Irritated Sinus Passages with nasal pillows?

[CPAPER Paul]

I love the ResMed P-10 nasal pillow mask. Without some minimul type of mask like it, I probably would not have complied at first. But with all of it's pluses, there appears to be one minus: irritated sinus nasal passages.

Daily, usually later in the day, I begin to feel a slight, dull pain in the area around the bridge of my nose in the nearby nasal passages. If I should cough, or sometimes, if I should sneeze, it really hurts.

I was wondering if others had this, or a similar sensation when using nasal pillow masks?

I have tried increasing the humidity and increasing the temperature, but it doesn't seem to help. Short of taking an over the counter analgesic there isn't any real relief.

I notice that my eyes do tend to tear easily as well, though that isn't so problematic.

I have not talked to a physician (ENT, etc.) about this yet.

Any thoughts?

Paul

[Pugsy]

I am coming on 6 years of cpap therapy next month. I have used various nasal pillow masks during that time (never really used anything else except maybe for a short trial) and I have never had nasal/sinus discomfort like you describe.
The closet thing might have been some nasal/sinus issues when I didn't get enough humidity because I either set the humidifier to low or forgot to fill the water chamber and ran out and used things without water.
But even then I had the typical nasal symptoms that go along with too dry nasal passages like sneezing, runny nose, pressure in the cheeks, etc.

Nasal pillows don't, or shouldn't, go that far into the nostril at all and really don't touch anything inside the nostril all that much.

My usual recommendation is to play with the humidity settings to see if it helps or hurts the situation which it sounds like you have already done.

If it is so painful that you feel the need for some sort of pain relief med...I think maybe a visit to the doctor might be in order.

Of course if you have a different mask available you could try something else in the mask department.
I suppose you could also try the usual nasal remedies like netipot rinses or maybe just add something like Simply Saline frequently during the day to see if the added moisture helps.

[CPAPER Paul]

Pugsy,

All good advice... I can't say for sure that the mask is the problem, but I just don't remember having this issue before. I have the humidity set at 3 on the Respironics, and the heater on 1.

Maybe it's too much humidity?

Anyway, I will play around with the settings and see what happens. If that doesn't work I have an ENT to whom I could go.

As always, I appreciate your help.

Paul

[Pugsy]

Typically too much humidity (if it is a problem) will present with the typical allergy like symptoms...congestion, runny nose, sneezing, sinus pressure, etc.
Same symptoms can also happen if there is too little humidity so we just have to tell people YMMV and play with the settings. It's simply an individual preference determined by what a person's nasal mucosa is happy with.
If you have been using the same humidity level all this time without problems then I seriously doubt it's the humidity level but it wouldn't be impossible for you nasal mucosa to have changed their preferences.

You might try altering hose temp first and see if that helps. I had some nasal discomfort when the air was too cool...again it also depends on bedroom temp. My bedroom is COLD by a lot of people standards because my house is normally a lot colder in general until warm weather arrives. My mom comes here in the winter and wears a coat all the time and when I go to her house I am shedding clothes because she thinks 74 degrees is cool.

And of course it might be something totally unrelated to cpap use at all...hence the suggestion to see a doctor.
What you are describing isn't typical or something we see often. Usually there are other symptoms other than just pain.

[ChicagoGranny]

it really hurts

Nasal endoscopy/Office Based Flexible Laryngoscopy

Personally, I believe every CPAPer, who has even a minor problem, should have his nasal airway scoped by an ENT at least one time. A consultation, including the scoping, is usually a $50 copay for most people. A good investment in my opinion, even if they only find that everything looks good.

Good ENTs do the scoping in the office on the first visit. It only takes a minute or two and you can watch the screen and the doc will describe what you are seeing.

Office Based Flexible Laryngoscopy

Nasal endoscopy is probably done in every ENT office more than 10 times per day.

...

A transnasal flexible laryngoscope can be used for office-based diagnostics. This office exam is extremely well tolerated and often performed multiple times per day to patients of all ages. This can even be performed on newborns if medically required. Prior to passing the scope, the patient's nose is decongested and anesthetized with topical sprays that do NOT sting or burn. The patient then sits in an upright position and the scope is passed along the floor of the nose into the back of the throat to a level just above the vocal cords. At this point the patient is asked to breath deeply and phonate, allowing the physician to directly observe the structure and dynamic motion of the true and false vocal cords. There are no lasting side effects to this procedure and the anesthetic spray wears off over the ensuing 1-2 hours.

Common reasons for performing this procedure during your visit include hoarseness, suspected vocal fold lesions, chronic shortness of breath, difficulty or inability to swallow, longstanding history of smoking, the need for postoperative visualization or tumor surveillance, and inability to otherwise visualize the vocal cords during the exam.
http://www.calsinus.com/otolaryngology_ ... nology.php

It is your choice!

[CPAPER Paul]

Granny,

I agree it's worthwhile doing....

When a lot younger (in my teens - probably a hundred years ago or so) I had sinus and allergy problems and saw the ENT regularly. Fortunately, the problem went away and I had not thought about it for many years.

I am out of the country for another week or so, but when I return I plan to see the ENT.

Thanks for the advice.

Paul

[OkyDoky]

Another thing you might consider is Ayer Nasal Saline Gel. Since it is a gel it lasts a little longer than the spray. When my nasal passages where getting dry and bleeding, I used it at night before masking up. Just put some on the end of a Q-tip and gently coat the inside of your nose.

[CPAPER Paul]

OakyDoky,

Thanks for the tip... I don't seem to have a problem with the lower nasal passages, it's only in the sinus passages and I doubt that the gel coating would be of help with them.

At first, when I was given the mask I picked out the medium size nasal pillow and it rubbed my upper lip raw and caused irritation to the lower nasal passages.. at that time your suggestion would have really helped. I'll keep it in mind should I need it.

Paul

[ChicagoGranny]

I am out of the country for another week or so

Did you by any chance have a long overseas flight? Those dry my nasal passages out badly.

Yes, Ayr Gel is a good product and I use it from time to time.

[Quickstrike]

I loved the Aloha and my current Swift FX nasal pillow masks the first few times I used them. Now I can't sleep more than an hour or two before I'm woken up by excessive air and it bothers my sinuses. I've had 3 separate colds in the month I've used pillows...sleeping with the window open doesn't help.