new to CPAP: are nasal pillows bad w/year-round allergies?

Hello all,

I am new to CPAP (2/2/16). I used to have a TAP device, which seemed to prevent terrible nights, but I was always still at least mildly fatigued and often moderately so, and thus when that broke I decided to go for a CPAP. Looking like I'm going to bed in a fighter pilot mask is less of an issue when one is married than when one is in college.

anyways, so far it is going quite poorly for me. My event numbers seem very low (CA is the highest and I am having very low to non-existant OAs and hypopneas) and the machine doesn't think leaks are an issue, but I still feel between moderately fatigued and terrible (today being terrible). I'll give more data from sleepyhead so we can delve into my overall issues when I get home, but my question right now is this:

Do I likely need a different mask? Nasal pillows seemed the least intrusive and most comfortable, which is why I chose them, but I have year-round allergies (despite flonase and/or zyrtec) and as a result my nose is partially plugged/restricted at all times. also, I am not generally a mouth breather, but since getting the CPAP I have on rare occasion awoken to an open mouth and the sound of air. I currently have a (very closely trimmed) beard.

vafan13 wrote: have year-round allergies (despite flonase and/or zyrtec)

Are you under the care of an ENT/Allergist?

vafan13 wrote:also, I am not generally a mouth breather, but since getting the CPAP I have on rare occasion awoken to an open mouth and the sound of air.

When using a nasal interface, a small amount of mouthbreathing will cause a small decline in your therapy. A large amount of mouthbreathing will cause a large decline in your therapy.

Do you use SleepyHead?

5-15 pressure setting

I should add that there is a high probability that your minimum pressure is not high enough. Best to get SleepyHead and do a detailed analysis of your therapy.

allergist: No
amount of mouth breathing: I would guess it's small
min pressure: I wondered that, so I bumped it up to min 7 last night (i was averaging 6-6.5 with 7 being the usual max) and I might actually feel worse today than yesterday, which was bad, too. I do think leaks were worse last night, though.

As far as sleepyhead, yes, I have it. I planned to post data when I get home, but right now I am looking to see if nasal pillows are in general a bad idea with year-round nasal congestion. One site I looked at said yes and it does seem logical to me. Further, putting upward/inward pressure on my nostrils (as the pillows do) with my fingers noticeably increases the restriction from the allergies.

I have the same question. I haven't gotten my machine yet and the doctor suggested nasal pillows which seems a bad idea for someone with allergies who already breathes through her mouth most nights.

vafan13 wrote:Hello all,

I am new to CPAP (2/2/16). I used to have a TAP device, which seemed to prevent terrible nights, but I was always still at least mildly fatigued and often moderately so, and thus when that broke I decided to go for a CPAP. Looking like I'm going to bed in a fighter pilot mask is less of an issue when one is married than when one is in college.

anyways, so far it is going quite poorly for me. My event numbers seem very low (CA is the highest and I am having very low to non-existant OAs and hypopneas) and the machine doesn't think leaks are an issue, but I still feel between moderately fatigued and terrible (today being terrible). I'll give more data from sleepyhead so we can delve into my overall issues when I get home, but my question right now is this:

Do I likely need a different mask? Nasal pillows seemed the least intrusive and most comfortable, which is why I chose them, but I have year-round allergies (despite flonase and/or zyrtec) and as a result my nose is partially plugged/restricted at all times. also, I am not generally a mouth breather, but since getting the CPAP I have on rare occasion awoken to an open mouth and the sound of air. I currently have a (very closely trimmed) beard.

I've only been on cpap since mid-December and also have allergies, I sleep with 2 of them(dogs) and have not had problems with my nasal pillows, but I wouldn't say that my nose is partially plugged all the time either. I just use Flonase. I have found I am breathing better with the humidification actually. Good luck finding your solution.

vafan13 wrote:I planned to post data when I get home, but right now I am looking to see if nasal pillows are in general a bad idea with year-round nasal congestion.

There is no general rule. If nasal airflow is sufficient and there is no or little mouthbreathing, then a nasal interface may work well. If nasal airflow is poor, a nasal interface may be a bad choice.

