higher AHI due to nasal congestion?

MrRandom · Post by **MrRandom** » Fri May 16, 2008 11:18 am

Ok, I'm wondering if part of my AHI during the sleep study (which was 32) is because of the terrible nasal congestion I had that night?

It seems when I have bad nasal congestion, my machine will record a lot more hypopneas. During the sleep study most of my AHI was due to hypopneas. I know that I will struggle to breathe through a congested nose LONG before I will go to mouth breathing. In fact, I think my nose would have to be pretty much entirely clogged before I'd go to mouth breathing.

So I'm wondering if it's possible my OSA is not as severe as all that and I can just give back this machine because the eye problems are still unbearable.

Plus I'm just wondering exactly how much of my apnea is related to throat collapse and how much is related to nasal congestion.

ww · Post by ww » Fri May 16, 2008 1:19 pm

I sure don't know, so this is just an opinion.

Absolutely none of the apneas or hypopneas were a result of nasal congestion! Your airway closes off when your muscles completely relax in your airway not in your nose. Congestion might cause your titrated values to be wrong since you could have pressure drop in your nasal passage and it would take a larger pressure to hold your airway open.

I also had bad nasal congestion when they titrated me at 7 cm. It seems they were way off in the opposite direction as it now takes 10.5 cm for decent therapy.

After reading your posts and all you have done to eliminate problems with your eyes, it sounds like you have to either give up your therapy (not advised by any means) or find an eye solution you can apply several times a night to keep them wet. Have you asked your eye doctor about a solution that would protect your eyes all night? Have you asked your eye doctor what the risk is of continuing your therapy and just getting dry eyes for a few hours each day? They seem to make lots of eye drops that are over $1000 an ounce, so you would think they would do something!

Just curious, but can you feel the air blowing in your eyes? If you can, then you might want to get some MACKS silicone ear plugs, roll one out kinda flat and stop the mask from leaking completely toward your eyes.

Goofproof · Post by **Goofproof** » Fri May 16, 2008 2:09 pm

Yes, nasal congestion raises AHI. Say you are trying to take in air, if the inlet is closed down, it will create a low pressure area in the lower airways. This causes them to close off. (A Apnea event).

But just because you had congestion, don't use that as a excuse to Jump Into De-Nile

You still need treatment, part of that treatment is XPAP plus overcoming the congestion. Jim

Guest · Post by **Guest** » Fri May 16, 2008 3:05 pm

Have you tried putting in over the counter eye ointment for dry eye to keep the eye moisturized at night? It is by the saline eye drops at most pharmacies. I bought some at Walmart called puralube ointment.

MrRandom · Post by **MrRandom** » Sat May 17, 2008 9:59 am

Hey guys of course you are completely right. I need to treat sleep apnea. I guess I haven't taken it all that seriously because my oxygen levels never dropped below 90% during the studies. I figured at worst I'm going to continue to be tired beyond belief. Still, I'm only 38 years old and I doubt that apnea is going to spontaneously cure itself or get better on its own. Unfortunately. This has got to be one of the most frustrating health problems I've ever had.

Anyway, I just want to say about the ointment, it actually makes the problem much worse for me. I don't have a clue why that would be. It seems counterintuitive because mineral oil and petroleum jelly would not evaporate like artificial tears would. However, each time I've tried using the ointment, my eyes would become dry and inflamed far more quickly, and worse, than using nothing at all or using thick tears (celluvisc). I finally just threw the ointment away. It's obvious that is not going to help at all.

So today I laid down to take a nap with the CPAP because last night I slept without it and feel like crap today. As soon as I put the mask on and turned on the machine I could feel air blowing in the corner of my left eye, from the inside.

Just to be sure I decided to try a little experiment. I took the mask off, put on a swimming nose clip, put the mask back on turned on machine, laid down and breathed through my mouth. Did not feel the air in the corner of my eye. Took nose clip off and laid down again in the same position and breathed through my nose and I could feel it.

At this point I'm pretty well convinced it is coming from inside out, not outside in. The mask seems to be sealed quite well, leak numbers have been under 30, and I know when it does leak it's usually under my chin.

So the eye doctor is going to put punctal plugs also in my upper ducts on monday. If that does not work, I'm going to just try sleeping with the quattro mask and swimmers nose clip. I guess I'd rather have dry mouth than dry eye, though it will certainly take some getting used to.

I am wondering if there is any other way (besides tear ducts) that air can travel from the nasal passage into the eye? Anyone know? I only sorta know the anatomy in there and haven't found much detail in searches I've done online.

JeffH · Post by **JeffH** » Sat May 17, 2008 10:22 am

I was in a car wreck that pretty much remodeled my face. That's why I have air/eye problems.

Again, I use Refresh Liqi-gel drops before I go to bed and anytime I wake up in the night. Do I still get some eye pain? Yes. I just deal with it.

Goofproof · Post by **Goofproof** » Sat May 17, 2008 10:37 am

Just a foolish idea: If they made, or you could get something like a diving mask, that covered the eyes and nose at the same time. The pressure would be equal, that should stop the air flow from the eyes. I know this doesn't exhist, but it could be lab-ratted, from parts of old masks parts, even a FF mask could be made that would cover the eyes too.

You would have to make sure you had CO2 vent flow correct, I have been messing with the vent flow on my ComfortGel and have it blocked to 28 LPM @ 15 cm water pressure, it is causing me no i'll effects and is providing me better treatment.

I did this because of poor manufacturing standards from different runs of the same mask as far as leak rates. I have found leak rates from 31 to 40 LPM at the same pressure with the same ComfortGel mask type. Jim

That's what to expect when you have your products made in China.

