Quieter nasal mask? Seeking help with congestion

[sls1995]

Hi everyone,

I was diagnosed with sleep apnea about a year ago, and have been trying to make CPAP work for about nine months (I spent a few months using an oral appliance but stopped because it was shifting my bite).

One of the biggest barriers for me has been the congestion that I've experienced while using the machine. I'm not aware of being especially congested otherwise, but something about the CPAP machine sets my congestion off. I've tried a bunch of masks: Resmed N20, N30, P10, and F20, among others. I find that the pillow mask is the most inherently aggravating to my congestion, followed by the N30 (nasal cradle). Less direct pressure seems to work better: the F20 kind of allows me to breath clearly, but I don't love having to use a full face mask because it's so clunky and makes sleeping less comfortable. Also the top of the cushion pushing against the sides of my nose seems to cause a bit of congestion, too.

I was really pleased to try the N20 (nasal) mask and notice that it clears up my congestion! I guess it's a combination of indirect pressure and connecting to my nose in a place that doesn't cut off my airways. The only problem is that the elbow of the mask blows air out really powerfully, so whenever I move my head in the direction of a pillow or blanket I hear a loud rushing sound, which makes it hard for me to fall asleep. I move a lot in my sleep so this is quite a problem.

Can anyone recommend any other nasal masks that disperse air more gently/quietly? Not cradle or pillow masks, but the kind that fits over your nose. I'm a light sleeper, so the less loud/intrusive the better. I have a Resmed Airsense 10; masks from other brands are compatible with it, right?

Also, would love to hear general stories from anyone else who has had congestion caused by the CPAP machine.

Thank you so much for your help!

~Sam

[Jlfinkels]

By congestion do you mean clogged nostrils? Any idea of root cause like allergies, deviated septum, etc? Do you use any nasal sprays like Flonase or others? Any allergy meds?

Some of us use nasal sprays nightly (Flonase, Azelastine, and others) and also take allergy meds (Claritin,et.al.) to help with nasal congestion. Even with that I still get occasional congestion likely attributed to nasal cycle.

Not sure about how a mask can address it. There is a newness factor to masks where they can seem awesome the first few nights, but we adapt to them and the problems we think they solved may reappear over time. If your nose/sinuses congest you’ll end up breathing through your mouth, so a FFM like the F20 or F30 can help as they will keep therapy going since they cover your mouth.

If you could post some OSCAR charts those that can interpret them can offer suggestions. You can download it here https://www.sleepfiles.com/OSCAR/.

[sls1995]

Thanks so much for your help!

Yes, I mean clogged nostrils. It's not a product of allergies, necessarily - it actually seems to be at its worst in the winter, when I'm not allergic to anything. I've found that excessive humidity makes it worse, as well - I'm better off keeping the humidity to a 1 or 2 on my Airsense 10 Autoset. My nose just starts feeling really clogged, and I sleep on my side, so usually I end up just breathing out of one nostril on a good night. On a bad night, even the top nostril is a little clogged, and breathing becomes very hard.

I saw a few ENT's who said that I have a slightly deviated septum and slightly enlarged turbinates, and they have offered to do septoplasty and turbinate reduction surgery to help with this. None of them can really guarantee that surgery would help with my symptoms, though, especially because congestion is a very subjective thing.

I've had some success using Flonase, actually, but I think it might be becoming less effective over time, which is a thing that can happen, says my ENT. I'm also wondering if it becomes less effective during the winter because it further dries out my already dry nose. I used it for a period of time last spring and summer and did pretty well with it, but found it to be less effective this winter. I don't love the idea of using a nasal steroid every day for the rest of my life, so would like to avoid it if possible, but that is a little safer than surgery, so perhaps I'll have to start accepting it. I may get back on the flonase train today (had a pretty rough night last night, congestion-wise).

I just ordered an SD card so that I can start using Oscar! My machine came without one. Thanks a bunch - I will post a chart as soon as I have one.

Appreciate the support,

Sam

[chunkyfrog]

" . . . because congestion is a very subjective thing."
I have a problem with this statement.

Whoever said this is dismissing your congestion as being "imaginary,"
--because they are totally incompetent, and unwilling to even LOOK for the cause.
I would run away from this idiot, and look for a competent provider.

Congestion as a reaction to something touching the top/sides of the nose
is not uncommon. I have experienced it myself.

[Jlfinkels]

You may want to consider trying a NeilMed nasal rinse (aka Neti pot). It flushes out the sinus and nasal cavities pretty well.

[sls1995]

Hi all!

Thank you for the suggestions. I just ordered a Neilmed rinse. And @chunkyfrog, I appreciate you saying that - I think what the doctor meant was that sometimes congestion doesn't match up with what they see structurally (e.g. some people with deviated septums don't have breathing problems), although I have definitely been gaslit by many medical professionals during my apnea journey so I will be wary of this one.

I started using Oscar, and discovered something interesting that may help answer why I've been having trouble with therapy, although it doesn't answer my congestion problem. Here are my charts from the last few nights. On Friday and Saturday night, I slept with fewer interruptions, but on Sunday and Monday night I woke up a few times with the feeling of an adrenaline rush (sometimes accompanied by a nightmare). I've found that these types of awakenings are more common when I am congested, and I did feel slightly more congested on those nights.

Trying to post screenshots below. Let's see if this works.

What I discovered was that although my AHI is relatively low when I use CPAP approx (0.5-1.5), I have a fair number of "Clear Airway" apneas. In fact, they make up more than half of my apneas, and far more than half on some nights. My original sleep study didn't show any central sleep apnea. Could this mean that these are coming up as a result of my treatment? I'm curious as to how to deal with these, and whether they are caused by congestion in that when breathing feels more uncomfortable, I am more likely to just stop breathing in the middle of the night regardless of whether my airways are truly obstructed.

Thanks all - curious to hear your thoughts.

[sls1995]

Shoot-I'm getting a message that says "quota reached" when I try to post attachments. Any pointers on how to fix that?