CPAP and prescription nose spray

Hi, this is my first post. I am a 31-year old married man who was diagonosed last summer with modrate-to-severe obstructive sleep apnea (OSA). I was surprised to learn that I have OSA, especially because I'm relatively fit and in-shape, and eat healthy. Throughout my life, I have alweays been a big napper, but never thought I had a "condition" until I went to my first sleep study last summer.

Shortly after my study, I was setup with a CPAP and haven't missed a night in almost 1 year. I must say that with the CPAP, my life has changed tremendously (for the better). I have more energy and feel more alive than ever. However, over the same period, I have searched endlessly for alternatives, including the TAP device, which hasn't worked for me, and have met with two surgeons and 2 ENTs seeking treatment altrernatives.

Last week, I consulted with a surgeon, who like others, discussed the many procedures available (with each one described as more terrible than the previous ones for reasons discussed in other posts).

However, the surgeon prescribed Nasonex, and recommended that I give it a shot while I sleep with my CPAP. Nasonex is a prescription nose spray. I tried it, and I must say that during these past few nights I have been more rested than ever, which is why I am making this post. Have any of you experienced the same thing? Does this make me a stronger candidate for a surgery? Do I (or should I) take such a medicine each night for the rest of my life?

Do not get me wrong, I feel great and rejuvinized after having slept with a CPAP, and even better after having used this nose spray with the CPAP. However, the thought of spending every night of the rest of my life on a CPAP motivates me to seek a sugical solution. Do any of you use a nose spray? Do you have any advice? Does sucess with the spray yield to sucess with any surgeries?

As a side note, I am grateful to the people who started this website, because I find that there are not many people to discuss OSA. It seems to me that you get a sleep study, get diagnosed with sleep apnea, go on a CPAP, and stay with it for the rest of your life, without much guidance from health professionals. Truthfully, I do not want to spend the rest of my life on a CPAP, but each other method of treatment is more awful than the other, and not doing anything can cause dire health consequences. If any of you can provide guidance, I greatly appreciate your input.

Best,
-JustinMtgeBanker

You seem a lot like me. I was a multisport collegiate varsity athlete that had been diagnosed in 1993 with my first sleep disorder. At that time, they pointed to my tonsils and uvula as the primary problem so I got them surgically removed. The Uvulaplastomy was not that much fun and I wonder if I made a mistake.

After the surgery, I had a second sleep study done and they concluded that I did not have OSA anymore - the surgery worked! I did not need a CPAP or anything...

Then, last year I had some issues with anxiousness and mood issues. After trying drugs from my doc and experiencing bad results, he made me get a sleep study. lo and behold, the new sleep study said that I had OSA now.

So, I am back on to a CPAP which was originally set up at 17. Today, the doc changed me back to 10.

With this experience, I would say that this medical arena is in its infancy and that they are still trying things.

As far as nose sprays go, Afrin didnt work well at all for me. The anefrin nose spray from walgreens did better for me. I have to have a nose spray before using a CPAP here in the midwest or the thingk just wont work.

Justin
If you search this forum for Nasal Irrigation you will find lots of info about the following:

• Nasal congenstion has a bad influence of sleep
  Nasal congestsion can make CPAP treatment far less effective
  Rinisng your nasal cavities with a simple saline solution can do wonders

There are a number of techniques to do nasal irrigation, I used NeilMed's spray bottle, and make my own saline solution (1/4 teaspoon salt to 1 cup of water, and I have started adding a dash of baking soda. )
http://www.neilmed.com.

Surgery:
You don't mention the kind of surgery suggested, and there are (roughly) four kinds

1. Anything that has to do with your UVULA or Palate, usually calle UPPP - avoid it at all costs it will not help your OSA, and will make cpap treatment much more difficult when you have to return to it. When post surgical AHI is measured it is rarely normal - and the ENT's rarely measure it. When the do, they talk about a 50% reduction in AHI. Absurd, since the aim is for everyone to get an AHI of less than 5 (or less than that if you ask many memebers of this forum).
2. Tosillectomy: if you have gigantic tonsils obstructing you airway, by all means, have them taken out. It is very painful an unpleasant for grownups, but may make cpap therapy more efficient an tolerable.
3. Taking care of a deviated septum and turbinate reduction - those have to do with your nose anatomy, and having them treated by surgery has been beneficial to many users on this forum. Both a deviated septum and large swolled trubinates can cause nasal congestion.
4. The most major surgery (truly major) has a surgeon rebuild your jaw and move you tongue forward. Called Maxilomandibular Advancement (if is only the jaw) or -Maxilomandibular Genioglossal Advancement (when the tongue is involved). Some people need it, and those that need it benefit from it - it for those people whose airway is structurally narrowed even when they are awake.

The fact that the spray help you means nasal congestion effects your breathing. I would not say it indicates you are a good candidate for surgery.

You're a good canditate for nasal irrigation

Welcome and good luck!
O.

The Nasonex (Also available as a generic) is simply a steroid to reduce allergies. I takes about 20-30 days of daily usage to be effective. It only has to be taken when allergies are bad in allergy season. I would not even consider any kind of surgery if CPAP will work for you. Most wind up back where they started, only worse. CPAP is not so bad and once you get used it, it is not so invasive as the other treatments.

I would not even consider any kind of surgery if CPAP will work for you. Most wind up back where they started, only worse.

Not so.

O.

Justin

Nasonex also works for me, but I try to avoid taking it every night coz it's steroid spray. I bring Nasonex when travelling, coz I still think that bringing the CPAP is too much of a hassle. I've tried once and that's it. I don't want to bring it again.

ozij gave you valuable advices as he (she?) always does. ozij, are you still using PB420E? How is it doing? Mine seems to start developing some problems again. when i turn it on it normally ramps to 3 and then back to that blinking In...li, which is normal, but after putting on my mask, the machine should be able to ramp up to my set level of 7, but it doesn't. So, i have to turn it off again and put my mask on right away after turning it back on. also, sometimes it goes up suddenly, too, making high pitch noise and then slows back to 7. Gee, i've seen posts that users have used their systems for over 10 years. for this PB, this is the third one i'm using since i acquired it in 2004. luckily, the last two times the product showed problems within one year of my purchase and i got a replacement. now, the warranty period is over, and i think i've run out of luck.

(She... and thanks for your kind words )

Yes, I'm still using my PB - the one I got two years ago as a replacement for the one that died on warranty after a year of use.

Have you considered snipping off the tip of the sensor tube on the machine side, , or possbily replacing it? I disconnect my hose daily, and notice the tip of the sensor tube eventually gets slightly wider - which means it is somewhat less firm about the machine's nipple. I snip about 2 mms off mine every 2-3 months to ensure there is no minute leak there. This might be voodoo of course - but what can you loose from trying?


O.

I have very good results using the generic Fluticasone nasal spray during allergy season.

Thanks for all of your help and advice. I will be sure to check back and continue to post. Best wishes to you all, -Justin

I'm using Nasonex for my allergies (script from the ENT). Did a medicated rinse for awhile, then he changed me to this.

I have had both UPPP and MMA -- I wish I hadn't had them. UPPP is useless surgery.


I use flonase daily

I use perscription Astelin spray when my allergies kick up. It is not a steroid.

Last night I woke up several times leaking out my mouth, which I almost never do. (And no I don't tape or anything.) I used Astelin & had no more problems the rest of the night.