Terrible Nasal Congestion

Greetings all. I'm still pretty new to my CPAP machine. I was diagnosed with severe sleep apnea and was setup with a machine on February 8th. Since then I've had a continuous battle with my nose being plugged up. I picked up some Zicam from the local pharmacy at the time and that works really well for getting my nose to open up but the directions say you are only supposed to use it for 3 days in a row.

During my one month follow up (March 15th) the PA told me to lower the humidity on my machine and she prescribed me Flonase. I haven't really seen any great improvement since using the Flonase. I hurt my lower back this last week so I went in to see my primary doctor and told him about the nasal congestion and he prescribed me Atrovent. I've only been using it for two days so far but haven't really noticed a different yet either.

I use a nettipot almost every day to try and break up my nasal congestion. Some times I get something to come out and other days nothing. When I can get both sides to drain nicely I can breath through both nostrils for a little while but then one or both will plug back up. The inside of my nose is so dry and sometime irritated when I can breath through it. I've been using saline nasal spray and Ayr Saline Nasal Gel to try and get some moisture in my nose. I am at my wits end here.

My next follow up with the sleep center isn't until June. Not that I couldn't get something sooner if needed. During my one month follow up they pulled the data from my machine and my AHI (events/hr) at the time of my study was 59.4 and one month it was down to 1.9. I feel like I'm getting better sleep but this congestion is a real pain.

Surely I'm not the only one who has ran into this problem. Any help you can provide would be greatly appreciated! I love the nasal pillow mask and really want to stick with it if at all possible. The only complaint I've had about the mask is it blows the air straight out. It bugs my girlfriend when I'm facing her so she usually will pull the covers up between us or a pillow. Too bad I can't change how it exhausts the air.

Machine: Philips Respironics REMstar Auto A-Flex
Mask: RedMed Swift FX
Humidifier: Philips Respironics System One Heated Humidifier
Pressure: 8-12 CM H2O

Is one or both sides plugged right now? Any runny nose?

At this moment both sides are plugged. But it has also bounced around from left and right as well. My nose has been a little runny when I'm outside in the cold air but that was a few week ago. It isn't runny now.

Sudafed might help you during the day. Might also ruin your sleep though.

How is the humidity level in house or bedroom?

I used a neti pot to good effect for quite a while, then I found this:





It works a lot better, is easier and neater, and easier to clean up after. And you can use your favorite brand of neti salts if you like.

Nasal congestion is very common side effect of CPAP. search.php?keywords=congestion

I've tried prescription and OTC, both of no use to me
Now only use sinus rise an hour or so before bed and it seem to help somewhat
I need maximum humidity ... some need less while others need none
Experiment to find your sweet spot ... everyone is different

I'm not sure about the humidity levels in the apartment or bedroom. I would guess low? Maybe I can pick something up from a Home Depot that could measure the humidity level. Both my girlfriend and I like the room to be on the cool side. I would guess the room temp to be around 64-67 degrees.

This is what I keep in the bedroom.

You can buy a digital humidity gauge at any Target, Walmart, maybe Home Depot, etc.
http://www.walmart.com/ip/AcuRite-Digit ... r/16888914

30% was my humidity level at the time. Humidifier was a cheapy one from target.

try cranking up the humidity on your machine. I need a lot of humidity to keep form getting congested. I run mine at 4.5.

Do you have the heated hose option with your machine?
What setting(s) is the humidifier set to?

Some people need more moisture and some people need less.
I get horrible congestion when my nasal mucosa dry out...if you are using lesser humidity setting and no relief in the congestion...try increasing it. It does take 2 or 3 days for the added humidity to maybe help with the congestion depending on how dry the nasal mucosa is.
You may need more humidity instead of less. There's no right or wrong...humidity preference is very individualized.

mcvickj,

Eighteen months ago, I was using a full face mask and REALLY wanted to be able to use a nasal mask, but was dealing with one or both nostrils blocked on a nightly basis. I tried nasal irrigation alone, and it helped but didn't do the job by itself. I also tried different humidity settings, but it didn't seem to make a difference.

My ENT suggested I add Nasonex nasal spray at bedtime, and it has worked for me. I eventually was able to decrease the frequency of the nasal irrigation, and just do it occasionally now.

Sprays like Nasonex (Flonase, etc) need to be used daily to be effective.

It's something to consider...

@Pugsy - My humidity setting is current set at 1. I have the option of 0-5 with 5 being the highest humidity level. I'm not 100% sure what those values equal to humidity levels. The System One humidity control maintains a consistent mask humidity be monitoring and adjusting for changes in room temp and room humidity.

@RandyJ - I assumed as much about using the nose spray daily to be effective. I guess I need to talk to my doctor to see if I should be using both the Flonase and the Atrovent together or discontinue one of them.

If you already use Flonase, try using it 30 mins before bed instead of in the morning. That made a difference for me.

As for humidity, I would try with setting at '3' (in the middle) and see how that feels. Then you can go up or down for less or more humidity. I like setting "4" on the System One.

mcvickj wrote:My humidity setting is current set at 1. I have the option of 0-5 with 5 being the highest humidity level.

You are getting the lowest amount of humidity available and probably your nasal mucosa are too dry.
When they dry out they respond by swelling in an effort to maintain some moisture.
I know it seems backwards but that is the response....the swelling causes the congestion.
Works a lot like a bad allergy attack and feels about like it too.

Increase your humidity to maybe 3 or 4 for a couple of nights and see what happens.

Also go get a bottle of something like Simply Saline nasal spray and use it often during the day so that the nasal mucosa can get rehydrated better and quicker.

Some people get congestion with too much moisture but I think most people get congestion from not enough moisture and how much moisture a person needs to maintain happy nasal mucosa is going to vary between individuals. You will need to experiment to see which is best for you.
I do the best with lots of humidity...I tried a setting of 1 a long time ago and that was with a machine that was providing more at a setting of 1 than your current setting does and man was I ever miserable for about 3 days. Horrible nasal congestion, runny nose, sneezing, sinus pressure and pain, etc and it wasn't an allergy attack because I have had it happen since then when I forgot to fill the tank and I ran out of water....same exact symptoms.

I do best with maximum humidity...you may need only a little more or a lot more but you definitely need more than the 1 is offering you. That's really very minimal added moisture.
When I had it happen to me...every time it took a couple of days for the symptoms to abate...my nasal mucosa was really, really mad at me. I don't forget to fill the tank now and I have to do it every night because of where I live and my own nasal mucosa moisture needs.

So an update from last night. I bought a digital humidity gauge at Walmart last night and put it near my CPAP machine. At the time I went to bed the indoor humidity was at 52% and the room temp was 61 degrees. I filled my humidifier tank to the full line and set my level to 3. When I woke up this morning the humidity in the room was at 54% and the room temp was 64 degrees. I checked the water level in the tank and it maybe went down a 3/16 of an inch.