Six Months on Cpap -Serious Sinus Infections

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Six Months on Cpap -Serious Sinus Infections

Postby sleepyme2 » Wed Mar 14, 2012 5:14 pm

I got my machine with an attached humidifier six months ago. After a just few nights, I adjusted quickly to the nasal pillows. A week into its use my sinuses became irritated, swollen and followed by an ear infection. I stayed off the machine until I got better, about ten days. A few days after getting back on the same thing happened. Since
September, I have had two to three long episodes of sinus isses a month. I do tend to have seasonal sinus problems two or three times a year due to allergies, but I have never had this problem. It has become chronic. I have tried, pillows, a nasal mask and facial mask, hoping to relieve the pressure on my sinues. The pressure on my machine is a low {6}. I have no problems sleeping with any of the masks, but none allowed enough air to get through my nasal passages. When I wake in the morning, my sinuses ache and drain throughout the day, but not completely. I would go to sleep and even more mucus would collect so by the third night I am totally stuffed and would wake gasping for a breath. I saw my algerist and have been using sprays, washes, antihitimines, and increased humidity. Soon I learned to stop using the machine as soon as I felt the build up of mucus, before a fullblown infection got going. I wash the hose, mask and humidifier every day. Since January, I have used the machine only two to three days a week in order to let my sinuses drain. In this period of time I've had several serious sinus infections and one event of vertigo, for which I was treated. Presently, I have a permanently stuffed right sinus that does not want to drain and am once again on antibiotics for an ear infection. I have just been fitted for an oral appliance and will be monitored to see if this will be a betteralternative. I have also noticed that since using the cpap, I tend to overbreathe during the day. I feel very stressed because of this problem. It's been a frustrating six months and a very exhausting. I have had more sleepless nights than ever before. I don't feel any more rested than I did before starting on CPAP.
Has anyone had this history?
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Machine: RepironicsREMstarPro C-Flex+
Mask: pillows, nasal and facial
Humidifier: yes
Year Diagnosed: 2012

Re: Six Months on Cpap -Serious Sinus Infections

Postby mothersongbird » Sat Apr 28, 2012 3:13 pm

I'm having the same problem! I was searching for similar stories, and I was just about to make my own post about it.

When I got my machine about a month ago, I lasted a whole week before I went to the doctor in tears. There were a bunch of problems, and sinus congestion was one of them. The doc said to go off it until the insurance company authorized my narcolepsy meds and I'd been on them a few days. Sinuses cleared up in a few days. When I tried to go back on the machine, I kept getting all panicky and I just flat-out dreaded going to bed. I just had my first followup, and he gave me a firm talking-to about my non-compliance. I tried to explain the problems I had, but he said it was only going to work if I made it work.

Okay. I'm feeling pretty shamed at this point, and I go home to set everything up. He did give me a different mask since I wasn't doing well with either the Swift Fx nasal pillows or the Mirage Quattro full mask. He gave me a F&P Flexifit 407 nasal mask. SOOO much lighter than the Quattro and easier to inhale with than the pillows!

Still, I'm having the same problems and as of this moment, sinus problems are the heavyweights. After the first night, I had a sore throat. So I babied it with extra water and orange juice and throat comfort tea. After the second night, I was completely stopped up. I couldn't even rinse with a netti pot because it kept sending it to my ears instead. Ow. I tried to put the mask on that night (last night), but I couldn't breathe though my nose.

I used to get really bad upper respiratory infections. When I was old enough to take myself to a doctor under my own insurance, I ended up having a tonsillectomy at 19 which helped for a couple years, then at 22, I had a FESS procedure when an infection just would not go away. I refer to it as the time they roto-rooted my face. :-D I have had no major events in the 4 years since, but I'm still familiar with the terrain.

Right now, my sinuses are all stopped up, and I have a sore throat, but no chest congestion. Trying to keep it that way. If certain people are more susceptible to sinus infections anyway, what can we do as PAP users to avoid this extra unpleasantness?
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Machine: ResMed S9
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Year Diagnosed: 2012

Re: Six Months on Cpap -Serious Sinus Infections

Postby truckerdad57 » Sun Apr 29, 2012 8:15 pm

Sleepme and Mothersongbird,

I can't tell from your posts...

Are you using humidification? Do you put water into the humidification chamber and is the humidifier turned on and set to a high enough setting that the humidifer water chamber is almost empty when you wake up?

It sounds backwards but the more water - humidification you can get up your nose from the CPAP the less mucous problems will come up.

Our sinuses do not like dry air. All the dry air from a CPAP dries out the sinuses. They react to being dry and irritated by creating more mucous.

You both have newer PAP with good humidifaction systems IF THEY ARE TURNED ON. One of the patient adjustable controls is the amount of humidification. Read through your user manuals and check. If you can't find what you need call the customer support phone number for your CPAP. I've used both of these PAP and the controls are different for each.

