How to stop nose bleeds?

[BHappy]

Hello, 

For the last 10 days or so, when I clear my nose in the mornings I can find some mucus with blood on it. It isn't very concerning as it happens only in the mornings - but the fact it isn't stopping is starting to worry me.

Have been using the dreamstation for about 3 years now and never had a nose bleed. 
These days I am also waking up in the early hours with a lot of discomfort (in my nose, primarily). I put aside the mask - but then I can't sleep. So I have turned the pressure down from the recommended 9.5 to 8.5 (its apap, so it will adjust. The 90% pressure usage since has been 9.5.) This hasn't helped. The AHI hasn't moved too much either - so am thinking this change is ok.

Usually my humidifier is set to 3 but about a month ago, i have turned it up all the way to 5.To avoid the heating up time, I pour in warm water in the tank. I use adaptive heating (hopefully thats what its called) on a heated tube. And now I have an iso beard/moustache - working from home - so can't be arsed to shave :-P



What can I try to do to stop these nose bleeds ?

Cheers,

[mesenteria]

You have imparted to the process several changes, any one or combination of which might also be the cause of your recent nose bleeds.  Except for a nasal rinse or spray once or twice a night that might help to retain moisture in the tissues, or ensuring you're sufficiently hydrated prior to retiring for the night, I don't know what else to suggest except maybe to dial back all the changes you have made.

I can't recommend a nasal spray because I have never used one for the purpose of improving moisture inside my nose.  Perhaps someone else will help you there.

[Hydrangea]

Humidity could help.

There are xylitol sprays that could help. Xylitol makes me depressed, so I can't use it... and I'd recommend if you notice you get depressed, then I wouldn't recommend continuing it. Xylitol is also deathly poisonous to dogs, so beware.

Have you been using a new sort of mask? My body is very sensitive, and I've experienced pain and loss of skin as a sort of allergic(?) reaction to contact with materials in certain masks. Just a thought.

It's possible it's not at all related to CPAP. Are you taking new meds? Does your house have new furniture, rugs, paint, or other things that could be off-gassing? Has your area had any new environmental conditions?

Those are my random ideas! (None of it is medical advice. This is all just my personal experience.)

[terrytheyounger]

My CPAP has been set on 19 for quite a while.  I had the same problem quite a few years ago using nose pillows.  I slept best with them, but went from some blood in morning to continuing nose bleeds even after trying varying humidity levels. Nasal washes didn't help; neither did Ayr Gel application. A late night ER visit where it took packing my nose with stents was the last straw (you REALLY don't want to wake up with a full fledge nose bleeds in a cpap mask).  The specialist I saw said that the back of my nose and sinuses were a web of veins that would continue to bleed with the nasal pillows.

I tried several full face masks (including one from lower back jaw to upper forehead) until settling on the medium Ultra Mirage II. With the humidifier set on either high or one less, I haven't had problems since.  I recommend seeing a reputable ENT to ensure there isn't another problem at work.  Best wishes!

[Deborah K.]

When beginning pap use I found that the insides of my nostrils were becoming extremely dry.  What helped me a lot was to smear just a little Lanisoh up into each nostril as far as I could reach with my pinky fingers.  You can find Lanisoh in the baby department of stores like Walmart or Target and probably in drug stores.  It's just lanolin and it works great because it stays in the nostrils all night, unlike vaseline based products.  Good luck with whatever you try!

[Hydrangea]

I was contemplating this more, and wondered if maybe your high level of humidity is opening up your sinus membranes too much. Perhaps lowering the heat and/or humidity could help??

[PaulaO2]

Nasal pillows are not for everyone. You use the Dreamwear which isn't directly pointed into the nostril which should be a good thing if you are prone to these issues. Your pressure is low enough that the air pressure itself is an issue.

First, don't make so many changes at once. Pick something and eliminate it as the problem or at least chalk it up as an unknown.

Second, sometimes too much humidity is as bad as too little.

Third, try lanolin or Ayr gel for your nostrils each night and gently blow your nose clear in the morning.

Fourth, someone can become allergic to anything at any time. Since it is spring, it could be allergy related. Saline nose spray or saline nose wash may help. Stay away from any other type of nose spray unless you see your GP and they recommend something. Clean your filter, hose, tub, and mask really really well. Vinegar and water solution is best. Let it air dry. Switch out for new anything you can. Wash the new stuff too. Then try again.

[Shorty]

I have a beard and use a Dreamwear nasal mask with pillows and have done so for 5 years now. I went through the bleeding in the morning problem and found that by leaving the pressures the same and bumping the humidity up to 3 (out of 5)  the nose bleeding stopped as it was due to my nasal passages drying out too much.
I do have to adjust it back down to 2 in winter as the ambient humidity is higher to avoid condensation in the hose and mask.