Nasal changes while on therapy

[Dyssomniac]

I've been on APAP therapy for 3-1/2 months now, and on nearly a daily basis someone says to me, "Are you getting a cold?"

Before APAP therapy, I would say my nasal passages were semi-stuffy but not too bad -- at any given time one nostril or the other might be stuffy, but it would go back and forth and I didn't have a problem breathing through my nose unless I was really sick. Immediately after starting APAP therapy, it seemed as though my nasal passages and sinuses were very dry, and I was getting headaches. I tried different humidifier settings, and the dryness went away fairly quickly. However, since then I have this nasal tone to my voice which prompts the question from friends. It's not that the nasal passages are blocked per se, I just have a different tone to my voice

About a month after starting APAP therapy, I got a sinus infection, and went through a couple of courses of antibiotics which seem to have taken care of it. However, this nasal thing isn't going away.

Besides the antibiotics, I've tried neti pots, nasal irrigators, spray antihistamine (Astelin -- this seems to help with breathing clearly at night with the machine on, but hasn't done anything for the "nasal tone"), spray steroid (Flonase -- hasn't helped much). I don't want to use any decongestants with a stimulant effect such as pseudoephedrine (Sudafed) or Afrin, etc.

If anyone has any other thoughts on this I'd be very interested. Have others encountered issues like this? Will I probably "sound this way" from now on?

[Wulfman...]

I've been on APAP therapy for 3-1/2 months now, and on nearly a daily basis someone says to me, "Are you getting a cold?"

Before APAP therapy, I would say my nasal passages were semi-stuffy but not too bad -- at any given time one nostril or the other might be stuffy, but it would go back and forth and I didn't have a problem breathing through my nose unless I was really sick. Immediately after starting APAP therapy, it seemed as though my nasal passages and sinuses were very dry, and I was getting headaches. I tried different humidifier settings, and the dryness went away fairly quickly. However, since then I have this nasal tone to my voice which prompts the question from friends. It's not that the nasal passages are blocked per se, I just have a different tone to my voice

About a month after starting APAP therapy, I got a sinus infection, and went through a couple of courses of antibiotics which seem to have taken care of it. However, this nasal thing isn't going away.

Besides the antibiotics, I've tried neti pots, nasal irrigators, spray antihistamine (Astelin -- this seems to help with breathing clearly at night with the machine on, but hasn't done anything for the "nasal tone"), spray steroid (Flonase -- hasn't helped much). I don't want to use any decongestants with a stimulant effect such as pseudoephedrine (Sudafed) or Afrin, etc.

If anyone has any other thoughts on this I'd be very interested. Have others encountered issues like this? Will I probably "sound this way" from now on?

And, what humidifier setting did you settle on?
I'm not sure if I have any advice or suggestions at the moment. Maybe others will have.
I can't recall if I've heard or read of this "condition" described on the forum before, but I suppose it may have and I missed it.


Den

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[Sleeprider]

Stick some nasal pillows in those nostrils and they'll open right up

[Wulfman...]

Stick some nasal pillows in those nostrils and they'll open right up

I think it's the tone of his voice that concerns him.


Den

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[Dyssomniac]

Thanks for the responses.

And, what humidifier setting did you settle on?

Currently, usually 4 or 3.

Stick some nasal pillows in those nostrils and they'll open right up

Actually when I was first given a machine to try, I was given nasal pillows. They worked okay, but I had a tendency to mouth-breathe, so they switched me to a full-face mask. Since then I also tried a Mirage Liberty, which essentially is a mouth mask with a couple of nasal pillows extending upward. For some reason I couldn't get good breathing through either of the sizes of the pillows that shipped with that mask, so I went back to the basic full-face mask.

I think it's the tone of his voice that concerns him.

Yes, the nasal passages don't seem any more closed than they used to be, but the tone of my voice has changed. I'm almost wondering if there is more mucus in there now and I need to bring the humidity level down lower. However, I don't want to get it so low that I get the headaches I was getting initially with the machine.

So, in response to my question as to whether this is a common problem with new users of PAP machines, I gather the answer is "not really."

[Wulfman...]

Thanks for the responses.

And, what humidifier setting did you settle on?

Currently, usually 4 or 3.

Stick some nasal pillows in those nostrils and they'll open right up

Actually when I was first given a machine to try, I was given nasal pillows. They worked okay, but I had a tendency to mouth-breathe, so they switched me to a full-face mask. Since then I also tried a Mirage Liberty, which essentially is a mouth mask with a couple of nasal pillows extending upward. For some reason I couldn't get good breathing through either of the sizes of the pillows that shipped with that mask, so I went back to the basic full-face mask.

I think it's the tone of his voice that concerns him.

