Upper Airway Anatomy and Sleep Apena

[Doce]

When a patient has certain airway characteristics that are conducive to sleep apnea such as a deviated septum, enlarged turbinates, and a low soft palate, is CPAP unlikely to help?

Edited for spelling

[Julie]

Not unless those features entirely block the airway - in which case the patient would be dead. Those are exactly the features Cpap helps with!

PS I think you mean 'con'ducive .

[Geer1]

I was just diagnosed with nonallergic rhinitis last week. I have enlarged turbinates and a slightly deviated septum. Dr prescribed Dymista which I believe is the best option whether rhinitis is caused by allergies or not (it is a combo nasal steroid and antihistamine spray). If after 4 months of use things are not better they are going to do surgery.

Just over a month ago I was diagnosed with OSA. I have now been on treatment for 29 days and it has made a significant change. When I lay down my congestion gets worse and if I sleep without CPAP I have now noticed how much worse the congestion gets. I think it is due to the mucous not draining and clogging up my small nasal airways. The CPAP helps and I when I wake up I do not feel congested.

One thing is that congestion can make CPAP uncomfortable so you need to do something to get the congestion under control. Don't use decongestants unless you absolutely have to (like once or twice a week or less frequently) otherwise they just make the congestion worse. I have been using nasal rinses and nasal steroids/dymista to keep nasal passages clear enough and as mentioned the CPAP seems to help as well.

I would highly recommend getting tested or trying CPAP if you know you have these issues and believe you might have sleep disordered breathing.

[KandyX]

Yea, Dymista is one of the best nasal sprays. I use it for nonallergic rhinitis.
The few times it doesn't clear me up 100%, doing a nasal rinse works.

[Doce]

Conducive was definitely the word I was looking for haha.
Thank you all for the replies. I’m going to look into the nasal spray Dymista to see if that will help me. Yesterday was the appointment with the ENT who said I have the above mentioned issues. There’s another thread on here with my cpap journey, but I’ve stopped using it for the time being with the intention of restarting. Wanted to keep the threads separated.

[miner49er]

Conducive was definitely the word I was looking for haha.
Thank you all for the replies. I’m going to look into the nasal spray Dymista to see if that will help me. Yesterday was the appointment with the ENT who said I have the above mentioned issues. There’s another thread on here with my cpap journey, but I’ve stopped using it for the time being with the intention of restarting. Wanted to keep the threads separated.

have chronic congestion. one nostral is always congested. when the other one is bothered nose masks are impossible to use. full face is easier but still a challenge. Overall would say that congestion definitely complicates cpap therapy and i can see why many people would not continue.

[ChicagoGranny]

Yea, Dymista is one of the best nasal sprays. I use it for nonallergic rhinitis.

You are using the wrong product. Dymista is a combination of azelastine hydrochloride and fluticasone propionate. Azelastine hydrochloride treats allergic rhinitis. Since you need something for nonallergic rhinitis, it would be better to use a single active ingredient product like fluticasone propionate. There is no use to treat with a drug you don't need and possibly have undesired side effects.

I was just diagnosed with nonallergic rhinitis last week. I have enlarged turbinates and a slightly deviated septum. Dr prescribed Dymista which I believe is the best option whether rhinitis is caused by allergies or not (it is a combo nasal steroid and antihistamine spray). If after 4 months of use things are not better they are going to do surgery.

Your doctor may have prescribed Dymista for the 4-month trial just to make sure he had all bases covered.

[ChicagoGranny]

I’m going to look into the nasal spray Dymista to see if that will help me. Yesterday was the appointment with the ENT who said I have the above mentioned issues.

You had a consultation with an ENT one day, and the next day you are asking strangers on the internet for a drug recommendation? What did the doctor recommend?

[Doce]

Yes, of course I’d be interested to learn all that I can and find out other’s experiences. When did I ask for a drug recommendation?

[miner49er]

Yes, of course I’d be interested to learn all that I can and find out other’s experiences. When did I ask for a drug recommendation?

i've done a lot of research on congestion given that iv had it for a long time.
have you had your sinuses checked? is there pressure around your nose in the morning?
sleep apnea causes a constant state of low grade stress and inflammation all over your body. I found that sometimes natural anti inflammatory supplements like grade seed extract or curcumin help

[palerider]

When did I ask for a drug recommendation?

It doesn't look like you did..

[Geer1]

OP you didn't ask for medication advice but what you will likely find is that CPAP alone is not effective, you need to keep congestion under control in order for CPAP to be comfortable and effective.

You are using the wrong product. Dymista is a combination of azelastine hydrochloride and fluticasone propionate. Azelastine hydrochloride treats allergic rhinitis. Since you need something for nonallergic rhinitis, it would be better to use a single active ingredient product like fluticasone propionate. There is no use to treat with a drug you don't need and possibly have undesired side effects.


Your doctor may have prescribed Dymista for the 4-month trial just to make sure he had all bases covered.

Not true. The following is from UpToDate which is the most used database for doctors.

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[ChicagoGranny]

When did I ask for a drug recommendation?

If you post in the forum that you are going to look into it, then you will get comments whether you like it or not.

I’m going to look into the nasal spray Dymista to see if that will help me.

Doesn't it seem strange that you get a diagnosis from an ENT and the next day you are looking into treatments? I guess the doctor told you what was wrong and left you to find the treatment. Are you getting your money's worth from that doctor?

[ChicagoGranny]

Not true. The following is from UpToDate which is the most used database for doctors.

It clearly says in the text, "the combination treatment has not been studied in chronic NAR."

[Geer1]

It clearly says in the text, "the combination treatment has not been studied in chronic NAR."

Point? It references studies stating Azelastine is effective which is the exact opposite of what you claimed...

It also states that combination treatment is the most effective. Nothing ends up on UpToDate unless it is correct or strongly believed to be.

A bunch more reliable resources claiming the same.

https://www.webmd.com/allergies/nonallergic-rhinitis#1

https://www.mayoclinic.org/diseases-con ... c-20351235

https://www.aafp.org/afp/2018/0801/p171.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650982/

The first doctor who gave me a trial of Dymista was the allergist who had just confirmed I did not have allergies (confirmed with both blood test and prick test). ENT confirmed nonallergic rhinitis and then prescribed me Dymista. Two doctors in the most applicable fields, one of which is the highest ranked ENT in my city... Part of the reason they did this is because I had only minimal benefit on nasal corticosteroid alone (or with oral antihistamines), which is also stated in the UpToDate article... For 2 months I used your recommendation to use corticosteroid alone and it was not effective. After 1 week Dymista was showing effectiveness then I accidentally dropped the bottle (broke it) and am now am fighting congestion again until I can get back to get prescription refilled on Monday...

I will believe the doctors, multitude of health resources and my personal experience over your false opinion that the other poster, myself and anyone else similar reading this is not on the correct medicine.