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Sinus issues with CPAP - Luka07 - 03-24-2024
Hello guys,
I am needing some help regarding CPAP and sinus issues.
I have chronic sinusitis and had sinus surgery(had polyps too) 1.5 year ago. In that time I didn't use cpap and wasn't diagnosed with sleep apnea.
I started to use cpap 8-9 months ago and everything was good with my sinuses.
In December and January I had cold and got sinusitis, was on antibiotic twice..
I am using steroid nasal spray + oral antihistamine + using neti pot twice a day.
Drinking oral antihistamine in morning, then washing the nose with neti pot.
1-2 hour before sleep I wash my nose with neti pot and then 1 hour after washing I put in steroid nasal spray.
So I am doing everything very strictly with my sinuses...
The problem is that when I go to sleep my sinuses hurt and clog up from using the cpap ...
I have a hygrometer in the room and it sits around 60-75 % of humidity at night, it is very humid here currently.
I visited ENT in the end of January regarding sinus issues to check with the endoscope.
I noticed a couple days ago that I am sitting in the circle with sinus issues and cpap, didn't connect that in February.
I am having regular ENT exam again in two weeks so I want to try some things to speak with ENT also about that and to ask for some advice.
This ENT is specialized in throat surgeries/sleep apnea area so I can cross-ask about CPAP and sinus issues I hope...
Things I tried : turning off the humidifier on the CPAP, it didn't help.
Things I will try today :
lower the cpap pressure from 6 to 4
I will try to put my humidity at level 1 and turn off the heated hose
RE: Sinus issues with CPAP - Deborah K. - 03-24-2024
I too have terrible sinuses and have had surgery as well. I live in an arid climate so the humidity is good. In your case, I think you should turn the humidity off altogether. I would definitely not lower the pressure.
RE: Sinus issues with CPAP - Luka07 - 03-25-2024
I lowered the pressure since I dont have apneas at pressure 4 so it is not an issue currently.
Will try to turn off humidifier this night. Thanks!
RE: Sinus issues with CPAP - apnea505 - 03-25-2024
Four is way to low, i would suggest using auto ramp. It not always about apnea, you can have respiratory arousals aswell that the machine can't measure, and the only way to overcome those is with higher pressure. Im surprised you can can breathe at all at 4. Personally i have the settings set at 7.4-12, and auto ramp starting at 5. Im seriously considering changing auto ramp to start at 6 though because even 5 is hard to breath out of when I reset the auto ramp after a bathroom trip for example. For some reason my sinuses close off at night and the congestion that builds throughout the nights does not help, its easier to breathe with more pressure. I too have sinus problems and am taking 2nd gen antihistamine at night and steroid nasal spray while I wait for a catscan of the sinus areas.
RE: Sinus issues with CPAP - PeaceLoveAndPizza - 03-25-2024
Please post some OSCAR charts. If you need instructions on how, reference the “Organising your OSCAR charts” link in my .sig.
RE: Sinus issues with CPAP - Luka07 - 03-25-2024
@apnea505 Hmm, I backed off pressure at 4 for sinuses... I noticed couple days ago that mine closes when I start to use CPAP so I am now aware that humidity may be the culprit... I am using bilastine as antihistamine and mometasone furoate nasal spray (nasonex called here )
@PeaceLoveAndPizza , here are the charts.. thanks
RE: Sinus issues with CPAP - PeaceLoveAndPizza - 03-25-2024
Thanks. Is there any way you can show the statistics on the left hand side? Initially, the graphs we need to see are: Events, Pressure, Flow Rate, Flow Limitation and the Leak Rate Graph. Always include the entire left side bar, minus the calendar and pie graph.
Set your display to the Standard view.
(View > Reset Graphs > Standard)
Take a screenshot of your Daily screen.
* For Windows or Linux: Use the F12 key
* For a Mac: Use Fn+F12 or cmd-space-3
Regarding your sinuses, the simplest solution is to use a full-face mask. You can still breathe through your nose as before, but when they clog up you just breathe through your mouth.
I admit I am surprised by how good things look at 4 cmH2O. How do you feel in the morning? Well-rested or a bit of a headache? Any grogginess or do you feel ready to take on the world?
You do have a bit of obstructions/FL’s going on, but as long as you feel good I would not overreact to them as yet. A bit more pressure and pressure support will likely help clear them up as you feel better. Based on what I can see I suggest a starting point something like:
Min pressure 7
Max pressure 10
EPR 3 full-time
That should hopefully be enough to give a good nights rest.
RE: Sinus issues with CPAP - Luka07 - 03-25-2024
@PeaceLoveAndPizza , thanks for input, here are the charts.
Maybe I can try then tomorrow a full face mask.
I felt good today with pressure 4cmH2O, except I have sinus congestion and sinus swelling...
I noticed that too at beginning of cpap journey that pressure 4cmh2o is not so bad for me, but I was using mostly 6...
Will try today or tommorrow pressure 6 and epr 2 because maximum epr on my cpap is 2. Will repost charts then..
Thanks again
RE: Sinus issues with CPAP - PeaceLoveAndPizza - 03-25-2024
Apologies, I forgot you were on a Sefam.s box. Thanks for the correction.
I think you are referring to the CC+ option, at least as I can recall from looking it up a short while ago. I thought it had 3 levels, but not sure if it corresponds to pressure support in cmH2O or some other technique.
RE: Sinus issues with CPAP - Luka07 - 03-26-2024
@PeaceLoveAndPizza , sorry, I didn't update my profile. I am using Lowenstein prisma smart
Anyway, yesterday I went to sleep without a humidifier and with pressure 6 and epr 2. After a couple of minutes, my turbinates got swollen.
Then I changed the mask to full face mask and the pressure of 4 fixed because it was leaking a bit and I didn't have time to deal with that in the night.
I won't post charts because I had some leaks and it is first time sleeping with full face mask in 6 months so I am not used to it, but the AHI is 1 , with just central hypopnea. So not bad at all.
I think my sinuses today are a tiny bit better, but still not perfect.
I was thinking to try to sleep without CPAP for 1-2 nights to see if sinuses will heal up a bit and then continue using cpap.
Anyway I have 2 more weeks before ENT exam and I want to see if just my sinuses are issue by itself because I have chronic sinusitis, or the cpap is creating some issue, or it is both.