Yes, the nasal passages don't seem any more closed than they used to be, but the tone of my voice has changed. I'm almost wondering if there is more mucus in there now and I need to bring the humidity level down lower. However, I don't want to get it so low that I get the headaches I was getting initially with the machine.

So, in response to my question as to whether this is a common problem with new users of PAP machines, I gather the answer is "not really."

I don't have any immediate recollection of reading about it, but maybe someone will see and read this thread who may have experienced it and comment.


Den

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[Pugsy]

So, in response to my question as to whether this is a common problem with new users of PAP machines, I gather the answer is "not really."

I don't remember anyone ever mentioning this problem either. While not impossible for cpap to be a factor (nothing is ever totally impossible because we are all individuals) it certainly isn't very common.
Den and I have been here a long time (he longer than me) and I haven't seen this complaint either...at least that I remember and my memory is fairly decent especially when it comes to off beat complaints as new and unusual will usually stick in my mind pretty well.

I am trying to think of anything in the skull/head/facial area that could be responsible for voice tonal changes.
If people are saying you sound congested the it makes me think sinus area. I don't know if a polyp would do it or not.

Have you by chance seen an ENT specialist or at least talked to your primary care doctor about this issue?

It's not common..that's for sure and when people have something pop up that isn't common and they are concerned then my first suggestion is to have it checked out by a specialist.
You have already done just about everything that we would suggest you try in terms of varying humidity, etc.
Should you do go see a specialist and he comes up with something....please share with us what the doctors thoughts are...so we all learn something.

[Dyssomniac]

Have you by chance seen an ENT specialist or at least talked to your primary care doctor about this issue?

Thanks. I was holding off on seeing my primary doctor because I've been finishing the second round of antibiotics for the sinus infection that I also picked up, and I didn't want that to be a complicating factor in discussing the background issue of the nasal speaking tone. The soonest I can see my primary now is in mid-March. I figured between now and then I'd experiment with PAP machine humidity levels and anything else I can think of (for example my nasal irrigation regimen) to see if any of that makes a difference. So it may take a while -- but I'll certainly report back whatever comes of it.

[chunkyfrog]

Not everything can be attributed to apnea or cpap.
Any lasting change in your voice should be investigated by a specialist.
Of course, if it's not cancer, that is most certainly a good thing!

[ericob]

Thanks for the responses.

And, what humidifier setting did you settle on?

Currently, usually 4 or 3.

I may be missing something, but that sounds like the heated hose setting, not the humidifier setting. The humidity settings are only 1, 2, or 3. If you're using SystemOne Humidification and a heated hose, the dial adjusts hose temperature. To change the humidity, you need to use the Setup menu.

[BrooklynCPAPer]

This is the exact same problem I tried to articulate in another thread the other night although this is laid out far clearer than I was being. I also had a sinus infection and it's gone now and am about 6 weeks into APAP. But, I have that nasal tone to my voice and all day long I get asked "are you getting sick?" or "do you have a cold?"

I've turned the automatic climate control off and am down to a 2 out of 8 on humidity and temperature of 81 degrees. It is slightly better but definitely still there. Like the OP, I don't want to go so low on humidity that I wake up dried out.

There - now we have two people stating the same problem so it's not so rare anymore.

[Dyssomniac]

Have you by chance seen an ENT specialist or at least talked to your primary care doctor about this issue?

It's not common..that's for sure and when people have something pop up that isn't common and they are concerned then my first suggestion is to have it checked out by a specialist.
You have already done just about everything that we would suggest you try in terms of varying humidity, etc.
Should you do go see a specialist and he comes up with something....please share with us what the doctors thoughts are...so we all learn something.

Just a follow-up on this topic -- after a bit of a wait, this week I saw an allergist to discuss the sinus/nasal issues I'd encountered while on APAP therapy. After testing me with 40 samples of allergens on my forearms, he concluded that I have a definite allergy to mites. He suggested that as a first step I work on environmental controls (mite-proof pillow covers, washing bedding in hot water, having carpets deep-cleaned, etc). He also suggested that I try using Astelin spray morning and evening since it had been somewhat helpful in opening up my nasal passages. As a last resort he said I could get allergy shots, but it was a fair amount of a time commitment with weekly shots for eight months or more.

I see a fair amount of hits when I do a search for "mites" on this site, and will have to start working through the threads. If anyone has pillows/covers that they've found effective against mites, though, I'd be interested to know. I was interested in some of the pillows that use various types of materials for filling. I definitely need something I can use sleeping on my side. Also, I've been sleeping with a large wedge pillow for some time (along with a couple of regular-sized pillows), and would like to find a way to keep using that -- I wonder if they sell mite-proof coverings for those?