I'm at a loss and need help. Congestion/Dryness issues

[ctb617]

Hello,

I'm new to this site, but I made an account because I'm dealing with some issues that I really don't know how to fix.

I've had a CPAP for a little over a year now, and I've only had a good experience for maybe two months of that time. I'm struggling with the ongoing issues of nostril dryness and also congestion.

I started with a nose pillow mask, which was working fine...until it started making my nostrils extremely dry, sore and cracked. It felt and looked awful. So I looked online for what to do and I've tried many creams, lotions, sprays etc which didn't work. (Many CPAP users I read recommended the product called Lanolin, meant for nursing mothers. Which I tried too.) So I have no idea what to do to help this problem.

I'm also more recently (within the past couple months) dealing with severe nasal congestion during and after using my CPAP. After it started happening, I've gotten into the habit of blowing my nose before I put on my mask and go to sleep. Often nights, I'll wake up several times, not feeling like I can breathe. When I wake up, I can tell I've been sleeping with my mouth open and my nose is completely congested. I can't even sniff through my nose because it's full. I'll blow it again and go to sleep...then wake up again to the same issue. It will slowly get better throughout the day, but then come back after another night of sleep.

I've tried raising the humidity level, but it caused a rainout in my tubing. So I eventually switched to a heated hose. I've had it for a few weeks now, but I still every so often have rainout and feel dryness in my mouth. I have no idea what settings I should have it on because I don't know why these issues are happening. And the weird part is that I checked the quality of sleep online and on my machine and it says it's fine. But I'm surprised that it is, even though I can tell I'm breathing through my mouth sometimes.

With the congestion going on, I'm also wondering if it's non CPAP related. (Sinus infection?) Even though, it certainly gets really bad only during and after the time I use it.

My CPAP company hasn't been the greatest with me about helping these issues, so I thought I'd write here. I'm desperate and if anyone has any insight, it'd be greatly appreciated.

So basically:
-How do I solve the dry nostril problem?
-What could be causing this congestion?
-What settings should I have my CPAP and CPAP hose on to help?

[Pugsy]

Google "cpap rhinitis".

Here's the deal about nasal congestion caused by humidity (or lack of enough) when using cpap...it's an individual preference. One person might need maximum humidity and the next person need minimal if any added moisture.
I can't tell you what your nasal mucosa want. It's something you will need to sort through.

The nasal mucosa are funny...when they get irritated they respond with the typical allergy like reaction...they swell up causing the congestion and they can also start draining creating the runny nose thing.
Either too much or not enough moisture will trigger this irritation.

If you are using a lower setting on your humidifier...increase the setting.
If you are using a higher setting then you might try lower.
If you find that rain out develops at a higher setting but your nasal mucosa like the higher setting then there are ways to reduce the rain out or condensation in the mask or hose. It's easier to fix the rain out than deal with unhappy nasal mucosa.

[ctb617]

Thank you for the response! I'm googling that now.

My hose is currently at the humidity setting, 4. The temperature is at 82F. So, I may try to increase the humidity like you said since that is on the lower scale, correct? Should I change the temp? I'm not entirely sure on how that works with the humidity.

[Pugsy]

A setting of 4 for humidity on your machine is indeed on the lower side.
As far as temperature goes just use whatever is comfortable that keeps the condensation from forming.
The condensation in the mask or hose won't hurt you but it sure is annoying.
My nose prefers as much moisture as possible and rain out for me is mainly a winter issue because I keep my house fairly cool in the winter. It isn't so much a problem now. When summer gets here and I turn the air conditioner on I may need a little more warmth in the hose because I tend to keep the air cooler (I just like cooler air).
So the temperature needed to prevent the condensation will vary a lot depending on the ambient air temperature in your bedroom.

You might also use something like Simply Saline frequently during the day and a good shot of it before bedtime.
It seems to help keep the nasal mucosa hydration level more stable and will help with the congestion.
It may take a few days at the higher setting to see any improvement. Often it takes the nasal mucosa a bit of time for them to heal from the irritation.
If your congestion gets markedly worse with the increase in humidity setting then back off and reduce the setting.
I did a poll a while back to see where most people were setting their humidity and more people used higher than used a lower setting.

If a hot steamy shower helps...then you probably are needing higher.

[Sir NoddinOff]

If the excellent tips you received from Pugsy don't solve your nasal dryness problem come back and ask about full face masks - they cover your nose and mouth and equalize pressure throughout those cavities without emphasis on just the nasal passages. Long ago I had some similar nasal dryness problems and the FMMs fixed that - also they alleviated some of my ear issues.

[norestfortheweary]

I would recommend seeing an ENT Doctor. You could have excess Turbinate tissue in your nose and/or a deviated septum. I had this problem and always felt congested and nothing helped until I saw an ENT Doctor. I had surgery and that corrected the problem. My nostrils have gotten very sore from my nasal pillows too. My ENT Doctor gave me a script for Mupirocin Calcium Cream 2% and that healed my nostrils quickly. You just put a small amount on a cotton swab and swab it inside each nostril. Be sure to use seperate ends of the swab for each nostril to avoid cross contamination and a new swab if you need more cream so not to contaminate the medicine. I hope this helps.

[norestfortheweary]

P.S. If your mouth gets dry your mouth may drop open when your sleeping. You may need a chin strap to keep your mouth closed. You might post another question about what chin straps others like best. I'm still trying to find the right one. Good luck.

[Marigail]

The congestion/dryness has always been an issue with me. I have been on cpap therapy for 5 1/2 yr. I have a bipap with pressure of 17/12. What I have found to work for me I keep the humidifier set at 3 yr round. Most of the time I use nasal pillows, Pilairo. If I have breathing issue I will switch to a nasal mask, Wisp. First thing in morning I use a saline spray, before bed I use spray again and a nasal gel on a Q-tip and spread around inside each nostril, Ayr has a spray and gel that states for use with cpap. I have found a store brand at Walgreen's that is a little cheaper. I have COPD and lots of breathing issues. My pulmonologist, who is also my sleep Dr, also has me run a vaporizer in the winter when room air is dryer. I use aroma therapy discs with Spice oil to help keep sinus' clear and because I like the smell. Drink water before bed and if you get up. I keep a bottle of water on nightstand.