Nose Stuffed All Night

[Starlette]

Hello everyone,
It is just about time for me to go to bed. But before doing so, I wanted to create this post to get things moving along.
Not that long ago, I had created a post regarding my data AHIs looking so bad and I was going to provide documentation.
Since then, AHIs have not improved. So, I have decided to go another route to reduce the AHIs.

While sleeping, my nasal passages collapse to where I cannot breathe at night through my nostrils. The consequence is that in the morning, I have an excruciating migraine that lasts about two days. This has been going on for years. There have been times when folks on the forum have talked about their dealings with stuffy noses at night. From the forum, the recommendation has been to use "Ocean Spray" to open up nasal airways. I have been following this advise for quite a while, but to no avail.

I sent an e-mail to my primary care physician and received a reply. Which states as follows:

To: PCP
From: Starlette
Date:8/28/2014 12:03 PM
Subject: RE: ENT Referral Request

Good afternoon,
I would appreciate a referral for an ENT.
While asleep, my nostrils collapse/become stuffy to prevent breathing. As a result, I am very, very sleepy the next day.

This is their response:
Our first step in evaluating this is to order a nocturnal pulse-ox study to help us understand if perhaps the flow of oxygen is disturbed while you sleep. This is something we can handle at this point and will refer if we need to later. My team will call you to set this up within 10 days or so.

Thanks!.
__________________

So, all that said, what is a nocturnal pulse-ox study? What can I expect from this procedure?

Thank you,
Starlette

[Wulfman...]

Hello everyone,
It is just about time for me to go to bed. But before doing so, I wanted to create this post to get things moving along.
Not that long ago, I had created a post regarding my data AHIs looking so bad and I was going to provide documentation.
Since then, AHIs have not improved. So, I have decided to go another route to reduce the AHIs.

While sleeping, my nasal passages collapse to where I cannot breathe at night through my nostrils. The consequence is that in the morning, I have an excruciating migraine that lasts about two days. This has been going on for years. There have been times when folks on the forum have talked about their dealings with stuffy noses at night. From the forum, the recommendation has been to use "Ocean Spray" to open up nasal airways. I have been following this advise for quite a while, but to no avail.

I sent an e-mail to my primary care physician and received a reply. Which states as follows:

To: PCP
From: Starlette
Date:8/28/2014 12:03 PM
Subject: RE: ENT Referral Request

Good afternoon,
I would appreciate a referral for an ENT.
While asleep, my nostrils collapse/become stuffy to prevent breathing. As a result, I am very, very sleepy the next day.

This is their response:
Our first step in evaluating this is to order a nocturnal pulse-ox study to help us understand if perhaps the flow of oxygen is disturbed while you sleep. This is something we can handle at this point and will refer if we need to later. My team will call you to set this up within 10 days or so.

Thanks!.
__________________

So, all that said, what is a nocturnal pulse-ox study? What can I expect from this procedure?

Thank you,
Starlette

It's a device that clips onto one of your fingertips and records your blood oxygen while you sleep. Then, the download the data and generate a report to see what your blood oxygen is doing at night. It's not supposed to drop below about "89".
It essentially tells them how your therapy is working. I had one done (over a two night weekend) back when I started therapy. There are some that a person can buy from various sources these days for personal use. They've been discussed frequently on the forum.
In fact, you posted in this thread that you had one.

viewtopic.php?f=1&t=58734&p=552829&hilit=+CMS50#p552829


Den

.

[Pugsy]

You put one of these on your finger and sleep with it on the finger and then give it back to them and they tell you if your oxygen levels dropped during the night.
Probably won't be this brand but they all work on the same premise. I thought you had one?
http://www.pulseoxstore.com/Downloadable-Pulse-Ox.html

If your nose gets stopped up ...then you most likely will breathe through your mouth...and the oxygen levels won't drop so I don't know how much help this will be but......
This is what a doc might do in prelude to a sleep study...does the office person who sent this know you are already a sleep apnea patient with a cpap machine already? You might want to clarify things with them.

