CPAP vs Enlarged turbinates

[Atomized]

I have very narrow nasal passages due to my enlarged turbinates. At night it gets worse and there's only a little bit open to breath through; however, I still manage to breath through my nose. I am considering surgery, but I won't be able to get it in the near future (at least not until the new year)
I've been trying CPAP for the last 2 weeks and it's not doing well at all. I feel a lot of pressure inside my nose and it's hard to exhale even at the minimum setting. It's not so bad when I'm up during the day, so I assume these issues are due to my narrowing passages. I haven't been able to fall asleep with CPAP at all so far, after couple of hours I give up the struggle and take the mask off.
So my question is: is it even possible to benefit from CPAP when one has enlarged turbinates like this? Should I just keep trying to get used to it? Anyone with similar problems could share their experience with CPAP?

[CynthiaR]

Have you tried simply using a nasal dilator and see if that might circumvent the need for a CPAP? There is one called NasalAid that looks quite strange but is actually very comfortable. Almost as comfortable but considerably cheaper are the light blue tubular ones, such as the Snore Care Sets you find on Amazon. My impression is that producing just millimeters in additional width of the passage can have a huge effect.

[kteague]

Are you expecting turbinate surgery to make it easier to use your CPAP? Some on here have reported that the surgery did make their CPAP use easier. You don't give us much to go on for us to be able to offer much input. Do you have a copy of your sleep study report? Sometimes there are helpful clues in them. Knowing the severity of your OSA, if it's positional, etc can make a difference in how the conversation goes. Aside from that, did you read the thread at the top of the page for new users? If you could download your machine data, some of the data gurus might be able to spot something that could improve the comfort of your treatment. Please know that getting off to a rough start is not necessarily an indicator of one's eventual ability to successfully use CPAP. A lot of us struggled mightily early on but worked through things. I got a lot of help here way back in 2006. Hopefully you'll find the help you need to make this work for you.

[Miss Emerita]

Atomized, you might consider using your machine during the day or evening, outside your bedroom, to get used to it. Ideally you could set it up so you can watch TV, read, or use your devices -- something mildly pleasant and distracting. This approach means that while your acclimating, you don't have the additional frustration of lying awake and yearning for sleep to come. When you do try night-time use, I'd suggest spending no more than 30 minutes waiting for sleep to come.

On the mask front: have you considered trying a full-face mask? That could allow you the option of breathing through your mouth when nose-breathing seems too hard.

[sleepcrapnea]

@atomised you are like my doppleganger. My god.

I have englarged turbinates and have been trying CPAP for the last 2 weeks too with terrible results.

I also have been contemplating the surgery. I am on the waiting list so probably also will be waiting some time. I doubt it will happen this year.

I am almost certain that the source of all my sleep problems is the turbiates rather than sleep apnea. Im just trying the CPAP as a last ditch non surgical method to fix it.

Like you, my nasal stuffiness is not a problem during the daytime. I still have a bit of it but not enough to notice. Night time is the problem. I have horrendous sleep problems. Wake up repeatedly and ultimately cant sleep again. Lose a lot of sleep I actually think my apnea level is very low. I think its all down to the turbinates.

Funnily enough I am noticing that my nose is less blocked using the CPAP. Bt I do sometimes feel pressure which is when my nose is a bit stuffy. Uncomfortable. And also often a craving to open my mouth which is really difficult I think, But I think it might be that my nose is less blocked on CPAP because I simply do not get to sleep on it. I lay awake all nigth with it in. My nose always gets more blocked once I am asleep.

The CPAP is running me into the ground more than pre CPAP. I really hope I can sort things out.

Re the exhaleing - this is not something that is a problem for me. So I thnk you might need to adjust your machine settings. I have my exhale relief on maxinimum settings and that aspect is fine.

@cynthiaR - interesting suggestion of a nasal dilator. I havent heard of this before. I might look into this. Have you tried it youreself for fixing swollen turbinates? Results? I have used the nose strips but they are useless for me. Not strong enough of an influence.

[Dog Slobber]

CPAP was intolerable for me until I had my Septoplasty and T. Reduction.

Some things that helped.

Using Nasal Pillows vs a Nasal Mask.

