Nasal pillows causing blocked nose.

Hi, I've got two issues which I will split into two different posts. First:

Nasal pillows causing blocked nose. Resmed Airsense 10 APAP

I'm struggling with the nasal pillows. (Why I'm using NP over full face mask will be in the other post)

I like the nasal pillows a lot, but am often waking up with a blocked nose which gets progressively worse throughout the day. My CPAP healthcare provider sent me the humidifier which they thought would help but it has not eliminated the problem. The first few days the humidifier felt good but today I've woken again with the blocked nose/sneezing.

Settings are on default at the moment: humidity level 4. Other settings (pressure) are set by my health provider and seem to be working fine for controlling the OSA.

A search online really doesn't provide much info at all on this topic. It usually's the inverse – people have a cold and want to use the nasal pillows. In my case the nasal pillows is *causing* something effectively similar to a cold (blocked nose/sneezing).

This is a miserable. I just want to be able to use CPAP. I'm wondering if there is a particular dust problem where I live and the machine is drawing in irritants which are being blown up the nose. The air filter is installed properly though and looks totally clean.

Any help would be appreciated.

So how many nights using the humidifier and at what setting?

Pugsy wrote: ↑

Sun Nov 27, 2022 8:58 am

So how many nights using the humidifier and at what setting?

I think 4 or 5 nights so far and went well, then this morning the blocked nose/sneezing appeared again. Humidifier is still on the default of 4 as a I mentioned. Thanks.

Origin wrote: ↑

Sun Nov 27, 2022 8:44 am

Settings are on default at the moment: humidity level 4. Other settings (pressure) are set by my health provider and seem to be working fine for controlling the OSA.

You've got plenty of room to play around with the humidifier setting.

Your particular nose may want more humidity than a setting of 4 is providing. The maximum setting is 8. So you could turn the humidifier up. The main problem with using a humidifier setting that is much higher than 4 is that the chance of rainout increases as the humidifier setting is increased. Using a heated hose helps minimize the problem with rainout---should it occur.

But it's also possible that your particular nose may want less humidity than a setting of 4 is providing. Some people's noses are actually better off with a humidifier set to something less than 4.

So you need to experiment with both increasing and decreasing the humidity level. One way to think about which way to decide which way to experiment first is to think about whether your nose really enjoys the steam from a hot shower. If it does, then increasing the humidifier may help. If it doesn't, then decreasing the humidifier may help.

A search online really doesn't provide much info at all on this topic. It usually's the inverse – people have a cold and want to use the nasal pillows. In my case the nasal pillows is *causing* something effectively similar to a cold (blocked nose/sneezing).

So your nose didn't get that particular memo about how "nasal pillows should help". Like lots of things connected to xPAP, many people's own experiences don't mesh very well with conventional wisdom about what should happen.

My guess is that your nose may be a bit more sensitive to the air being blown directly into the nostrils. And irritated noses tend to react by getting clogged up. Increasing (or decreasing) the humidifier setting may help the nose become less sensitive to the air being blown in through the mask.

But you might also want to consider a small nasal mask (not a full face mask) as an alternative. If you don't want something covering the top of your nose, you might want to consider a nasal cradle mask like the AirFit N30i nasal mask or the AirFit N30 nasal mask as alternatives to the nasal pillows mask you are currently using.

This is a miserable. I just want to be able to use CPAP. I'm wondering if there is a particular dust problem where I live and the machine is drawing in irritants which are being blown up the nose. The air filter is installed properly though and looks totally clean.

If you are particularly worried about allergens making their way through the air filter, you can also use a hypoallergenic air filter designed for your AirSense 10. These filters will filter out most common allergens, including pet dander, pollen, and dust. They are made differently from the regular air filters, but you can't really tell what type of filter you are currently using just by looking at it. The default filter is not the hypoallergenic one.

Thank you for the detailed reply robysue1.

It's very strange. Even before without the humidifier in the machine, I might go 4 nights no problem at all, then the blocked nose appears. Then other times I would get only 1 night and then the blocked nose.

Ok I will definitely try the humidity settings, again appreciate the help.

Steam in the shower...hmmm..interesting.. Normally I just 'breathe' and don't think about it too much. But I will try upping the humidity a bit to begin with.

When the nose gets like this I have to take a break from the machine. It's that miserable, so it will be back to the mandibular splint tonight (my OSA is not severe). I've tried to 'tough it out' before with a blocked nose from one night into the next and the result is like utter hell the next day.

Thanks for the links to alternative nasal masks and filters. The hypoallergenic filter looks like it might be worth a shot.

My only other thought is that as leaks sometimes occur as one changes position during sleep, part of me wonders if the leak itself is contributing to the irritation somehow. Not sure.

Consider when blocked up using an OTC nasal spray like fluticasone or similar. Some of us use a nasal rinse as well like NeilMed.