Need help with swollen nasal turbinate's caused by CPAP

[LBTRS]

Hello,

I was making good progress with my CPAP treatment that started on March 5, 2021. One issue I've been dealing with is nasal swelling which interferes with my ability to breath through my nose and causes sinus pain and pressure. It seems to be getting worse.

Later in the day things start to feel a bit better and I go to bed. In the middle of the night I can feel my nasal passages starting to swell and makes it harder to breath. When I wake up and sit up I develop a lot of mucus that I can clear in the shower. My nasal turbinate's remain swollen for most of the day and keep me from breathing and give me sinus pain, pressure and headaches. I also feel ill due to this. Later in the day they start to feel a little bit better and the cycle starts again.

I've tried everything under the sun, antihistamines, flonase, neti pot, saline spray, Ayr gel, adjusting temperature up and down, humidity up and down, etc. I've tried a dozen different masks, etc. I'm currently on manual humidity and temp of 1 and 78 degrees as auto seems to cause more mucus.

I've never had sinus issues or allergies. Getting up and moving around clears things up a bit but when I sit back down things swell shut again. I'm not congested with mucus (except after first waking up before I shower), things are swollen and painful.

I've been to numerous doctors and they all want to try the same things that don't work.

Anyone have experience with swollen nasal turbinate's caused by CPAP use and how you found relief?

[mesenteria]

I think you should see an allergist/physician and get an assessment of your nasal, pharyngeal, and sinus passages.  This IS pollen season, and it will produce a response in people who are merely a year older as their sin, even if they have never had problems with seasonal allergies. Most of us know that we are likely to experience more allergies as we age, and maybe the use of PAP has sped up your own 'demise'....not sure.

It could also be that, despite an absence of any indication or detection by your machine, you are snoring.  While snoring doesn't necessarily damage soft tissue inside the nares and beyond, including the throat, it does induce periodic pulses that could force material higher into cavities through mucous barriers, and that would include the sinuses.

Finally, you'd be surprised at how prevalent your complaint is.  I have a blocked nasal passage most mornings, and often I have two.  That wouldn't be a huge problem, 'cept I also have to tape to get a good mouth seal (I use a nasal pillow mask).  I have sat upright, clawing at my face, at least three times that I recall, about once a year on average.    But, you live your own misery, such as it is, and we do offer our sincere commiseration. 

[Geer1]

You are 100% sure this is caused by CPAP? If you aren't 100% sure then try sleeping without CPAP to confirm that you do in fact have no congestion without CPAP (and that this isn't related to allergies or some other issue).

If it is in fact caused by CPAP there are a few things you can try.

1) Adjust temperature and humidity. Sounds like you have tried this but it is the usual cause of CPAP rhinitis and usually caused by being too dry but too much humidity can cause issues in some people as well. I would start at preset temp and try a bit more humid and then a bit more dry to see which one works better. Then try temp up and down to dial that in. You might have to increase temp to avoid rainout issues when increasing humidity. Too dry is probably more likely your issue although

2) Clean your machine if it has been a while since doing so.

3) Use distilled water if you don't already.

4) If you have lots of leaks they might be mouth leaks which can dry out nasal passage and mouth. You could try a full face mask to see if that helps maintain more humidity (would also allow you to mouth breath if too congested).

[LBTRS]

Thanks guys. A bit more info that I left out.

I clean the machine and mask weekly so it's clean. I only use distilled water. Oscar shows little/no leaks so that should be good.

That's the problem, I can't sleep without it for some reason. I developed terrible insomnia (didn't sleep for days on end for over a month) and that's what caused me to get the sleep study and CPAP. The CPAP is the only thing allowing me to sleep for some reason. I've tried napping without it and can't sleep at all without it on.

I'm 53 years old and this sinus swelling started after I started CPAP in March. Never had anything like it before. I'm almost 100% certain it is caused by the CPAP as it will be improving in the evening and when I go to bed things get flared up again.

Appreciate the ideas. I'll mess with the humidity/temp again.

[Geer1]

I am not sold it is the CPAP causing the issue, if it is then humidity/temperature should almost certainly effect on it. What it may be doing is allowing you to sleep better/get into different sleep stages where congestion is an issue. Nasal congestion is always worse at night due to blood flow/pressure effects of laying down, worse mucous drainage etc. Do you have high blood pressure by chance?

I looked through your last couple threads and I don't believe you have ever posted your sleep study results. Would be curious to see them (redacted version or just type in some of the critical data). Also have your centrals improved, worsened, stayed the same?

[LBTRS]

My centrals improved a bit when I turned off EPR but then the night before last I had an AHI of 20+ and another night at 8. I've not had time to evaluate those events but think these sinus issues are interfering with being able to get things dialed in. I was hoping to figure out the sinus issue so I could tackle the central issue. I'll load those into OSCAR take a look at post them here along with the limited sleep study information I received.

I hope it isn't the CPAP causing these issues since I need the CPAP to get any sleep. The nasal swelling is causing me to feel ill all day and wakes me up many times in the night as breathing becomes more difficult.

I just ordered a F20 face mask to try since the other full face masks I have are the ones that cover the nostrils and not over the bridge of the nose. I'm wondering if prolonged use of a mask that isn't blowing directly into my nose may relieve some of the irritation.

I'll work on getting the sleep study redacted and look at the oscar data to evaluate the 20+ AHI night.

Forgot to answer your last question...I do have high blood pressure and take medication for that. However, since I've been feeling so poorly due to these sinus issues, I've started a diet and exercise program, lost some weight and my blood pressure has become normal and I've had to cut my BP pill in half each day since my BP is doing so well.

[Geer1]

Have you noticed any correlation with worse congestion on nights where you have more central apnea?

[SarcasticDave94]

That sounds typical of Central Apnea. There's a consistently inconsistent attribute to CA. That's not unique to your situation, so in itself doesn't indicate anything significant other than that's what your dealing with.

[SarcasticDave94]

Something else I've noted, 3 of your 4 threads are a scattered collection of your therapy. We as a group suggest things, and seemingly making a bit of progress. Then you disappear for a few weeks then return in a new thread, starting over with some of the same as prior.

Second issue, I don't think you've ever posted your diagnosic sleep study data. Do you have the detailed version? If you don't you need it ASAP to post it. Choose one of these threads.

[LBTRS]

Hi guys,

Sorry, I thought the different issues should be in separate threads. I'll limit them to a single thread.

Adjusted the humidity down (off last night) and that was a mistake as I woke up in the middle of the night very dry and a splitting headache. I turned the humidity back up to 3 at 3am and didn't sleep much the rest of the night. No turbinates are very swollen and sore today, can't breath at all. I'm going to try it at 2 tonight as the higher humidity seems to cause me to wake up more throughout the night due to my nose feeling stuffy.

Here is the limited sleep study info I received and my two recent terrible nights.

Is there a way to merge my threads with a generic subject requesting help?