A nasal mask puts physical pressure on the bridge of the nose and air pressure on both the outside and inside of nose.

Nasal pillows only puts pressure on the inside of the nasal passages with no equalizing pressure on the outside and no physical pressure on the bridge. This helps to inflate the nasal passages and makes a huge difference in my ability to breathe through my nose.

[Atomized]

Have you tried simply using a nasal dilator and see if that might circumvent the need for a CPAP? There is one called NasalAid that looks quite strange but is actually very comfortable. Almost as comfortable but considerably cheaper are the light blue tubular ones, such as the Snore Care Sets you find on Amazon. My impression is that producing just millimeters in additional width of the passage can have a huge effect.

I have tried Breath Right stips in the past without significant benefit. I'll try them again with CPAP as I have several left. Do you think nose dilators would interfere with nasal pillows? I have narrow jaws with bad overbite, so likely my nose is not the my only obstruction, I'd still need CPAP even if my nose was clear.

[Atomized]

Are you expecting turbinate surgery to make it easier to use your CPAP? Some on here have reported that the surgery did make their CPAP use easier. You don't give us much to go on for us to be able to offer much input. Do you have a copy of your sleep study report? Sometimes there are helpful clues in them. Knowing the severity of your OSA, if it's positional, etc can make a difference in how the conversation goes. Aside from that, did you read the thread at the top of the page for new users? If you could download your machine data, some of the data gurus might be able to spot something that could improve the comfort of your treatment. Please know that getting off to a rough start is not necessarily an indicator of one's eventual ability to successfully use CPAP. A lot of us struggled mightily early on but worked through things. I got a lot of help here way back in 2006. Hopefully you'll find the help you need to make this work for you.

My AHI was low during the study, RDI of 15, worse during REM. They concluded I likely have UARS. My nasal obstruction is similar when I sleep on my back and on my stomach. I have already downloaded Oscar, I'll upload some data if I'm able to actually fall asleep

[Atomized]

Atomized, you might consider using your machine during the day or evening, outside your bedroom, to get used to it. Ideally you could set it up so you can watch TV, read, or use your devices -- something mildly pleasant and distracting. This approach means that while your acclimating, you don't have the additional frustration of lying awake and yearning for sleep to come. When you do try night-time use, I'd suggest spending no more than 30 minutes waiting for sleep to come.

On the mask front: have you considered trying a full-face mask? That could allow you the option of breathing through your mouth when nose-breathing seems too hard.

Despite all my obstruction problems, I'm pretty much an exclusive nose-breather. If I have to mouth breath for long periods of time (ie during a cold), I get dizzy and miserable, and unable to sleep. Using the machine during the day feels a lot easier, likely because the obstruction subsides.

[Atomized]

CPAP was intolerable for me until I had my Septoplasty and T. Reduction.

Some things that helped.

Using Nasal Pillows vs a Nasal Mask.

A nasal mask puts physical pressure on the bridge of the nose and air pressure on both the outside and inside of nose.

Nasal pillows only puts pressure on the inside of the nasal passages with no equalizing pressure on the outside and no physical pressure on the bridge. This helps to inflate the nasal passages and makes a huge difference in my ability to breathe through my nose.

I use Resmed p10 nasal pillows (sorry for not putting it in my profile earlier)
Could you please tell me a bit more about your experience with CPAP before your surgery? Did you have difficulty exhaling like I do? Were you able to breath through your nose even a little bit? At what point did you realize that CPAP won't work until surgery?

[Dog Slobber]

I use Resmed p10 nasal pillows (sorry for not putting it in my profile earlier)
Could you please tell me a bit more about your experience with CPAP before your surgery? Did you have difficulty exhaling like I do? Were you able to breath through your nose even a little bit? At what point did you realize that CPAP won't work until surgery?

I was diagnosed with an AHI of 59 during non-REM, during REM my sleep apnea is considerably worse, but I never achieved REM during my sleep study so I have no idea what it is.

I had a deviated septum all my life that I wasn't aware of, it had never really bothered me. Coincidentally, at about the time I started CPAP my turbinates started to swell.

My first two months on CPAP were absolute hell, I stopped because I couldn't tolerate it. I stopped for a month. I then tried nasal pillows and they appeared to work for a while, but my turbinate swelling continued to get worse and I had to discontinue CPAP again. My turbinate swelling got so bad, not only could I not breath with CPAP, but I could no longer breathe through my nose in the daytime. I slept sitting up in bed.

