Nasal congestion with pillows

[catmama]

I have only just started 3 weeks ago and every few days I wake up congested and have a tickle in one
nostril all day that drives me crazy! I have the ResMed Escape with humidifier set at 3.5 I use the Swift fx
for her and love them but wondering if it is too much pressure for my nose.Only use 7 pressure but have allergies.
I take Flonase,Singular,astlyn spray.

[twokatmew]

Sounds like your allergies are flaring up, causing congestion. I have the same problem, and I've been on xPAP for 2.5 years.

Have you tried the Resmed "hypoallergenic" filters? They have an extra fine filter layer on the machine-side of the filter, and it helps to filter out extra fine particles.

When my allergies flare up and I have congestion, I find that I have more events, and the pressure on my APAP goes higher to compensate. The only way I know of to help prevent this is to either take a decongestant and/or use a full-face mask. As my face is way too small for a full-face mask, I use the decongestant.

One other thought. How often do you wash your nasal pillows? I was washing the pillows every other day and the whole mask weekly. But since my congestion problems returned, I'm finding that washing the pillows every day helps somewhat.

I doubt a pressure of 7 is too high. It's more likely that your machine is sucking in air that contains something to which you're having an allergic response. My pressure is 11.5-17. On days when I have little or no congestion, the pressure rarely goes above 12.5. When I'm more congested, the pressure tops out at 17. I assume the need for higher pressure is due to my having events, because my nose is plugged, and I'm not getting the necessary airflow to control my OSA.

HTH.

[Pugsy]

I doubt it is the pressure. I suspect it is the humidifier setting. Some people have same symptoms and it from the nasal mucosa squawking about the difference when using the humidified air vs room air.

Some people like more humidity and some people like less. Since you are already using a lower setting you might increase the humidifier setting just a little and see how that works..if it makes it worse..then reduce the setting.
BTW this is a common problem. Do you have the ClimateLine hose or the standard hose? The climateline hose offers more customization of the humidity settings.

Are you aware that the ResMed Escape S9 machine offers zero data to monitor the effectiveness of your therapy. It only offers "hours of use" on that little SD card. Used to prove to your insurance company that you are using the machine. If you had a full data machine there is software available to monitor your leaks and other data. You might want to read the "Help, I am stuck with a brick" here at Janknitz blog...scroll down and you will see it. http://maskarrayed.wordpress.com/

[Ms Piggy]

I seem to remember some postings, not recently, about flonase etc and your problem. think it
had something to do with those type of products, hope you can trace them or try not to use it
as much and see how it goes. I remember having some problems when using it myself ages ago.
good luck with it.

[robysue]

catmama,

First of all, I want to second what Pugsy said about the S9 Escape providing no meaningful data in spite of containing that little SD card in the back. Please do read through JanKnitz's Help! I'm Stucke with a Brick

Pugsy also gives some good advice about playing around with the humidifier setting. And twokatmew's suggestions about using an ultrafine filter and being pretty stringent about cleaning the equipment is also well worth doing.

And since you are already on Flonase,Singular,astlyn spray, you obviously have some doctor who deals with your allergy (and asthma?) issues. So reporting the problem to both the sleep doc and the allergy doc (or your PCP) is in order as well. It could be that a small adjustment in the dosing of your allergy might help.

Finally have you ever tried a neti pot or sinus rinse bottle? That too might be useful.

[catmama]

I have a Modem on the back of my machine that looks like a walkie talkie that she said
sends the info as well as a SD card. I don't have a problem every night but will try all
suggestions. I went today to get a neti pot will try that also. One nostril feels like I jumped in
a pool and water went up it. It tickles and is making my eye water I though maybe that would be from
too much humidity but at 3.5 that does not seem like much.

[Perrybucsdad]

One thing I have noticed (more with nasal pillows than when I was on the FFM) is if I "cheat" and use tap water for the humidifier, my nose and nasal passages have more issues the next day. If I use distilled water, I have never had an issue the next day.

I know with room humidifiers, if you use tap water you can get something called "white dust" and I wonder if this may be what is causing some of the issues I will see or that you are seeing.

John

[robysue]

I have a Modem on the back of my machine that looks like a walkie talkie that she said
sends the info as well as a SD card.

The point remains: The only data being gathered by your machine and reported via that modem is usage data----i.e. how many hours are you using the machine each day. And the only reason the DME is collecting this data is to make sure they get paid for the machine.

No one---not the DME, not the sleep doc, and not you, will ever be able to tell if your machine is actually controlling your apnea. And no one---not the DME, not the sleep doc, and not you, will ever be able to definitively determine whether you have enough leaks during the night to undermine your therapy.

Now, if you're actually feeling better with the CPAP than without it, then it's reasonable to assume that the pressure is sufficient to control your apnea and that your leaks are under control. But if you are having difficulties and/or still feeling pretty lousy, everybody will be working blind when they make suggestions for what you should try to make things better.

I went to get a neti pot will try that also. One nostril feels like I jumped in
a pool and water went up it. It tickles and is making my eye water I though maybe that would be from
too much humidity but at 3.5 that does not seem like much.

Pardon my denseness: Is it the neti pot or the CPAP that is tickling and making your eye water?

