Does CPAP cause congestion?

[NMchop]

I've been congested the last 3 nights. Driving me crazy.

I'm only on Day 12 of therapy, got 3 hours sleep this morning is all.

CAN CPap cause congestion?

I also may just have allergies or a cold bug, but it doesn't feel like a cold.

[Sleeprider]

High levels of humidity can cause congestion. You might turn down the humidity level a bit.

[Pugsy]

It's not so much cpap itself but most likely related to humidity.
Google "cpap rhinitis" and you will see what I mean.

You may need more or less humidity to keep your nasal mucosa happy.
When the nasal mucosa get unhappy (from either too much or not enough moisture) they react just like they do when they are fighting off a cold bug or allergens...they swell up and start to produce excess fluids.

I get horrible allergy like symptoms when my nasal mucosa get dried out...so my nose likes lots of added moisture but some people find that too much moisture does the same thing. It's a highly individual thing and there is no right or wrong in this situation.
It's just something that you have to figure out what keeps your nasal mucosa happy.

So I tell people if they aren't using a humidifier...use one.
If they are using a humidifier at a low setting...increase the humidifier setting.
If they are using a humidifier at a high setting....decrease the humidifier setting.
If they are using a humidifier at a middle of the road setting...toss a coin as to which way to go but if going by the majority of cpap users...increase the setting if playing the odds.

Remember also that ambient humidity levels can affect how our nasal mucosa respond...and also it is entirely possible that some symptoms would be present even if you didn't use cpap therapy...like if you tend to have allergies this time of year or if you are really coming down with a cold.

[chunkyfrog]

My husband has previously tried all the solutions mentioned on this forum for this problem, without success.
I used to think it was just him being a big baby, but now I am convinced this is a real thing.
He claims the machine gave him an infection.
Unfortunately, it is unusual enough that the medical profession seems to have no interest in addressing it.
Maybe our pneumonologist has an idea. Our yearly appointment is Wednesday.

[borgready]

Yes, it will cause the nasal passages to swell causing congestion. Use an afrin type nasal spray 1/2 hour before bed time.(Oxymetazoline hydrochloride is one version and is affordable) Its good for about 9 hours. Your nose is likely already restricted but the cpap justs adds that extra irratation that makes it impossible to breathe through the nose. If you can't breathe through the nose then cpap is pretty much useless.

I'm not sure of all the side effects of Oxymetazoline hydrochloride aka Afrin nasal spray. It may keep you from getting the full amount of sleep. It will be interesting to see what others have to say from their experiences.

There are other nasal sprays and meds so maybe others will post what they use and if its over the counter or prescription.

I would say nasal swelling/ congestion is the biggest problem that keeps cpap use from being successful and its the last thing a doctor will look at unless the patient complains of congestion. Newbies get frustated and will usually quit because the swelling will occur from 1/2 to 2 hours during use and will result in the patient ripping the mask off cause they can't breathe.

[chunkyfrog]

There have been reports that Afrin is addictive.

[englandsf]

Afrin is very dangerous in that it is addictive, you should not use it for more than a few days, and it will cause horrendous rebound congestion. Try nasal rinsing and cortico steroids instead.

[janet444]

Yes, I used CPAP successfully for over a year, but I'm having trouble dealing with the congestion now too, to the point that I've stopped using the machine. I need to try to get back on it. For me, it's not so much nasal congestion as it is thick phlegm at the back of my throat and a cold nose. Sorry to be so disgusting. But it is disgusting and makes sleep more difficult, not easier. I'm using a heated hose, but that doesn't help, plus I don't think I can adjust the humidity when I use the heated hose.

I came back here to look up the great advice I had been given when I started two years ago. It got me off to a great start and I was successful with the machine for a long time. Just wanted to add my two cents as another voice letting you know it really is probably the machine.

Janet

[Pugsy]

I'm using a heated hose, but that doesn't help, plus I don't think I can adjust the humidity when I use the heated hose.

Yes, you can change the setting so that even with the heated hose you can set the amount of humidity to be delivered and the temperature of the air independently.
The default for when the Climateline heated hose is attached is for "automatic" which does only allow air temperature change but you can go into the clinical setup menu and change it from "automatic" to "manual" and it will allow settings for for humidity and temperature independent of each other. 2 choices.

The automatic setting is supposed to deliver 80% humidity no matter what the temperature setting and if that is too much or too little then we advise people to change the setting over to "manual" and adjust the humidity and air temp that way.
So if a person wanted less than 80% but they still wanted the warmth of higher temps they can get things more customized to what they need or want.
So you may be one of those people who finds that the 80% humidity causes congestion but you want the warmth of the air because your bedroom air temp may be on the cool side...changing it to manual will allow you to set the humidity lower and not give up the warm air.

