Looking for sinus thoughts.

[Gregg]

I am having increased sinus troubles. I have been to two doctors. One prescribed Flonase, and the other prescribed something else. The last one did so to see if my problem was allergies. Neither nasal spray did a thing.

Whenever I lie down my sinuses swell up, and it is hard to breath out of my nose. Almost always. But not always. But even when it's not really bad, it's still the case that they swell up. It can be one side or the other, or both. And it can also happen when not laying down. Sometimes it happens on it's own, and sometimes it seems to be brought on by heavy exercise. I rode my bike 20 miles yesterday at a race pace, and when I got back my sinuses began to swell.

Sometimes the sinuses swell upon laying down to go to sleep, and midway during the night they open.

Even when my sinuses are "open", I always have some resistance in one or the other nostrils.

I should also add that breathe rite strips do essentially nothing. I've even doubled them up.

I've changed my diet. I've lived in several different places. I can also add that I lived at elevation on two properties, and in both places my nose would bleed pretty heavily. I've never had a nose bleed in my life up until then, nor since.

I'm hoping I can get some replies that can help me to try and discover either what this is, or how to determine it. I don't live anywhere near an ENT, so that complicates things. And I've searched high and low on the internet without getting answers.

Thanks.

One thing I should add is that there are exercises that open my sinuses up totally. One is when I'm on the bike.

I also forgot to mention that I've done the whole netipot thing. Didn't do anything.

[Perrybucsdad]

Have you tried adding humidity to see if that clears things up r makes them worse? For example, what happens if you go into the bathroom, close the door, turn on the shower and make the water fairly hot (don't worry, you are not going into the shower) and then let the steam build up. Then sitting there, breath in through your nose. After 30 minutes of this, are your sinus's better or worse?

[robysue]

Sounds like you've got some kind of nonallergic rhinitis going on.

A really fine source of information about sinus problems and nasal problems and how they relate to PAP therapy is Dr. Krakow's The Nose Knows video series. He has one very long part on nonallergic rhinitis and the difficulties that patients with nonallergic rhinitis face with PAP therapy.

I'd start there for ideas to try.

[Gregg]

Have you tried adding humidity to see if that clears things up r makes them worse? For example, what happens if you go into the bathroom, close the door, turn on the shower and make the water fairly hot (don't worry, you are not going into the shower) and then let the steam build up. Then sitting there, breath in through your nose. After 30 minutes of this, are your sinus's better or worse?

Worse. Thanks for asking. I forgot to mention this. If I get in the shower, it's only a matter of minutes before my sinuses are swollen shut.

[Gregg]

Sounds like you've got some kind of nonallergic rhinitis going on.

A really fine source of information about sinus problems and nasal problems and how they relate to PAP therapy is Dr. Krakow's The Nose Knows video series. He has one very long part on nonallergic rhinitis and the difficulties that patients with nonallergic rhinitis face with PAP therapy.

I'd start there for ideas to try.

Thanks. I was reading about that. I just didn't see any solutions. I'll watch the videos. Great..

[robysue]

Sometimes the sinuses swell upon laying down to go to sleep, and midway during the night they open.

Does this happen WITH PAP? Without PAP? Or both?

In other post you indicate that your nose and sinuses react badly to added humidity. So have you considered not using the humidifier at all? As in disconnecting it from the machine and just attaching the hose directly to the blower unit? And though it sounds counterintuitive, if you are not a predominate mouth breather, using nasal pillows may help since the air is blown directly into the nostrils

Even when my sinuses are "open", I always have some resistance in one or the other nostrils.

Does the "freer" side typically switch back and forth for what seems like no reason at all? If so, it could just be that you are very sensitive to the variations in your nasal cycle. It's perfectly normal for one or the other side to seem more "open" and doing more of the work breathing for a while and then for the "open" side to start to feel stuffy as we switch to using the other side for more of the breathing. Google "Nasal Cycle" and you'll get some hits.

I've changed my diet.

What did you eliminate? What did you add to the diet? And are you keeping yourself properly hydrated?

[n0hardmask]

I am having increased sinus troubles... Whenever I lie down my sinuses swell up, and it is hard to breath out of my nose. Almost always. But not always.
>Even when my sinuses are "open", I always have some resistance in one or the other nostrils.
>One thing I should add is that there are exercises that open my sinuses up totally. One is when I'm on the bike.
>I also forgot to mention that I've done the whole netipot thing. Didn't do anything.

