Stuffy Noise, Bloating and Bothered

I'm a 56-year-old man who has been diagnosed with with mild-to-moderate OSA (15 episodes an hour) and am trying out a CPAP machine with full face mask for a month. I appreciate that you have to give these things time and that adjustments inevitably must be made. But I admit I'm starting to feel frustrated.

Firstly, I've always had trouble breathing through my nose. Five years ago, when I was first diagnosed with apnea, I saw an ear, nose and throat surgeon who said I had a deviated septum. He subsequently carried out a septoplasty and turbinate reduction procedure. This helped my breathing,but recently my wife told me I was returning to old habits - snoring and stopping breathing during sleep. I was in denial for a while, but recurring morning headaches and feelings of sluggishness and persistent low mood led me to taking another sleep test.

Sure enough, I still had OSA. Having tried surgery, I opted for the CPAP machine. I've had a couple of nights of good sleep in the three weeks I've had it, but the general experience has been less than ideal. The biggest problem is stuffy nose and bloating. Despite using a nasal saline rinse before bed, I find my nose quickly stuffs up. I end up breathing through my mouth again in sleep. My mouth becomes dreadfully dry and I end up feel bloated and flatulent from swallowing so much air. This leaves me getting up in the middle of the night, which sort of destroys the point of the therapy.

The clinic advised me to turn up the humidifier, which I've done, and tighten the straps on the mask to prevent leaks. But that hasn't fixed the problem. Essentially, if you suffer from nasal congestion and breathe through your mouth, you can't use pillows or a nasal mask. And if you use a face mask you end up getting even more congested and swallow so much air you feel like Elvis after 45 cheeseburgers and 100 cokes.

On top of this are the usual reservations and feelings of claustrophobia, inconvenience and feeling like Denis Hopper from Blue Velvet.

My next stop is trying a mouth splint. I'm not particularly overweight (BMI of 25), 72 kilos and 170cm tall. But I do have something of a receding chin and wonder whether that is the real problem. I don't smoke, am a moderate drinker and exercise regularly.

Anyway, I'm interested to hear what others think.

A few things:

(1) what machine are you using? (add it to your profile)
(2) are you using a humidifier?
(3) what is your current pressure?
(4) have you taken a look at your stats on Sleepyhead?

If you answer those four questions, people here can help you a lot easier.

Couple more questions:

(1) What is the pressure that is set up on your machine? You state it is auto but there is still a range like 4-20, or 8-16, etc...
(2) Based on your pressures and your AHI scores, you could have your machine set too high. But the only way to find out is to state what the pressure that is set on your machine.
(3) Do you use EPR? It's an option to reduce the pressure when you exhale.

Surgery isn't foolproof - as you've found out already. You could easily be still on CPAP after the surgery.

All good questions, but I'll need to check on the machine settings when I get home. I'm pretty sure the range for pressure is 4-20. I also recall EPR being part of the set-up. It's the top-of-the-line Resmed machine. And, yes, I've discovered surgery isn't foolproof, though I probably needed it anyway. My main concern is that the nasal stuffiness is being brought on by the CPAP.

Nasal stuffiness or congestion could be from the humidity.
Humidity needs vary and some need more humidity and some need less humidity.
Since you have already tried more humidity you might try less.

Also, you might be like me and the weight of the mask on the nasal bridge area causes the congestion.
Usually when it it the weight of the mask the congestion will pretty much go away quickly once the offending pressure is removed. I get it with any mask across the bridge of my nose. I even get it with the weight of sun glases. Relief is rapid...remove whatever is on the nasal bridge area and within a short time I breathe quite freely through my nose.
Take your finger tips and press gently on the sides of your nose up by the nasal bridge area for a few seconds...if you get congested and when you remove the pressure the congestion clears up then you are like me.
This greatly limits any mask choices but there's a full face mask that doesn't touch the nasal bridge area.
The Innomed/RespCare Hybrid or the Amara View or ResMed Liberty.

The bloating...that's aerophagia and a common complaint.
wiki/index.php/Aerophagia
There are ways to reduce the risk...maybe limit the pressures or utilize EPR more fully.
You may need to evaluate the pressure in greater detail so see where it is actually going.
You need to use the software for that.
https://sleep.tnet.com/equipment

The machine you have pictured is the Elite and it is a single pressure CPAP. Is that the correct machine or does yours say Autoset?

Need to check on the machine. They told me it was their top one. Will try reducing the humidifier.

your situation sounds like mine. Here is what I discovered YMMV
1. congestion was not always congestion. CPAP is pressure inside your nose, your brain being new to this interprets this pressure as congestion. Anyway mine did. used ramp to keep pressure low until I was asleep. The pressure does not wake me up.
2.I also can't have anything on the bridge of my nose. Amara View mask.
3.I also have trouble exhaling into pressure so no nasal pillows, tried the P10 and not a chance I could use it. I am on BiLevel now and happy.
4.I thought I liked humidity, but no, not with CPAP. 63 degrees humidity off. water in the tank for passive humidity. happy with that

Play with your comfort settings, that's what they are there for. Make CPAP comfortable for you.

It sounds like the Airsense 10 Autoset.