Continued Sinus Issues - Tried Auto on my S9 Last Night

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lytepole
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Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by lytepole » Tue Oct 21, 2014 9:09 am

Hi everyone -

I'm still battling sinus drainage and ear pressure after a couple weeks on CPAP. Here is what I have tried so far:

On straight CPAP with pressure of 12 - I've tried humidity at 2, 2.5, 3, 3.5. I've also tried the auto climate thing where you only move the temp, but I can't stand warm air blowing in my face, so set it on 74 and ended up feeling like I had dry sinuses in the morning. When the humidity setting is in the twos, I'm ending up with thick goopy junk in my nose the next day. In the threes, I'm ending up with thinner stuff. No matter where I am at, I'm getting a lot of drainage down my throat that is giving me a very sore throat. My ears feel plugged up all the time.

Last night, I decided to try moving my machine to Auto instead of straight CPAP and gave myself a range of 10-12, with EPR at 3. Graphs from last night below. I woke myself up a couple times last night becauseit felt harder to breathe with less air blowing up my nose, so that was interesting. Does anything stand out in my graphs?

Any other suggestions? Did anyone else experience these sinus issues when first starting? How long did it take to work itself out? 30 day follow up sleep doc appt next week so will talk with him then too.

Thanks!

Image

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Pugsy
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by Pugsy » Tue Oct 21, 2014 9:24 am

Your graphs are boring...that's good.
I wonder if there is more room for reduction in pressures (might help the ear issues) and still have a really low AHI.

Your sinus/nasal issues...man that's a tough one because I suspect it is related to whatever humidity you are getting but I don't know which way to tell you to go. Nasal mucosa moisture preferences are highly individual and what one person's nose is happy with may not work for the next person.

If it wasn't for the air temp on automatic delivery (80% is what it is supposed to deliver when set to automatic with climiateline)...was your nose otherwise happy with the humidity....you mentioned that at 74 degrees the air felt drier.... but warmer air wasn't real comfortable...if the air wasn't warmer would the humidity level be okay?

When you were using these settings?
lytepole wrote:I've tried humidity at 2, 2.5, 3, 3.5
Did you have the machine set up so you could also use the temperature setting? Or were you just using the humidifier setting alone?

In general...are the higher numbered settings an improvement or make things worse?

Sore throat...could be mouth breathing or drainage. Need to fix the drainage issue anyway...see if the sore throat remains after drainage issue is resolved.

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lytepole
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by lytepole » Tue Oct 21, 2014 9:47 am

Pugsy wrote:Your graphs are boring...that's good.
Yay for boring!
Pugsy wrote: If it wasn't for the air temp on automatic delivery (80% is what it is supposed to deliver when set to automatic with climiateline)...was your nose otherwise happy with the humidity....you mentioned that at 74 degrees the air felt drier.... but warmer air wasn't real comfortable...if the air wasn't warmer would the humidity level be okay?
With the auto delivery at 74, my nose felt dried out the next morning. If I pinched my nose, it felt like it was stuck closed for a minute because it was gooey. [GROSS]
Pugsy wrote: When you were using these settings?
lytepole wrote:I've tried humidity at 2, 2.5, 3, 3.5
Did you have the machine set up so you could also use the temperature setting? Or were you just using the humidifier setting alone?

In general...are the higher numbered settings an improvement or make things worse?
I started out at 2 with no temp adjustment when I first got CPAP. I had some sinus pain.

So, I started bumping up my humidity, started feeling congested, so I've been tracking the last week or so where I'm at and how I've been feeling:

3.5 for several nights + temp somewhere around 74 (I forgot to put it in notes) - felt congested, lots of thin drainage down my throat.
3.0 for a couple nights + temp somewhere around 74 - this is the best as far as sinus pain, but still tons of thin drainage down my throat
2.5 for a couple nights + temp somewhere around 74 (tried 76 one night, but had to turn it down - too warm) - thicker goo in my nose the next morning

Went back to 3.0 last night - but also took Afrin before bed as well as some Sudafed PE - lots of drainage last night during the night and still going this morning, but probably related to the built up goo from the last couple nights and the meds to get rid of it + this thin drainage has always been there since CPAP.



The other weird thing I have going on since starting CPAP is feeling like during the day, my air flow isn't going the same was as it was before. Sometimes when I breathe in through my nose during the day, I feel like I have air bubbles/pockets getting trapped in my mouth. Feels similar to when I get air trapped in my mouth with the CPAP and have to let out a bubble during the night instead of swallowing it.

Thanks for the help, Pugsy!!

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knothead
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by knothead » Tue Oct 21, 2014 10:07 am

I have the sinus problem(drainage), my Dr told me to take a allergy pill daily, especially during this time of year. I have noticed a big improvement, he also gave me prescription for nasal spray(Dymista), this has helped a lot...

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Pugsy
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by Pugsy » Tue Oct 21, 2014 10:17 am

Sounds like cpap rhinitis if you never had this sort of nasal drainage issue before.
Google cpap rhinitis.
It sounds like you are damned either way you go...with more or less humidity which makes figuring out what setting to use really difficult.