MrRandom · Post by **MrRandom** » Sat May 17, 2008 11:00 am

You mean something like this?

https://www.cpap.com/productpage/total- ... onics.html

I considered trying that, wasn't sure if it'd work since air would then be blowing into my eyes from the outside. But if I can find one for a reasonable price on the auction site, maybe. I'm really feeling the pinch here as far as finances go. I can't believe how much basic things like food and gas have gone up in price. Makes it that much harder to deal with needed health care too.

Goofproof · Post by **Goofproof** » Sat May 17, 2008 11:09 am

It looks like I was trying to reinvent the wheel. A mask like that while bulky and unsightly should solve your problem because the pressure is the same all over. (As long as your ears don't blow off)

Probably won't get on on the auction, due to the fact probably won't be that many sold, most people don't have that eye problem. Jim

MrRandom · Post by **MrRandom** » Sat May 17, 2008 11:12 am

Jeff, I use Refresh Celluvisc eye drops. It has the exact same active ingredient as the liquigel and does not contain a preservative (as the liquigel does). The preservatives can actually make your dry eye worse over time so I try to avoid them as much as possible.

I also use Refresh dry eye therapy that has glycerin and polysorbate 80 as active ingredient. This is actually the most refreshing drop of them all (I also use bion tears), but I'm not sure if it contains a preservative.

MrRandom · Post by **MrRandom** » Sat May 17, 2008 11:16 am

I was mad I saw one on the auction site for $10 and I wasn't paying enough attention and got outbid. There's one on there now for $45, but I was a bit miffed the person put it up for auction at $40 then when the other one sold for so low a price $10.50, they raised the price to $45. How annoying. We are not made of money here, people, sheesh. I also can't believe how much people are charging for shipping. I've sold a couple masks on there and it didn't cost any $15 to ship it! At most $8.

JeffH · Post by **JeffH** » Sat May 17, 2008 12:40 pm

MrRandom wrote:Jeff, I use Refresh Celluvisc eye drops. It has the exact same active ingredient as the liquigel and does not contain a preservative (as the liquigel does). The preservatives can actually make your dry eye worse over time so I try to avoid them as much as possible.

I also use Refresh dry eye therapy that has glycerin and polysorbate 80 as active ingredient. This is actually the most refreshing drop of them all (I also use bion tears), but I'm not sure if it contains a preservative.

My eye doc told me the gel part was the key, but you are going to do what you are going to do.

MrRandom · Post by **MrRandom** » Sat May 17, 2008 1:01 pm

He/she was probably talking about the fact that they are highly viscous. The celluvisc tears are as well. They have the same active ingredient

See for yourself:

http://tinyurl.com/6e35zq

http://tinyurl.com/65dsaa

According to this page (link below), they are actually far more viscous than the liquigel. BTW, that page seems to be an excellent resource for choosing the best drops.

http://www.agingeye.net/dryeyes/dryeyes ... atment.php

<i>Celluvisc is a 1.0% solution of a high-viscosity Carboxymethyl Cellulose (CMC). Liquigel is also a 1.0% solution of CMC , however it is blended from a 0.35% high-viscosity and a 0.65% medium-viscosity CMC. This results in Liquigel being less viscous than Celluvisc.</i>

JeffH · Post by **JeffH** » Sat May 17, 2008 2:47 pm

MrRandom wrote:He/she was probably talking about the fact that they are highly viscous. The celluvisc tears are as well. They have the same active ingredient

See for yourself:

http://tinyurl.com/6e35zq

http://tinyurl.com/65dsaa

According to this page (link below), they are actually far more viscous than the liquigel. BTW, that page seems to be an excellent resource for choosing the best drops.

http://www.agingeye.net/dryeyes/dryeyes ... atment.php

<i>Celluvisc is a 1.0% solution of a high-viscosity Carboxymethyl Cellulose (CMC). Liquigel is also a 1.0% solution of CMC , however it is blended from a 0.35% high-viscosity and a 0.65% medium-viscosity CMC. This results in Liquigel being less viscous than Celluvisc.</i>

So if ointment hurts really fast and the Celluvisc hurts pretty fast, maybe you are going TOO thick. Try Liquigel and see if it does any better.

My last advice.

wabmorgan · Post by **wabmorgan** » Sat May 17, 2008 3:15 pm

MrRandom wrote:Ok, I'm wondering if part of my AHI during the sleep study (which was 32) is because of the terrible nasal congestion I had that night?

It seems when I have bad nasal congestion, my machine will record a lot more hypopneas. During the sleep study most of my AHI was due to hypopneas. I know that I will struggle to breathe through a congested nose LONG before I will go to mouth breathing. In fact, I think my nose would have to be pretty much entirely clogged before I'd go to mouth breathing.

So I'm wondering if it's possible my OSA is not as severe as all that and I can just give back this machine because the eye problems are still unbearable.

Plus I'm just wondering exactly how much of my apnea is related to throat collapse and how much is related to nasal congestion.

Nasal congestion can certinly be a contributing factor. It certinly is not helping your sleep apnea and your numbers will look worse when you have nasal congestion.

However I wouldn't advised getting off of cpap treatment without follow-up sleep test saying you don't have sleep apnea, which is not likely to happen.

My advice would be to consult with an Otolaryngologist (ENT) as to the cause of your nasal congestion.

Mask

Additional Comments: Equipment isn't correct, S9 ASV w/H5i

higher AHI due to nasal congestion?

higher AHI due to nasal congestion?

Re: higher AHI due to nasal congestion?