Howdy, Gregg and 'welcome' to sinus hell. Wish I was facetious, but I've had nearly that bad sinuses with allergy/asthma for a long time. I'll start and end with - if you find a solution, I'll try it too.
My best remedy was a very warm humid sauna/steam room, but obviously that doesn't work for you. I would get up anywhere between 2a and 4am and have to go to the gym steam room cause I couldn't breathe. Steam rooms are nearly nonexistant any more.
Today I use Eucalyptus vapor rub (Vicks) directly inside my nostrils, and like last night, sometimes that doesn't work so well. Sounds like you know the rest of the drill.. nose sprays, antihistamines and/or decongestants, and nasal RotoRooter jobs. A couple years before I met CPAP I had a septum straighten operation to reduce my propensity for sinus infections, and a few months later, the ENT recommended a Turbinates reduction operation. I opted out of a second surgery, only to have the mild Apnea determination.. and, frankly, CPAP is much better so far than the nose operation was.
Good luck, and - if you find a solution, I'll try it too.

[Gregg]

Sometimes the sinuses swell upon laying down to go to sleep, and midway during the night they open.

Does this happen WITH PAP? Without PAP? Or both?

In other post you indicate that your nose and sinuses react badly to added humidity. So have you considered not using the humidifier at all? As in disconnecting it from the machine and just attaching the hose directly to the blower unit? And though it sounds counterintuitive, if you are not a predominate mouth breather, using nasal pillows may help since the air is blown directly into the nostrils

Even when my sinuses are "open", I always have some resistance in one or the other nostrils.

Does the "freer" side typically switch back and forth for what seems like no reason at all? If so, it could just be that you are very sensitive to the variations in your nasal cycle. It's perfectly normal for one or the other side to seem more "open" and doing more of the work breathing for a while and then for the "open" side to start to feel stuffy as we switch to using the other side for more of the breathing. Google "Nasal Cycle" and you'll get some hits.

I've changed my diet.

What did you eliminate? What did you add to the diet? And are you keeping yourself properly hydrated?

I am properly hydrated. Not quite a gallon per day, but trying.

My diet is per The Paleo Diet. Which I strongly suggest to everyone. I have not totally eliminated dairy, nor all salt. But basically I'm now eating a diet of fruits, vegetables, high quality proteins and fats. It is a huge improvement in my life. I'm very healthy.

With or without the humidifier I have the problem. I used the cpap without humidifier for a year. Then decided to turn it on, and no improvement in sinuses.

I've thought about the nasal pillows. I think that's going to be my next step. It seems that the face mask, or just cpap in general, is causing real problems with my sinuses.

[archangle]

Have you tried sleeping in a recliner?

Sometimes, if you lie on the left side, your right nostril may clear out and vice versa. Sometimes I can clear out my sinuses this way. I have to tinker a lot with the exact position, and how the pillow presses on my face seems to make a difference.

[jamiswolf]

Hi Greg,
I used to deal with congestion big time, but over time things have improved.

You mentioned you changed your diet. Sounds like you're on the right track. Food allergies are often mild and manifest in nasal congestion. How I identified my biggest offender was to follow a protocol I read about. If you can fast for a day or two to purify a bit...and then add foods back one at a time to see how you react. For me, the worst offender (and a common one) was wheat. If I eat bread or even a beer, my airways become very congested. So I now eat corn tortillas and drink tequila, Ole!

Just to clarify, your big issue seems to be your nasal passages and not your sinuses. They often go hand-in-hand, but sinus problems and blockage are actually a bigger problem and sometimes manifest with pressure or pain on the cheeks (maxillary) and the forehead (frontal) and the ethoidmal sinuses are a little deeper. Don't mean to be picky but it helps sometimes to be totally clear about what's being discussed.
Take care,
Jamis

[Gregg]

What is really bugging me is this-

Even if my sinuses, or whatever it is, is swollen to where there is resistance to breathing, when I do vigorous exercises, they open right up.

Tonight I'm really upset about this whole thing. I watched that video, and I can see that cpap is aggrivating the situation. It has been obvious. So tonight I'm going to sleep without it. And man I am worried. Not to mention I've got a 4-5 hour bike race tomorrow. I may wake up with a head like a lead balloon.

But I don't see what the culprit is. I'm very poor at doing things in a scientific way. And I'm a mechanical engineer. You'd think I could organize my efforts into a coherent plan. I don't see the offending problem. This spans different houses, locations, diets. And I've changed diets completely, several times. I have no animals any more. So that's not it.