If setting the PAP humidification up higher does not solve the issue, consider adding nasal irrigation (look at the forum stickies for more information). It's flushing out your nose with a saline solution. Sounds gross but feels GREAT.

Last resort- The Resmed S-9 does have a climateline hose option (costs more). This is a heated hose with a humidification sensor at the end of the hose. Using an S-9 with climateline hose set all the way up it feels like you are sleeping in a nice warm wet swamp. For me that's just the ticket during hay fever season when anti-histamines have me all dried out. There are heated hoses (AKA Aussie hoses) available as aftermarket items for other makes and models of PAP. I would try nasal ittigation before I spend the extra money on a climatelien or Aussie hose.

PS... Talk to your sleep doctor about all this. If the sleep doc does not seem to understand what's going on ask to talk to one of the RT's (Respiratory Technicians or an RPGST). These are specially trained folks that work with sleep docs for PAP settings, masks etc. At times the docs don't know as much about the details. Finding a good local A. W. A. K. E. chapter can also help. Being able to talk face to face with other "hosers" you often get quick solutions.

Keep on trying.
(just a truck driver with sleep apnea)
Co-coordinator Truckers for a Cause Chapter of A. W. A. K. E.
awake.truckersforacause.com
Do not substitute information from here for professional medical advise.
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Humidifier: YES - must have
Year Diagnosed: 2002

Re: Six Months on Cpap -Serious Sinus Infections

Postby Dude » Wed May 02, 2012 11:37 am

One more important thing to ask is if you have a HEPA filter in your hose?

If not I highly recommend getting one. Mine looks like 2 funnels put together with the wide ends touching.
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Re: Six Months on Cpap -Serious Sinus Infections

Postby truckerdad57 » Thu May 03, 2012 1:58 am

Phillips has a HEPA filter available for the air intake. Most major PAP do. It just takes some hunting to find them.
(just a truck driver with sleep apnea)
Co-coordinator Truckers for a Cause Chapter of A. W. A. K. E.
awake.truckersforacause.com
Do not substitute information from here for professional medical advise.
truckerdad57
 
Posts: 1014
Joined: Thu May 22, 2008 12:01 am
Location: Batavia, IL
Machine: CPAP tester, you name it I've got 1
Mask: tend to like nasal pillow
Humidifier: YES - must have
Year Diagnosed: 2002

Re: Six Months on Cpap -Serious Sinus Infections

Postby jsbelljr83 » Sun May 06, 2012 8:43 am

I am an old hand to sinus infections, have had two very painful surgury's over the years to correct the problem. Have you seen an ENT doc yet? If not, I would suggest getting seen and have them do a culture of your sinus to find out exactly what type of infection you have going on. Do you eat/drink a lot of dairy products? Dairy increases the mucous production, just something to keep in mind. I use the humidifier year round and keep it on the highest setting and warm air.
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Re: Six Months on Cpap -Serious Sinus Infections

Postby a.b.luisi,d.m.d. » Sun May 06, 2012 3:59 pm

sleepyme2 wrote:I got my machine with an attached humidifier six months ago. After a just few nights, I adjusted quickly to the nasal pillows. A week into its use my sinuses became irritated, swollen and followed by an ear infection. I stayed off the machine until I got better, about ten days. A few days after getting back on the same thing happened. Since
September, I have had two to three long episodes of sinus isses a month. I do tend to have seasonal sinus problems two or three times a year due to allergies, but I have never had this problem. It has become chronic. I have tried, pillows, a nasal mask and facial mask, hoping to relieve the pressure on my sinues. The pressure on my machine is a low {6}. I have no problems sleeping with any of the masks, but none allowed enough air to get through my nasal passages. When I wake in the morning, my sinuses ache and drain throughout the day, but not completely. I would go to sleep and even more mucus would collect so by the third night I am totally stuffed and would wake gasping for a breath. I saw my algerist and have been using sprays, washes, antihitimines, and increased humidity. Soon I learned to stop using the machine as soon as I felt the build up of mucus, before a fullblown infection got going. I wash the hose, mask and humidifier every day. Since January, I have used the machine only two to three days a week in order to let my sinuses drain. In this period of time I've had several serious sinus infections and one event of vertigo, for which I was treated. Presently, I have a permanently stuffed right sinus that does not want to drain and am once again on antibiotics for an ear infection. I have just been fitted for an oral appliance and will be monitored to see if this will be a betteralternative. I have also noticed that since using the cpap, I tend to overbreathe during the day. I feel very stressed because of this problem. It's been a frustrating six months and a very exhausting. I have had more sleepless nights than ever before. I don't feel any more rested than I did before starting on CPAP.
Has anyone had this history?