[robysue]

Yes, it will cause the nasal passages to swell causing congestion. Use an afrin type nasal spray 1/2 hour before bed time.(Oxymetazoline hydrochloride is one version and is affordable) Its good for about 9 hours.
...
I'm not sure of all the side effects of Oxymetazoline hydrochloride aka Afrin nasal spray.

The problem with the afrin-type nose sprays is that they will trigger rebound congestion if they are used for more than 3 days at a time. Which means that if you use these nasal sprays for an extended period of time, you will start to get congested every time the spray starts to wear off. Not good if you're dealing with chronic nasal congestion.

There are other nasal sprays and meds so maybe others will post what they use and if its over the counter or prescription.

In reading boards like this for the last five years, the usual suggestions for CPAP-related congestion include:

• Change the humidifier setting. And change the hose temperature if you are using a heated hose. As Pugsy explained, some noses like a lot of humidity and some hate it. Some noses also like a lot of heat and others hate it. If the lowest setting of the humidifier still seems like too much humidity (and heat) turn the humidifier off and use it in passover mode. Or remove the humidifier and just use the blower.
• Saline nasal sprays (which can be used every day with no risk of rebound congestion) can help. So can neti pots and sinus rinse bottles. The neti pot should be used at least 30-60 minutes before you go to bed so you don't have a drippy nose to contend with inside your mask.
• Prescription nasal sprays such as Flonase can help.
• OTC decongestant medicines can help---if you can tolerate them for long periods of time. They don't tend to trigger rebound congestion as easily as decongestant nasal sprays do.
• If it's allergy season for you OR if you have year-long inside allergies (to dust or pet dander), taking OTC antihistamines can help keep the nasal congestion from getting severe enough to cause serious problems with PAPing.
• Changing mask style can help. If using a nasal pillows mask, consider trying a nasal mask that goes over the nose. If using a nasal mask, try using a nasal pillows mask.
• If nose breathing is difficult in the first place, then a full face mask may be the answer. A lot of us will do almost anything to avoid a full face mask, but there are also a lot of full face mask users here who swear by them. If you tend to breathe through your mouth anyway, it's worth a try.

It's also worth point out that both Dr. Krakow and Dr. Park have some really useful web resources about CPAP-related nasal congestion. See Unstuff your stuffy nose by Dr. Park and the Nasal Breathing Video Series by Dr. Krakow.

I would say nasal swelling/ congestion is the biggest problem that keeps cpap use from being successful and its the last thing a doctor will look at unless the patient complains of congestion. Newbies get frustated and will usually quit because the swelling will occur from 1/2 to 2 hours during use and will result in the patient ripping the mask off cause they can't breathe.

I'm not sure I'd say that nasal congestion is the biggest problem that keeps newbies from becoming happy, long term PAPers. But it is certainly one of several very common seemingly insurmountable problems that lead people to quit PAP. The sad fact is that too many newbies quit PAP for reasons that seem insurmountable, but are not---provided the new PAPer can find experienced PAPers who have managed to figure out ways to overcome the problem or at least live with the problem. Very few new PAPers are pointed towards CPAP support groups run by PAPers like this forum.

[borgready]

Right now I am a long time user of the Oxymetazoline hydrochloride Afrin type nasal spray. I've been using it for several months. I do get the mild rebound congestion during the day but when used at nights for sleep it does work and seems to work very well. I don't know what some people mean by addiction. What are the addiction symptoms that occur? The only addiction that I can see is that its nice to get some sleep. The only bad thing that I might say is that it might effect the amount of sleep you get as sound sleep. I can usually max out at 4 hours. Any more and I am wide awake and can't sleep anymore. So I am not sure if this is a side effect of the nasal spray or just normal sleep pattern.

I would like to know what other people are using everyday for congestion relief and what are the problems from using long term are. Don't say what you heard or read, but what you use or what you used and it didn't work.

Anybody use nasonex or flonase or any other corticosteroid type spray. Do they work? How do you use them so that they are effective? Anyone used them everyday for over a year?

[VVV]

Right now I am a long time user of the Oxymetazoline hydrochloride Afrin type nasal spray.

Prolonged or too frequent use of oxymetazoline may irritate nasal mucosa.

People are telling you it is addictive, but their terminology is incorrect. The correct word is "reliance". With most individuals, reliance happens after 5 to 7 days of use. Reliance means you get congestion caused by discontinuing use and must use again to open up the nasal passages.

Oxymetazoline should not be used more than three or four days. You likely are reliant on it and if you try to skip it one night, you will be horribly congested.

If you want to "get off" this drug, use it in one nostril only for several nights. The other nostril will likely be clogged, but after a few nights it will open and you can discontinue the drug in the other nostril. The second nostril will likely take a few nights to open up.