I think the clue of vigorous exercise must be worth something. I have no itching, no sneezing, no runny nose.

Additionally, up until 40 I never had any issues with sleep or breathing. Every night was refreshing. I woke up at 6am ready to go.

This is seriously impacting my life. I'm starting to lose it.

One more thing. I find it revealing that after years of using the bathroom every night, several times, from the first day I started cpap, I never got up once to urinate at night.

The video mentioned Astilin as the most effective action against nonallergic rhinitis. Maybe that's a good place to start.

I'd give anything to get my life back. It's so weird that I'm awake at 10pm, and then fatigued at 8am when I wake up. Everything is backwards.

[jamiswolf]

Greg,
Sorry about your issues and wish I had more to offer.

Did this congestion start when you started CPAP? Could there be something you're reacting to with your machine or with cpap? What humidity level are you using. Do you live in a desert climate?

Both too little and too much humidity can cause congestion.

Is your bedroom clean and with good clean air? Don't mean to be personal, but such things matter. I personally am a bachelor and a slob and have had to change my habits. I also use an activated charcoal room air purifier to make sure I have clean air while I sleep.

Oh, your comment about getting up to pee but not after cpap. That's completely normal and one of the benefits of using cpap and getting good sleep.

I find even if I have a little congestion, when I fire up my cpap machine, that clears it up. So I'm having just the opposite effect.
Jamis

PS: Did you give the Flonase a good trial. It is not like Afrin where you spray and get relief. Can take a week or more to get good relief. It's a nasal steroid and needs to be used daily.

[Gregg]

I really want to thank Robysue for posting that video. As a result, I am stopping cpap until I get a handle on the sinus/nasal problem. On one hand I'm thrilled to even find an identification of the problem. But I'm not so happy that it could be a difficult job curing it. I may need help. Fortunately, from that video link, there is help.


The congestion started before cpap. I have a daily health diary that may or may not even indicate the beginning. It's interesting how we can be unconscious of something until it starts shouting at us. My sleep problems started when I moved to the country. Between people and their stinking roosters, dogs, logging all night long, peacocks, living under jet flyover corridors, and other things that most people don't even hear, I started having problems with sleep. There is also another problem which I think I'm resolving. And hydration. But these things took years before I was able to be conscious or deal with them.

I'm really hoping this isn't due to the two hours of biking per day that I do. Because that is my life. I exercise every morning for a few hours, and then go off through the forest on my bike. It's a hard life to beat. And I'm 55, going on 25 as far as physique.

My bedroom? Haha. I ought to post a picture. It's 40' by 60' with a 20 foot ceiling. And it's new. I had an old rug in it that I thought could be contributing. I pulled it, but that's not it.

I gave the Flonase a six month trial. It didn't do the trick.

For the record, the swelling and plugged sinus/nasal passage can literally go from one nostril to the other in a matter of minutes. Sometimes. And something they said in the video rings true. Anxiety may play a roll. Last night I woke up with both nostrils plugged. I have done this many times before, where I relax totally. It take some concentration. And sometimes some coaxing by plugging the nose and putting some pressure behind it. I got the left nostril open. And it stayed open until morning. If I do this when one nostril is plugged, I've had it switch notrils in a matter of minutes. It will go from one side plugged to the other. I suppose that info might be helpful if I talk with a physician about this.

Thanks everybody. I appreciate your input.

I forgot to make my point. I'm racing out the door to a very special group bike ride today. I probably had breathing issues with my nose for years before I realilzed it. They may have been undetectable at first, and maybe crescendoed into something that finally began interfering with sleep.

Greg,
Sorry about your issues and wish I had more to offer.

Did this congestion start when you started CPAP? Could there be something you're reacting to with your machine or with cpap? What humidity level are you using. Do you live in a desert climate?

Both too little and too much humidity can cause congestion.

Is your bedroom clean and with good clean air? Don't mean to be personal, but such things matter. I personally am a bachelor and a slob and have had to change my habits. I also use an activated charcoal room air purifier to make sure I have clean air while I sleep.

Oh, your comment about getting up to pee but not after cpap. That's completely normal and one of the benefits of using cpap and getting good sleep.

I find even if I have a little congestion, when I fire up my cpap machine, that clears it up. So I'm having just the opposite effect.
Jamis

PS: Did you give the Flonase a good trial. It is not like Afrin where you spray and get relief. Can take a week or more to get good relief. It's a nasal steroid and needs to be used daily.