If it's the CPAP, then you might have an intermittent leak that is blowing into that eye. Or it could be the exhaust flow from the mask bouncing off your bedcovers or bedpillow and back into the eye making it water. Unfortunately, you need leak data to tell for sure, and your machine doesn't record any leak data. In working blind, somethings you could try: Be very careful about figuring out just where that strong stream of exhaust flow is going before you fall asleep. Try to make sure it's not bouncing off the covers and back into your face. Or cover your eyes with an eye mask or even just a hanky, and see if that helps. And if you report this problem to the DME or the sleep doc, they're likely to assume that you've got a mouth leak and tell you to try a chin strap. Which will help IF you do have a mouth leak, but not do much if that's not the cause of the problem.

[catmama]

I asked and was told that the Rescan modem gave more info than usage. I can see on the machine everyday the usage but will ask
next week when I go back. I have not used neti pot yet the tickle is all day and makes my eye water from the tickle in it. I have only
used distilled water never tap and have been very good about cleaning.

[Pugsy]

I asked and was told that the Rescan modem gave more info than usage.

The modem can and will transmit any and all data the machine gathers. If the machine doesn't record anything but hours of use then the modem can't transmit something the machine doesn't record.

Ask your DME to prove it. Show something more than hours of use. If it is a S9 Escape there is nothing on the machine except hours of use.
Now if you happen to have a S9 Escape Auto...model names are plainly shown on the machines, the you have hours of use, pressure and AHI. Nothing else.

http://www.resmed.com/us/products/s9_se ... patients#s

put a check mark in the S9 Escape and scroll down for the data information.

Efficacy data (AHI, AHI breakdown, leak, pressure, flow, etc) small blank line.
Compliance data which is hours of use...365 days...that is all.

[Kairosgrammy]

Shouldn't be. I use nasal pillows at 12. I have to ramp at the beginning of the night but other than that I'm fine. Suggestion would be to up humidier some and/or check your filter. It may be letting in more allegens because it is dirty. I feel your allergies. I have trouble with them two and everything for allergies messes me up. Astelin and most other nasal sprays don't help at all, singular makes me crazy and flonase doesn't work either. Most pills either make me so sleepy I can't function or make me sleepy/hyper at the same time. Right now, I find that upping the humifier and then using a netti pot is helping.

I have only just started 3 weeks ago and every few days I wake up congested and have a tickle in one
nostril all day that drives me crazy! I have the ResMed Escape with humidifier set at 3.5 I use the Swift fx
for her and love them but wondering if it is too much pressure for my nose.Only use 7 pressure but have allergies.
I take Flonase,Singular,astlyn spray.

[twokatmew]

I asked and was told that the Rescan modem gave more info than usage.

The modem can and will transmit any and all data the machine gathers. If the machine doesn't record anything but hours of use then the modem can't transmit something the machine doesn't record.

Ask your DME to prove it. Show something more than hours of use. If it is a S9 Escape there is nothing on the machine except hours of use.
Now if you happen to have a S9 Escape Auto...model names are plainly shown on the machines, the you have hours of use, pressure and AHI. Nothing else.

http://www.resmed.com/us/products/s9_se ... patients#s

put a check mark in the S9 Escape and scroll down for the data information.

Efficacy data (AHI, AHI breakdown, leak, pressure, flow, etc) small blank line.
Compliance data which is hours of use...365 days...that is all.

What Pugsy said! I started off with an S8 Escape. The DME insisted this machine provides efficacy data as well as usage data. I got the machine home and checked. Sure enough, it's only usage data. In my case, the respiratory therapist was a dim bulb. But DMEs can and do outright lie. I had to do battle to get them to swap the machine, which they ultimately did. And it's a good thing, because my prescribed pressure was 7, and I felt no better. Turns out I needed an auto with a pressure range of 11.5-17.0. How did we find that out? By using a machine that provides efficacy data.

It's to *your* advantage to make sure you get a machine that provides this efficacy data. If not, and you have problems, you'll have to have another sleep study. What would you prefer, checking data from your machine, or having a sleep study every time you have a problem? Also remember that unless you buy your machine(s) out of pocket, you'll be stuck with your existing machine for several years, perhaps five or more. The chances that you *won't* require a pressure change during that time aren't that great.

[catmama]

Ok I turned the humidifier up last nigh to 5 from what they set it on 3.5 and woke up with a lot less
congestion and no burning or tickling this morning.Also I called my insurance company first to make
sure about my machine to see what I was allowed and they said mine has been bought and paid for
already so the sleep clinic would have to agree to swap out for a different one. Why did they give
me this one if it does not give any info and any suggestion on how I get them to switch it? My AHI
was 32 so it is not mild I would think they would want to know how I am doing.

[twokatmew]

It's all about money. A brick is cheaper than a CPAP that provides efficacy data. And that's cheaper than an auto that provides efficacy data. Most insurances pay a set amount no matter which machine you get, so most DMEs will give you the cheapest machine they can ... unless your doc specifies a specific machine or machine-type on your Rx. Probably the best way to "encourage" your DME to swap that brick with a better machine is to ask your doc to write a new, more specific Rx. If an Rx says only CPAP at a specific, constant pressure, you'll be sold a brick.

[apneawho]

To answer your question about why they gave you the Escape, they gave it to you because they have a higher profit margin on a "brick". Read Janknitz blog info mentioned earlier to learn about this. You must be educated to advocate for yourself.
For your congestion, try aromatherapy, PurSleep.com, I use Clear and it is pleasant smelling and keeps me clear! I use nasal pillows like you. You place the aroma disc next to the air intake on your machine. I hope this will help you.