Good to see you again. I am sorry things aren't going well.

[SleepGuy]

Neilmed sinus rinse provides decent relief but this same problem I had did not resolve until my septoplasty surgery. Good luck! Getting treatment is very important. That low blood oxygen will kill you eventually.

[49er]

Hi Starlette,

I agree with Pugsy about their recommendation not making any sense. As one who feels that emailing my PCP has not resulted in adequate communication, I have found it is better to all or make another appointment. Perhaps, you might want to do the same thing and when you do, state that you are perplexed by this recommendation because it your understanding according to the mainstream literature that problems you have require an extensive evaluation by an ENT. Does your insurance company require that you get a referral to a specialist?

Also, have you played with the humidity to see if a certain level works better than others?

I hope you feel better soon.

Hello everyone,
It is just about time for me to go to bed. But before doing so, I wanted to create this post to get things moving along.
Not that long ago, I had created a post regarding my data AHIs looking so bad and I was going to provide documentation.
Since then, AHIs have not improved. So, I have decided to go another route to reduce the AHIs.

While sleeping, my nasal passages collapse to where I cannot breathe at night through my nostrils. The consequence is that in the morning, I have an excruciating migraine that lasts about two days. This has been going on for years. There have been times when folks on the forum have talked about their dealings with stuffy noses at night. From the forum, the recommendation has been to use "Ocean Spray" to open up nasal airways. I have been following this advise for quite a while, but to no avail.

I sent an e-mail to my primary care physician and received a reply. Which states as follows:

To: PCP
From: Starlette
Date:8/28/2014 12:03 PM
Subject: RE: ENT Referral Request

Good afternoon,
I would appreciate a referral for an ENT.
While asleep, my nostrils collapse/become stuffy to prevent breathing. As a result, I am very, very sleepy the next day.

This is their response:
Our first step in evaluating this is to order a nocturnal pulse-ox study to help us understand if perhaps the flow of oxygen is disturbed while you sleep. This is something we can handle at this point and will refer if we need to later. My team will call you to set this up within 10 days or so.

Thanks!.
__________________

So, all that said, what is a nocturnal pulse-ox study? What can I expect from this procedure?

Thank you,
Starlette

[JDS74]

Hi Starlette:

Did you try a full face mask (FFM) and that failed for some reason? With a FFM, it won't matter if the nasal passages collapse or not, you can still breathe through your mouth and get therapeutic pressures to keep your airway open. Humidity will be required though.

If you can switch to a FFM for a test, then I suggest that you add a soft cervical collar at night to keep your jaw supported and prevent leaks that happen with jaw drop as you are asleep.

[englandsf]

Your PCP is acting as if they do not know you are on CPAP, for sure. I'd clarify that for them.

What was your oxygen saturation number (minimum) during your sleep study?

When I tested nasal masks and the smaller FFMs - they both hit the narrow bridge of my nose and stopped me right up, making me think I was right when I thought I might be a mouth breather. Then I got into nasal rinsing and corticosteroids (PM me for more info, it's boring to others) and now use nasal pillows to great effect (AHI around 1, three months in, 8 hrs a night).

I also now breathe through moderate congestion when it happens (used to scare the crap out of me) and manage my humidity at the low end of the spectrum (most need lots but some need little - you need to know which you are).

Above all, be patient. 30/60/90 days of mask experiments (and maybe a few $100s) will get you where you need to be and you'll be just fine. It took me about 40 nights of relative hell and about $300 (mostly with CPAP.com and some insurance orders with them) to crack it but now I'm doing and feeling so much better.

[49er]

When I tested nasal masks and the smaller FFMs - they both hit the narrow bridge of my nose and stopped me right up,

That was my experience with several FFMs as I had to severely tighten the straps to avoid massive leaks. This leads to another point.