You may need to get your doctor involved.

When you used the automatic 80% and the temp of 74...other than the drying sticking together thing...was the congestion and/or drainage improved or not?

I am trying to figure out if more or less humidity (temperature aside for now) is what your nasal mucosa is wanting.

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lytepole
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by lytepole » Tue Oct 21, 2014 11:04 am

knothead wrote:I have the sinus problem(drainage), my Dr told me to take a allergy pill daily

Which allergy pill are you taking? I will have to think about adding one

lytepole
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by lytepole » Tue Oct 21, 2014 11:07 am

Pugsy wrote:
When you used the automatic 80% and the temp of 74...other than the drying sticking together thing...was the congestion and/or drainage improved or not?
I'm going to set it back on auto for a couple nights and report back and will try a few different temps too. My notes for that test were not very helpful so I'll try it again and see how it goes.

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knothead
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by knothead » Tue Oct 21, 2014 11:09 am

lytepole wrote:
knothead wrote:I have the sinus problem(drainage), my Dr told me to take a allergy pill daily

Which allergy pill are you taking? I will have to think about adding one
I take the generic Zyrtec, little white pill daily.

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knothead
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by knothead » Tue Oct 21, 2014 11:13 am

lytepole wrote:
Pugsy wrote:
When you used the automatic 80% and the temp of 74...other than the drying sticking together thing...was the congestion and/or drainage improved or not?
I'm going to set it back on auto for a couple nights and report back and will try a few different temps too. My notes for that test were not very helpful so I'll try it again and see how it goes.

Also just a thought...you might try a Netti Pot sinus rinse about an hour before bed. That helps a bunch to clear me out. This is available in drug stores..

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englandsf
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by englandsf » Tue Oct 21, 2014 11:25 am

I would try NeilMed or other rinse aids in the am and a cortico steroid (again in the am) for a week. It worked for me.

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lytepole
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by lytepole » Tue Oct 21, 2014 3:45 pm

Thanks for the additional suggestions - I do use the Neilmed Sinugator (almost) daily and use a steroid nasal spray as well as Patanase.

I'll keep that up too!

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Pugsy
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by Pugsy » Tue Oct 21, 2014 3:53 pm

Did your sinus/nasal issues get markedly worse when you started cpap?
You had those meds on hand didn't you? So you had a prior history anyway?

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lytepole
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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by lytepole » Tue Oct 21, 2014 4:47 pm

Yes, I had sinus and allergy problems before, but they were very well managed after two years of allergy shots and the right meds.

The constant draining, sore throat, and ear pressure I'm experiencing now feels like my very worst allergy season years ago, before I ever was getting treatments.

I'm 99.999% certain the current symptoms are from the CPAP as it started immediately after hooking up at night and has not let off.

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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by Pugsy » Tue Oct 21, 2014 5:13 pm

I thought that was the case...cpap made things worse.
I had something similar when I tried a low setting on the humidifier when I was first starting therapy. I learned real fast my nose doesn't like dry.
But I know that other people get the same reaction with too much humidity.

It's the nasal mucosa pretty much acting like it is in the middle of a bad allergy attack...that's what nasal mucosa do when they are unhappy...they swell up and itch and make us sneeze and produce lots of gunky drainage..all that good stuff.
They are fighting an irritation...now how to reduce the irritation is what is sometimes difficult to figure out.

It's tied to the humidity but I don't know which way you need to go. Since you have been using on the low end and things have been really bad I would tend to want to go to the high end to see what happens...that's why I wondered about the automatic and 80% thing. There's a reason they use 80%..it's because that's where most people's nasal mucosa are the happiest.

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Re: Continued Sinus Issues - Tried Auto on my S9 Last Night

Post by Greg Riddle » Tue Oct 21, 2014 6:33 pm

Pugsy wrote:Your graphs are boring...that's good.
I wonder if there is more room for reduction in pressures (might help the ear issues) and still have a really low AHI.

Your sinus/nasal issues...man that's a tough one because I suspect it is related to whatever humidity you are getting but I don't know which way to tell you to go. Nasal mucosa moisture preferences are highly individual and what one person's nose is happy with may not work for the next person.

If it wasn't for the air temp on automatic delivery (80% is what it is supposed to deliver when set to automatic with climiateline)...was your nose otherwise happy with the humidity....you mentioned that at 74 degrees the air felt drier.... but warmer air wasn't real comfortable...if the air wasn't warmer would the humidity level be okay?

When you were using these settings?
lytepole wrote:I've tried humidity at 2, 2.5, 3, 3.5
Did you have the machine set up so you could also use the temperature setting? Or were you just using the humidifier setting alone?

In general...are the higher numbered settings an improvement or make things worse?

Sore throat...could be mouth breathing or drainage. Need to fix the drainage issue anyway...see if the sore throat remains after drainage issue is resolved.
Your comment about humidity levels being very individual are very good. I keep reading about people recommending to turn down the humidity. I tried it and my nasal discharge got worse.
Right now I have the temperature set at 86 degrees and humidity is set on auto. But the humidity is set high enough to empty the tank every night