive breathing events. During these times, microscopic levels of stomach acid can be drawn up into the oral and nasal cavities. While the levels are not perceptible to the individual, they nonetheless can be quite damaging. Could this damage include making the sinuses more prone to inflammation and infection. I personally think so.

[HalfAsleep]

Hi, new to the forum. I searched through, and didn't see this brought up before.


Can Sleep Apnea be a secondary condition to Sinusitis/Rhinitis?

Weather is be from swelling of the nasal area causing sleep apnea to be worse than it would normally be? Mucosal inflammation, or just mucus from sinuses draining to throat?

Technically, OSA is when something is restricting or blocking your airway. Commonly caused by your tongue pushing on your soft palate. However, what if that were minor to the point where you didn't have sleep apnea, but inflammation commonly found in people with sinusitis and rhinitis restricted the airways further causing it to become mild OSA?

The reason I ask this is because it may seem pretty possible, and there are tons of doctors who have written about the connection. I have been to several ENT doctors, and they say it's impossible for there to be a connection. Even though my rhinitis was why they sent me to do a sleep study which found out I had mild OSA. Looking around, it seems there is a 50/50 split between Doctors of whether it's possible or not and wanted some more opinions from other people. Maybe someone else has gone through the same thing.


I can't post links since I'm new, and have less than 4 posts. There are plenty of articles online talking about the connections, and studies that have been done.

IIRC Many PAPpers are mouth breathers. Seems to me, that's because they run short of O2 and have to take in a lot at once, ergo the need to use the mouth to breathe. Many PAPpers also have stuffed noses that seem to clear once the airways return to an unimpaired state. Humidification also helps.

I have terrible post nasal drip. This might be part of the same complex in my case. I thin it with Simply Saline.

It's possible--but maybe unknowable--that rhinitis and sinusitis come in a package with OSA for a significant number of people. On the other hand, the vast majority of folks with rhinitis and sinusitis don't develop OSA. And I can't imagine how you'd do a study to find out: it would have to be a long-term study, and there'd be no way to demonstrate causation.

[Queen Celeste]

Thanks to Gregory, I am currently reading Dr. Park's "Sleep Interrupted".  As I have had Sinusitus/Rhinitis for years and recently was told I have LPRD, I can definately relate.  It is a fascinating work.  I will bet many can relate to parts of it.  I ha found daily nasal rinse as well as saline spray greatly improve nasal issues.  After 7 months on cpap with a rocky roller-coaster start, I have started positional therapy (no back sleeping)  and have been recoriding #'s under 5 since mid-June. Most are under 1with an occasional 2-4.  I believe everyone needs to analyse their own bodies, symptoms, and results.  I hope I have found an answer.  Time will tell, I guess.  This forum is a great tool and asset.  Thanks!  Keep up the great work on providing info.