Due to being a terrible mouth breather in spite of having constricted nasal passages, an FFM was not necessarily the best option since I still needed room to breath though my sinuses at least simultaneously along with opening my mouth. Of course, this may not be applicable to Starlette's situation but I wanted to throw it out there.

49er

[englandsf]

49er - there is too much of a push to FFMs IMHO, with bridge issues coming next, especially at higher pressures. There should be more investigation of how to get the patient to nose breath and then have all their options open.

DMEs don't seem to have any triage system for mask selection and it's the biggest issue for compliance/success. Biggest problem in the CPAP game I think.

[BlackSpinner]

49er - there is too much of a push to FFMs IMHO, with bridge issues coming next, especially at higher pressures. There should be more investigation of how to get the patient to nose breath and then have all their options open.

k.

It is called Hybrid mask - solves all the problems. It encourages nasal breathing but doesn't prevent mouth breathing and goes no where near the bridge of the nose.

[englandsf]

Tried one but the straps were so huge and claustrophobic and the chin bar thing so odd/painful (Innomed version) for me. I was still under the impression that I could not nose breath.

[RandyJ]

Starlette,

I suffer from the same issue, more during the summer when I am running my central air conditioning 24/7. I'll be OK when I go to sleep but I'll wake up at some point and feel like I'm breathing through a straw. The NeilMed rinses help, but I need a presciption nose spray that ENT gave me; I use Nasonex, but there are others (Flonase, etc).

The spray keeps my nostrils open all night, usually. On the rare night it doesn't, I'll use Afrin (just for that one night) so I can get back to sleep.

Good luck!!

[Day_Dreamer]

Starlette,

I suffer from the same issue, more during the summer when I am running my central air conditioning 24/7. I'll be OK when I go to sleep but I'll wake up at some point and feel like I'm breathing through a straw. The NeilMed rinses help, but I need a presciption nose spray that ENT gave me; I use Nasonex, but there are others (Flonase, etc).

The spray keeps my nostrils open all night, usually. On the rare night it doesn't, I'll use Afrin (just for that one night) so I can get back to sleep.

Good luck!!

Same as above but I add a breath-rite strip Extra strength
I'll also blow my nose and redo a neilmed rinse if I take a bathroom break and feel stuffed

I might try the Afrin for those rare nights when I wake up an feel like I am breathing trough a straw...I did not realize it could be used with Flonase

[RicaLynn]

Starlette,

I suffer from the same issue, more during the summer when I am running my central air conditioning 24/7. I'll be OK when I go to sleep but I'll wake up at some point and feel like I'm breathing through a straw. The NeilMed rinses help, but I need a presciption nose spray that ENT gave me; I use Nasonex, but there are others (Flonase, etc).

The spray keeps my nostrils open all night, usually. On the rare night it doesn't, I'll use Afrin (just for that one night) so I can get back to sleep.

Good luck!!

Same as above but I add a breath-rite strip Extra strength
I'll also blow my nose and redo a neilmed rinse if I take a bathroom break and feel stuffed

I might try the Afrin for those rare nights when I wake up an feel like I am breathing trough a straw...I did not realize it could be used with Flonase

Randy, do you take the Nasonex at night then? The ENT I saw last week prescribed Flonase, but indicated I should take it in the morning.

DayDreamer, do you find that the breathe right strips help?

[Pugsy]

do you take the Nasonex at night then? The ENT I saw last week prescribed Flonase, but indicated I should take it in the morning.

Maybe he was thinking use it in the AM to help with daytime stuffiness. I use Flonase prn but really only use it occasionally at bedtime for minor stuffiness. That and a little saline spray (like Simply Saline) seems to keep my nasal passages nice and open until the humidifier's humidity kicks in and I normally wake up in the AM breathing clearer than when I went to bed.
But I will admit..any allergy like symptoms I might have aren't huge...so YMMV