Nosebleed Issues

I used my CPAP for several years for a mild diagnosis of sleep apnea. I stopped using it a few years ago, but recently decided to start using it again as I now have a atrial fibrillation diagnosis which may be due to sleep apnea.

I used an AirSense 10 with humidity and a heated hose which I have set on Auto. I use a P10 pillow mask. All of this equipment I used for about 3 years without issue.

Because of the Afib diagnosis I now take Eliquis blood thinner which I did not take back when I originally used the CPAP equipment. My issue is for the last 7 nights that I have used the CPAP, I get up in the morning to a pretty severe nose bleed about 2 hrs after I get out of bed. I have no idea why it happens 2 hrs after waking up, but it has all 3 mornings out of 7 since I resumed using the CPAP equipment.

It takes me like 10 min to get the nosebleed stopped since the blood thinner greatly exaggerates the flow of blood. Once I stop the nosebleed in the morning, it never reoccurs until the next morning after using the CPAP. I have no history of nosebleed at all, so quite confident it’s due to resuming use of the CPAP.

Trying to understand if it’s the air flow drying out my nose, irritation from the nasal pillow mask, or something else. My RedMed app shows I scored a 100 on all 7 nights and I am sleeping well, so no issues with the successful use of the CPAP, just this annoying nosebleed.

Any thoughts? Seeing my pulmonologist/ sleep doc next week and certainly will ask him. Stopping the blood thinner is not an option per the cardiologist, so hopefully the sleep doc will have some thoughts or tell me to see an ENT.

Here's a web site with some information:

https://www.sleepassociation.org/sleep- ... e-effects/

I gather from this that the CPAP may be causing the nosebleeds, and that it might help to increase the levvel of humidity you're using.

The two-hour lag is a mystery, though!

My son is prone to bad nosebleeds, using his CPAP can continually reopen the scab and make it difficult for the nose to fully heal. Some things that help him that you can try.
-Use a few sprays of Afrin in the bleeding nostril.
-Since your nose starts bleeding a few hours after you get up perhaps dry room air could be a factor, you might try using humidifiers to increase the humidity inside your house.
-Try increasing the humidity level on your CPAP machine until your nose has time to fully heal.
-Avoid blowing you nose, that can dislodge or loosen the scab
-Using a saline spray or gel before bed and when you wake up can help keep your nose moist.

Since you’re on blood thinners if this continues to be a regularly reoccurring problem I would push the doc for a referral to an ENT. If nothing else works the ENT can cauterize it.

A few more bits of info. I used AYR Saline Gel before putting on my mask. I have also used Afrin to try to stop the bleeding, but not proactively. I don’t think you can use Afrin indefinitely.

My machine pressure is set to 6 (by prescription) and the ramp up starts at 4.

For the seven days I resumed using the CPAP, my recorded events per hour were 0.0 to 0.3, so it doesn’t seem like I am having much apnea events (unless I am interpreting g this incorrectly).

I am going to discuss with my sleep doc next week and hold off on using the CPAP to allow my nose to heal.