Nasal and full face masks tend to expand the nasal airway due to the pressure they deliver.

vafan13 wrote:allergist: No

Why suffer? Get a recommendation on an ENT/allergist. During the first office visit he should perform an In Office Nasal Endoscopy & Laryngoscopy - http://www.tampaent.com/treatments-nasa ... el-fl.html

He may also perform some allergy tests.

You are going to be using CPAP a long time. You should get your nasal problems taken care of now. I see people on here who wait and eventually say, "I should have done this years ago."

ShannonCC wrote:I have the same question. I haven't gotten my machine yet and the doctor suggested nasal pillows which seems a bad idea for someone with allergies who already breathes through her mouth most nights.

You seem to be starting out the right way --> Thinking for yourself and questioning what doctors tell you. Keep it up and you will do well.

I have severe allergies too, and use a pillow mask. I find (even with a cold) the pillows push just enough air into my nasal passages to keep my nose clear all night .
Once I latched onto pillow masks I won't done my full face mask for anything.

My ENT also wanted nasal pillows for me and indicated they were actually better for me. However my mouth never closes properly so I use a Hybrid mask - best of both worlds.

Also remember with the cpap machine you are breathing clean moist filtered air for 8 hours - great for allergies. Make sure you have clean filters and look for the extra filters .

What kind of filters do you use in your machine? How often do you change them?
Does Resmed still say every SIX MONTHS? That is INSANE!
https://www.cpap.com/productpage/resmed ... -pack.html
Filters (hypoallergenic) make a huge difference. I change mine every 3 weeks.
I have allergies year round, and this helps a lot. Hardly notice I am allergic any more.
Consider taking an antihistamine. Loratadine has eliminated at least 90% of the "colds" I used to have.
Don't endure allergies--DESTROY them.

chunkyfrog wrote:What kind of filters do you use in your machine? How often do you change them?
Does Resmed still say every SIX MONTHS? That is INSANE!
https://www.cpap.com/productpage/resmed ... -pack.html
Filters (hypoallergenic) make a huge difference. I change mine every 3 weeks.
I have allergies year round, and this helps a lot. Hardly notice I am allergic any more.
Consider taking an antihistamine. Loratadine has eliminated at least 90% of the "colds" I used to have.
Don't endure allergies--DESTROY them.

Whatever type that came with the machine from the DME and I've had the machine for 1.5 weeks so the filter hopefully isn't an issue (yet), but I'll make a point to change them often. Is there any chance the filters that came with it aren't hypoallergenic?

On a filter-related note: Somewhere I saw a thread suggesting one use an in-line outlet bacteria filter to help with allergies. Is this accurate, and can one still use the humidification?

antihistamines: I started up zyrtec recently, and as indicated in the OP, it unfortunately hasn't been super effective, nor has the flonase. gonna give it a bit longer and then try something else.

I've always had chronic sinusitis and allergies. I treat the allergies with Claritin and Flonase.

I love my nasal pillows. They might be, surprisingly, the BEST way to battle a stuffy nose. I begin by resting on my back. (I can't sleep in that position, but I rest there for 10 mins to clear my nostrils a bit. I have a very high tolerance for post-nasal drip. That helps.) The PAP tends to blow my nostrils open a little.

In any case, once I roll on my side I can sleep, and the forced air up my nose keeps the nasal passages from closing up. I clean the pillows every day - between the condensation and the snot, they need it!

Doug

ChicagoGranny wrote:

vafan13 wrote:allergist: No

Why suffer? Get a recommendation on an ENT/allergist. During the first office visit he should perform an In Office Nasal Endoscopy & Laryngoscopy - http://www.tampaent.com/treatments-nasa ... el-fl.html

He may also perform some allergy tests.

You are going to be using CPAP a long time. You should get your nasal problems taken care of now. I see people on here who wait and eventually say, "I should have done this years ago."

+1

Why people mess around with OTC and home remedies, I don't know. Best to first have a doctor find out what is wrong. Maybe the doctor needs to correct the problem. Or maybe it is minor, seasonal allergies and the doctor can recommend OTC treatment.

My allergic rhinitis was diagnosed by my doctor, years ago.
I took prescription Hismanal for several years, until my HMO switched to Allegra, which was ineffective.
I have taken Claritin, and then its generic, Loratadine, for years.
Before, I suffered. Not any more.