During the day, inhaling through my nose was difficult, but try to exhale through my nose impossible. The force I was using trying to exhale was just closing what little passage was there. On CPAP, the pressure allowed me to inhale, but exhaling was simply not possible.

I tried a full-face mask, but couldn't use one. I *think* I have a prolapsed palate because sometimes when exhaling through my mouth I feel my throat momentarily close up. This only happens on CPAP, and I've never been diagnosed.

I went through hell waiting to see an ENT and finally saw him in August. The wait-list in Canada can be brutal. When the ENT saw me, he couldn't believe how malformed my septum was and swollen my turbinates were and expedited my surgery.

I waited three weeks, which is completely unheard of in Canada, wait times are typically 6-9 months.

The day I put the CPAP on after recovering has been heaven. I have been 100% compliant. In fact my surgery was not 100% successful because of how malformed my septum was. I still have some difficulty breathing through my nose and it's worse in the evening.

I keep my spare machine in my living room and often end the day watching TV wearing my CPAP as I find it much easier to breath wearing CPAP.

Here is my CPAP usage chart.

You can see the first 2.5 months of usage was very spotty, and I stopped. I tried again a moth late for a couple months but couldn't. Then after my surgery, not a problem.

CPAP_compliance.jpg (385.38 KiB) Viewed 1330 times

[CynthiaR]

Have you tried simply using a nasal dilator and see if that might circumvent the need for a CPAP? There is one called NasalAid that looks quite strange but is actually very comfortable. Almost as comfortable but considerably cheaper are the light blue tubular ones, such as the Snore Care Sets you find on Amazon. My impression is that producing just millimeters in additional width of the passage can have a huge effect.

I have tried Breath Right stips in the past without significant benefit. I'll try them again with CPAP as I have several left. Do you think nose dilators would interfere with nasal pillows? I have narrow jaws with bad overbite, so likely my nose is not the my only obstruction, I'd still need CPAP even if my nose was clear.

Yes, most nasal dilators would probably interfere with nasal pillows. There is one called NasalAid that might work fine with nasal pillows. It looks odd, but it is actually quite comfortable.

[CynthiaR]

@atomised you are like my doppleganger. My god.

I have englarged turbinates and have been trying CPAP for the last 2 weeks too with terrible results.

I also have been contemplating the surgery. I am on the waiting list so probably also will be waiting some time. I doubt it will happen this year.

I am almost certain that the source of all my sleep problems is the turbiates rather than sleep apnea. Im just trying the CPAP as a last ditch non surgical method to fix it.

Like you, my nasal stuffiness is not a problem during the daytime. I still have a bit of it but not enough to notice. Night time is the problem. I have horrendous sleep problems. Wake up repeatedly and ultimately cant sleep again. Lose a lot of sleep I actually think my apnea level is very low. I think its all down to the turbinates.

Funnily enough I am noticing that my nose is less blocked using the CPAP. Bt I do sometimes feel pressure which is when my nose is a bit stuffy. Uncomfortable. And also often a craving to open my mouth which is really difficult I think, But I think it might be that my nose is less blocked on CPAP because I simply do not get to sleep on it. I lay awake all nigth with it in. My nose always gets more blocked once I am asleep.

The CPAP is running me into the ground more than pre CPAP. I really hope I can sort things out.

Re the exhaleing - this is not something that is a problem for me. So I thnk you might need to adjust your machine settings. I have my exhale relief on maxinimum settings and that aspect is fine.

@cynthiaR - interesting suggestion of a nasal dilator. I havent heard of this before. I might look into this. Have you tried it youreself for fixing swollen turbinates? Results? I have used the nose strips but they are useless for me. Not strong enough of an influence.

I have a deviated septum. On nights when I can't or don't use CPAP, I use a chin strap (Knightsbridge Dual Band, the only one actually designed to work) with a nasal dilator. I use the NasalAid (which looks odd but is actually quite comfortable). Sometimes, to mix it up I use the blue tubular Snore Care Set nasal dilators, which are substantially cheaper than the NasalAid and almost as comfortable.