Effect of Stuffed Nose on CPAP Pressure

[greyhound]

As a CPAP user with a frequently stuffed nose (long story, but it is under treatment), I am wondering whether my recommended cpap pressure would vary significantly, depending whether my nose was partially stuffed or clear.

If it would, an (uninsured) apap would seem to make sense. However, depending whether the cpap pressure (currently 12) increased significantly, cflex might be a significant feature to deal with exhalation. If not, I'd prefer to go with the PB420E since I already have the humidifier and it's much smaller.

Any thoughts?

[NightHawkeye]

As a CPAP user with a frequently stuffed nose (long story, but it is under treatment), I am wondering whether my recommended cpap pressure would vary significantly, depending whether my nose was partially stuffed or clear.

Greyhound, I fight a similar problem with sinuses most nights and there does seem to be a little difference in pressure required, but the difference is small, even when my sinuses almost completely clog up. I think the APAP algorithms work on short term changes in resistance rather than the long-term characteristics such as caused by stuffiness.

If it would, an (uninsured) apap would seem to make sense. However, depending whether the cpap pressure (currently 12) increased significantly, cflex might be a significant feature to deal with exhalation. If not, I'd prefer to go with the PB420E since I already have the humidifier and it's much smaller.

I personally don't care for C-flex, and although I may be in the minority here, I'm not the only one, so I'd recommend that C-flex not be your main consideration in making this decision. You probably wouldn't be very happy to get your brand new APAP with C-flex only to discover that you were one of the folks who doesn't benefit from or like C-flex.

Regards,
Bill

[WillSucceed]

I'm not a Dr., but my personal opinion is that a stuffed up nose can make a difference regarding pressure requirements.

I like the idea of APAP, even though APAP does come with it's own set of issues. Making sure that you get the right APAP machine for you (the different manufacturers use different algorithms in their machines) and, checking to see that you don't have arousals from pressure change during the night.

While C-FLEX can help many, it is not the be-all-to-end-all. If at all possible, trial several APAP's for at least a week each, before you buy.

[Goofproof]

For stuff up noses, you need a FF Mask, then you can breath, This is the dog I fight every nite.

[greyhound]

That assumes you can avoid significant FFM leaks. I've got a second cushion on order for my Ultra Mirage FFM and, hopefully, Sereveena's solution will make this mask a "stuffed nose alternative" (I prefer the Swift when I can breathe through my nose).

Unfortunately, since my insurance won't cover a cpap, I don't have the luxury of testing the c-flex (or any other apap) to see if helps (or is needed) when/if the pressure is higher than my normal 12.

[snork1]

I used to have a nose that varied from clogged up to REALLY clogged up.
At that time my pressure was set at 10-14cm and spent most of the time bouncing around between 12-14cm, and often pegged at 14cm.

NOW, I have my sinuses and nose fixed and I saline flush my nose every day. My pressure is now set at 5.5-10cm and spends 90% of the time at 6cm.

I will let you draw your own conclusions.......

[rested gal]

You probably wouldn't be very happy to get your brand new APAP with C-flex only to discover that you were one of the folks who doesn't benefit from or like C-flex.

C-Flex can always be turned off if a person finds he/she doesn't like it.

[Goofproof]

I can't understand how a person wouldn't benefit or like C-Flex, the only thing I can think of that might be better it Bi-Flex. At 15.5 cm, the only problem I have is when the machine comes on, it's always a rush when the pressure hits you. It takes about 30 sec to get used to, and 5 minutes to learn to ignore the breathing sounds (stacked breathing) from the machine, you have to forget to listen to it and return to your normal breathing pattern.

Running a T.V. or Radio, or as I do Nature Sounds helps you forget to listen to your breathing. I think the main problem with people not liking C-Flex or EPR is not allowing thereselves to adapt to it. If the technology didn't exist I am sure there would be much more non-compliance in treatment.

The most important thing in our treatment is accepting we will do everything needed to suceed in our treatment.

[LandKurt]

I can't understand how a person wouldn't benefit or like C-Flex, the only thing I can think of that might be better it Bi-Flex.

I can see how it wouldn't be for everyone.

I've just spent two nights on a REMstar Auto with C-Flex after starting on five weeks of straight CPAP at 10 cm/H2O. I found starting at the minimum pressure of 6 with a C-Flex setting of 3 to be very disconcerting. It felt like the machine was shutting off for every exhale at that pressure. It caused the mask to surge with every breath as the pressure came and went. I immediately backed the C-Flex setting to its minimum 1. I find that setting reasonable, though the variation in motor pitch is slightly annoying. I'm going to give myself some time to get used to it before I decide whether to up the setting or just turn it off.

The pressure you need is obviously a big factor in how helpful C-Flex is. I, myself, have no trouble breathing against a straight 6 (which was where I had my ramp set to start). At that level C-Flex might be more trouble than it's worth, for me anyway. I got used to breathing against a constant 10 cm, but often wished for C-Flex to eliminate the stuffy feeling of breathing against the pressure. My auto is now set to go up to 12, but so far I've been asleep whenever it used the higher pressures, so I don't notice if C-Flex is helping me then.

Once I have a few weeks data I might tighten up on the pressure range I use. The sleep center set the Auto for 4 below and 2 above my titrated pressure of 10. That seems like a somewhat loose range. I might be able to select a proper C-Flex setting better if my pressure didn't change by a factor of two.

[Goofproof]

LandKurt, I think your problems with it were due in part to the low starting pressure and the fact you were used to 10 cm. I never did use the ramp feature, I thought it wiser to get the most time in treatment I could, and 14 cm with C-Flex was doabled, despite just having my chest opened 4 weeks earlier, (good thing they sewed it up good) at the time I didn't think what that could have done at 14 cm, lucky I didn't think on that too hard..

Being use to 10 cm I can understand your concern starting on 6 cm, it always is in the back of my mind when I switch on. Keep looking at your data, and good luck with the program.

[Ergin]

Well, I think the most important factor is too feed your nose with clean air.
Therefore I recommend primarily a machine with ultra fine or equvalent air
filter. Auto is always a good option which you can turn off.