I am a dentist working in dental sleep medicine. There is no question that, in some patients, the stream of CPAP pressurized air can initiate/exacerbate sinus problems. I wouldn't be at all surprised if you successfully side-step your sinus problems with the oral appliance. It has worked for a significant number of my patients. Let us know how you make out.
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Re: Six Months on Cpap -Serious Sinus Infections

Postby Dude » Mon May 07, 2012 11:00 am

The HEPA filter I use goes in the hose. I think it really helps me.
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Re: Six Months on Cpap -Serious Sinus Infections

Postby mothersongbird » Mon May 07, 2012 9:19 pm

I have an air filter in my machine, but not in the hose itself. I change the distilled water in my humidifier nightly. The tech at the sleep center told me to crank the humidity as high as I can take it, so I turned it all the way up to 86º. I didn't feel there was a problem because I prefer more humid air. I read somewhere in these forums that *too much* humidity can make the tissues in your mouth/nose swell and become irritated. Woulda been a new one by me, but I'll try anything. So I turned it down to a degree or two above room temp. No change- still sore and dry and icky and achy.

I ended up with a nasty sinus infection that is just now clearing up, and perpetual sore throat. I brought it up to my sleep tech. He gave me a different mask to try, along with a chin strap, since my head scarves kept slipping off. He also suggested I try putting a small pillow or something under my chin as I sleep, since I sleep on my side. If my mouth is falling open when I sleep, and all that air is rushing through, drying me out, that's pretty much the set-up for a new sinus infection. Seems like a lot of stuff to have on my face- mask&hose, chin strap, pillow jammed between my chin and chest. Hell, I don't even wear britches to bed, and now I've got to fool with all this contraption! :-D I am not gonna let some stupid machine break me down- I will try every mask, every configuration, every tool and method.

Doc Luisi, it's funny you mention that. When I brought up the fact that I got a new sinus infection both times I'd started APAP, both doc and sleep tech said it couldn't possibly be PAP-related. They'd never heard of such a thing, and was I sure I didn't just have allergies? Yeah, allergies that come and go with APAP use. Are there a fair amount of dentists with that sort of specialty? How would I find one in my area? Just to explore my options.

EDIT: Forgot to say that I've got the climateline hose. No, not a lot of dairy for me, especially recently! I know from plenty experience how much it exacerbates sinus/chest congestion. And by "netti pot", I mean sinus irrigation. My bad! My mother and my friends call it that- didn't realize it might be regional thing(?). I was so congested for a few days, I couldn't even irrigate. It just went straight to my ears- hurt like a BEAST!!
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mothersongbird
 
Posts: 6
Joined: Sat Mar 31, 2012 1:02 pm
Location: Nashville
Machine: ResMed S9
Mask: SwiftFX Pillows/Mirage Quattro Face
Humidifier: H5i
Year Diagnosed: 2012

Re: Six Months on Cpap -Serious Sinus Infections

Postby a.b.luisi,d.m.d. » Fri May 11, 2012 8:27 pm

mothersongbird wrote:I have an air filter in my machine, but not in the hose itself. I change the distilled water in my humidifier nightly. The tech at the sleep center told me to crank the humidity as high as I can take it, so I turned it all the way up to 86º. I didn't feel there was a problem because I prefer more humid air. I read somewhere in these forums that *too much* humidity can make the tissues in your mouth/nose swell and become irritated. Woulda been a new one by me, but I'll try anything. So I turned it down to a degree or two above room temp. No change- still sore and dry and icky and achy.

I ended up with a nasty sinus infection that is just now clearing up, and perpetual sore throat. I brought it up to my sleep tech. He gave me a different mask to try, along with a chin strap, since my head scarves kept slipping off. He also suggested I try putting a small pillow or something under my chin as I sleep, since I sleep on my side. If my mouth is falling open when I sleep, and all that air is rushing through, drying me out, that's pretty much the set-up for a new sinus infection. Seems like a lot of stuff to have on my face- mask&hose, chin strap, pillow jammed between my chin and chest. Hell, I don't even wear britches to bed, and now I've got to fool with all this contraption! :-D I am not gonna let some stupid machine break me down- I will try every mask, every configuration, every tool and method.

Doc Luisi, it's funny you mention that. When I brought up the fact that I got a new sinus infection both times I'd started APAP, both doc and sleep tech said it couldn't possibly be PAP-related. They'd never heard of such a thing, and was I sure I didn't just have allergies? Yeah, allergies that come and go with APAP use. Are there a fair amount of dentists with that sort of specialty? How would I find one in my area? Just to explore my options.

EDIT: Forgot to say that I've got the climateline hose. No, not a lot of dairy for me, especially recently! I know from plenty experience how much it exacerbates sinus/chest congestion. And by "netti pot", I mean sinus irrigation. My bad! My mother and my friends call it that- didn't realize it might be regional thing(?). I was so congested for a few days, I couldn't even irrigate. It just went straight to my ears- hurt like a BEAST!!

To find a sleep medicine dentist go to www.AADSM.org. Use their "Find-A-DENTIST" feature to find an AADSM member in your area. Then call you local sleep disorders center and ask a few sleep docs if they refer to a local sleep dentist. Cross-check the names and make your selection.
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