Nose congested

[Machine]

I am 35, had my nose congested most of my life so i mostly breath with my mouth during day and night as well.

Could this be reason for Flow Limitations at night?

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[Sheepish]

How long have you been on CPAP?

Do you use a humidifier?

I've found that after a while of being on CPAP with a humifier (and heated hose), my nasal congestion abated to a good extent.

On particularly bad nights, I might have to use Avamys, the only decongestant that works for me after having spent a lifetime trying some.



And when that doesn't work, a couple of Reactine Allergy and Sinus (and not any other kind) taken at least two hours before bedtime do the trick.



YMMV 

[Sleeprider]

Flonase or flutiicasoe furanate (generic) is a very effective steroid nasal decongestant that has worked well for me. It takes about a week to feel the full effect, so it is not like you will suddenly feel no congestion, but it is worth a try. This is over the counter and not too expensive.

Any upper airway restriction that limits flow is the definition of flow limitation. If you use CPAP, a nasal pillows mask can often open your nasal passages in a way you have never experienced...it's great.

[tarah]

Hello.

Nasal congestion is the biggest impediment that I deal with currently, and yes it can drastically affect the ability of your CPAP to work correctly.  We're meant to breathe through our noses.  When you need to open your mouth to breathe, the structures at the back of your throat that are already susceptible to collapse are made that much more unstable.

I would get into an ENT who can take a look at what is causing your congestion.  They can help you identify and treat allergies, if that is the cause.  They can also give you nasal steroids and nasal antihistamine.  I cannot tolerate nasal steroids, they give me really bad insomnia.

What happens if you give yourself a few good sprays of Afrin in each nostril?  Does the congestion go away?  For how long?  You can't use that for more than 1 or 2 nights at a time, but it can be a good experiment for whether swollen turbinates are causing the majority of your congestion.  It would be a good thing to try before going to an ENT because they will most likely ask you to do that experiment.

[Machine]

I dont use CPAP atm.

Found over the counter spray that works great 6 hours effect, however my doctor said if i continue to use it constantly i will ruin my mucous membrane in my nose.

I wonder if there's some alternative solution other than surgery.

[Sleeprider]

If you have been using nasal decongestants like Afrin for any length of time, you have become dependent on them and the rebound effect will be difficult to tolerate when you try to withdraw. Afrin addiction (rhinitis medicamentosa) is a rea problem, and eventually you have to bite the bullet and quit. CPAP can help with congestion by inflating nasal passages, but is not really intended for that use. If your congestion arises out of physical causes from the shape of the nasal passages, surgery may be a solution, but if it's simply congestion, then find a doctor willing to work with you on the root cause of the congestion (allergy, infection, inflammation).

[Michaely6]

Flonase or flutiicasoe furanate (generic) is a very effective steroid nasal decongestant that has worked well for me.  It takes about a week to feel the full effect, so it is not like you will suddenly feel no congestion, but it is worth a try.  This is over the counter and not too expensive.  

Any upper airway restriction that limits flow is the definition of flow limitation.  If you use CPAP, a nasal pillows mask can often open your nasal passages in a way you have never experienced...it's great.

Is flonase safe to use everyday and does it become less effective over a period of time?

[tarah]

A nasal steroid is considered relatively safe long term, unlike decongestants, like Afrin, which can cause rebound congestion after just 2 or 3 days.

There could be any number of things going on, maybe allergies, silent reflux can cause congestion, perhaps a physical obstruction. The only way to know is to see an ENT.  Also, read Dr.Park's stuff on unstuffing your nose and try all the lifestyle things he suggests.

I am going to be having surgery but only after trying every medical option available. I would not try that as a first step, there are too many risks.

[SarcasticDave94]

I'm on a Flonase based medication in powdered inhaler format for COPD. No there's no relation to your nasal congestion, but I need to take this Flonase daily or my breathing is obstructed. With reasonable care, you should be OK.

[Sleeprider]

I have not seen any contradictions to using a mild steroidal nasal spray, other than consult your doctor if you use more than 6-months. I have had a lot of relief from using a Rite-Aid generic version for that past 6-months. I started at 2x/ day for the first week, then went to once per day in each nostril. Recently I cut back and noticed I should continue. This eliminated the complete shutdown of air I was experiencing. My OSCAR results were showing a strong inhale, followed by zero flow (swallow), and exhale, then repeat. I was being aroused multiple times per night and I seriously considered that I might have a nasal polyp or other issue that might need surgery. I decided to try generic Flucosone, and still have my original purchased flucosone propionate sprayer (needs replaced soon). It made a big difference for me, but I had to wait almost 1-week for it to be fully effective.

Not only on CPAP, but during exercise like bike-riding, I don't have to breath through my mouth unless I'm really getting aerobic. Before, i used find myself breathing through the mouth all day. My family commented that when I ate, I was breathing loudly. This is at best embarrasing, but the flucasone seems to have resolved those complaints. Congestion can seem to be your normal until you use a simple solution to resolve it...use the simplest and least invasive approach. If that doesn't work, use the next line of defense.