Anybody use nasonex or flonase or any other corticosteroid type spray. Do they work? How do you use them so that they are effective? Anyone used them everyday for over a year?

These are approved for long term use and are effective for most people.

But you really need to see an ENT/Allergist. Have him scope your nasal airway and after interviewing you he may also run allergy tests. There are plenty of good treatments available. You need to treat yourself better than OTC junk.

The problem with the afrin-type nose sprays

You should know that oxymetazoline causes insomnia in some people. I am one of those people. I would love to be able to use oxymetazoline occasionally before bed for transient congestion. But every time I try, I lie awake for three or four hours until the effect in the blood stream starts to wear off.

[TangledHose]

I was a daily user of Afrin a few years ago and I suffered the rebound effect to a high degree........it was very difficult to get off the stuff, but I went cold turkey and suffered for several days before my nasal passages returned to a more normal pre Afrin state. My primary care doctor actually studied and wrote a paper on this rebound effect, it is very real and I can attest to that fact. It's too bad I wasn't smart enough to do what VVV suggested and stop using one nostril at a time..........that probably would have saved me a lot of misery!

At this point I do the Neil Med nasal rinse similar to Neti pot, but I use the squeeze bottle version to increase the water pressure to my liking. After the nasal rinse I will often use Flonase with no ill-effects, I find that I don't always need the flonase so some nights I skip it, but if I am feeling congested I go ahead and use it with no qualms. Probably been using the flonase for about three years now, maybe four nights out of a week........I recently saw that flonase is now available over the counter in the same strength as the prescription version, so that's much more convenient than prescription run around.

Two other products that are useful, and not harmful or do not cause reliance is Ayr nasal gel, and my favorite product of all is Ponaris nasal emollient which I order through Amazon. So my primary routine is Neil Med nasal rinse followed by a few drops of Ponaris nasal emollient in each nostril which has it's own natural decongestant effect and a nice mild pine scent. One precaution with the Ponaris is that you want to be careful to not inhale it like you do a spray.......its to be applied with a dropper and just put the drops in your nose..........if you inhale strongly enough it might be possible to aspirate the drops into bronchial tubes or lungs which you would not want to do.

We are all different in our humidity needs, but I find that above average cpap humidifier settings also help me stay decongested ............ as a matter of fact I have much clearer nasal passages and sinuses with cpap heated humidifier than I ever did pre-cpap days. I get so much relief from breathing heated, humidified air from my cpap that if I was ever deemed Apnea free and no longer needed the cpap I would still use it just for the heated, humidified air that helps my sinuses so much!

[archangle]

Right now I am a long time user of the Oxymetazoline hydrochloride Afrin type nasal spray. I've been using it for several months.

Most OTC nasal sprays, including Afrin, are bad long term. After a while, you may find you have to use it all the time to be able to breathe. Chronic users find they have to keep a bottle at bedside and take another fix every few hours to be able to breathe. It's irritating to your nose even when you're currently unstopped. You may end up no worse off even after a spray than you were before you started using it.

The manufacturer says not to use it more than 3 days.

Some of the newer sprays, such as the steroids are more suitable for long term use, but there are concerns about them with long term use.

TL:DR - Don't use Afrin or similar sprays for long term use.

[postitnote]

Right now I am a long time user of the Oxymetazoline hydrochloride Afrin type nasal spray. I've been using it for several months. I do get the mild rebound congestion during the day but when used at nights for sleep it does work and seems to work very well. I don't know what some people mean by addiction. What are the addiction symptoms that occur? The only addiction that I can see is that its nice to get some sleep. The only bad thing that I might say is that it might effect the amount of sleep you get as sound sleep. I can usually max out at 4 hours. Any more and I am wide awake and can't sleep anymore. So I am not sure if this is a side effect of the nasal spray or just normal sleep pattern.

I would like to know what other people are using everyday for congestion relief and what are the problems from using long term are. Don't say what you heard or read, but what you use or what you used and it didn't work.

Anybody use nasonex or flonase or any other corticosteroid type spray. Do they work? How do you use them so that they are effective? Anyone used them everyday for over a year?

I used Flonase but it dried me out so badly that it was painful. The addiction to Affrin is that you keep spraying it up your nose to breathe. I have an aunt who uses it every hour or more! Not kidding. She can't breathe through her nose without it. I used it for several months a few years back and for me the addiction was simply using it when I woke up and 12 hours later. You just do it without thinking if you need it or not. You do get rebound congestion when you quit but it's for a few days only and I promise nothing similar at all to withdrawal from say pain meds! Okay, that's why I use the Vicks during the day. I knew there was a legit reason! I have allergies.

EDIT: Flonase has a weird scent added to it. Lavender like maybe. I didn't like that either.