Should be sleeping, but ...

... woke up after three hours and can't get back to sleep because the air just isn't getting in through my nose despite the pressure rising to 20. So here I am, mask off, having a bit of a breather. Gasp, gasp!

I don't have a cold. This just happens quite often when I lie down although usually it's only a partial blockage. I mentioned it to the consultant last week and he didn't seem concerned as I was breathing okay through my nose as I sat there.

I'm still just a few weeks into CPAP therapy. I've tried all the full face masks which the clinic has. Only one seals properly (with difficulty) but I find it very uncomfortable/painful and have higher leaks and AHI than with the nasal mask.

My nasal mask is fantastically comfortable in comparison and my AHI has been consistently below 1.0 lately so I want to stick with this arrangement. I just need to sort out this problem and find a way of breathing comfortably.

SarahB wrote: ↑

Thu Mar 15, 2018 9:36 pm

... woke up after three hours and can't get back to sleep because the air just isn't getting in through my nose despite the pressure rising to 20. So here I am, mask off, having a bit of a breather. Gasp, gasp!

Go out and get some afrin, or the generic, oxymetazoline hcl... and use it, *but only at night*... that way, your nose won't become dependent on it, and you won't suffer the rebound congestion that it's famous for.

Google "nasal cycle" and read up and see if anything strikes as a possibility.

Also...what humidity setting are you using?

And if you remove the mask how sooner before the nose opens up?

Sometimes pressure on the outside of the nose can cause the nasal tissues to expand.
On me, it is exactly where most full face masks rest on my nose.

Pugsy wrote: ↑

Thu Mar 15, 2018 9:42 pm

Google "nasal cycle" and read up and see if anything strikes as a possibility.

Also...what humidity setting are you using?

And if you remove the mask how sooner before the nose opens up?

Amazing what you can learn about your nose at 4am! I had never heard of the nasal cycle or its link to smell. Oddly, I'm always smelling things that nobody else notices.

I don't have the humidifier for my machine. The clinic nurse showed me it but didn't give it to me. She mentioned something about not using it and as I knew nothing about CPAP machines I didn't question it.

The nasal obstruction isn't linked to wearing the mask. I've always been aware of having restricted breathing through my nose. Usually I can use one nostril and things are fine but occasionally everything shuts down. That's not ideal with a nasal mask. Sitting up usually helps or pulling outwards from the sides of the nose, pressing on the cheekbones.

Get the humidifier...see if it helps with the congestion.
Google "cpap rhinitis"

Also get something like Simply saline which is a nasal saline rinse/spray. Use it frequently during the day.
Also if the congestion needs oral meds...decongestant or whatever...do whatever it takes to open up the nose...even that tiny bit of something like Afrin if you need to. Use the Afrin sparingly only at bedtime when nothing else works.

Use the saline nasal spray frequently during the day. As much as you want or nee dto.

Thanks! This is very helpful. I know I'm being silly but I feel embarrassed at the thought of contacting the clinic yet again. I've been messaging then constantly over the past few weeks in connection with difficulties with the full face mask. They only operate a message recording service and there was a lot of confusion and frustration trying to get in touch. It was like a game of Chinese whispers! Eventually the nurse herself got the message and phoned me directly. She invited me in last Friday and spent a whole hour trying me with every mask they had and giving me tips on fitting. The final conclusion was that the full face mask I already had was the best fit. I meant to ask about humidifiers at the time but it went out of my head. I don't feel I can phone back a week later, admit that I'm not using the mask after all that, and then ask for another piece of equipment!

SarahB wrote: ↑

Thu Mar 15, 2018 10:45 pm

I don't feel I can phone back a week later, admit that I'm not using the mask after all that, and then ask for another piece of equipment!

You wouldn't necessarily have to talk about the mask when you phone back; say that you were distracted by all the masks at the fitting, and forgot to ask for the humidifier. It's your health that matters here; you should be able to ask any question you have to ensure your treatment is optimal. And you'll be prepared for that conversation with everything you have researched in the meantime.

Jean

Thank you, everyone, for your suggestions and support and for your company during the gap in the chart below. I went back to sleep eventually but seem to have had a lot of events which is very unusual. I'm not sure what that was all about. If the little numbers in brackets, eg. (10) indicate the number of seconds then one of them lasted 72 seconds! Compare that chart to the night before when I spent ages trying to get to sleep but once I did sleep there were no events at all. Bizarre couple of nights!

Hi Sarah:
Regarding your nasal congestion, I have found the following to be helpful. 1. Be sure you are really hydrated - big glass of water first thing in the morning and at regular intervals thru the day. 2. I echo the saline rinses, but found that I seem to be sensitive to the preservative used in the less expensive types and had increased congestion, so I switched to a brand that uses baking soda as a preservative. ( Tho more $$ ).
I have the same mask as you do and also use a plastic splint device (variation on the nose cone concept) under the mask. It helps spread the nares and provides me with increased air flow especially on one side where I have a slightly deviated septum.
I will leave interpretation of sleepyhead data to those more knowledgeable than me. I am a relative newby as well (3 months) slowly improving with help from all the members on this forum.
xcountrygal

It may be your DME's policy to not offer a humidifier until the patient demonstrates a need for one. I happen to think every patient should have the option of having one readily available because our needs change with the weather and moving between climates and use of heat or a/c. You won't know if humidty will help your nighttime congestion until you try it. Your DME should want you to succeed. Their future monies with be zilch if you stop using the treatment. They are not doing you a favor by helping you succeed. You are doing them one by giving them your business.

I'm not familiar with your history, so forgive me if I'm being redundant. Have you tried a nasal pillows mask and if so, did the congestion happen then too? If so, that would rule out mask pressure on the sides of the nose as the cause.

Good luck with figuring things out. If you find you do need to stick with a full face mask, utilize forum tips on ways to manage your hose and best type of sleeping pillow for your sleep position, etc. until you reach a place where you can comfortably breathe and sleep at night.

Not quite on topic, but for allergies, I seem to be having some success with nasal corticosteroid sprays, which is what I'm gonna use instead of allergy pills this year.

Costco has an amazing price for it, $23 for five(5) bottles of 120 sprays each . . .

Kirkland Signature Aller-Flo, 5 Bottles
★★★★★
★★★★★ 4.5 out of 5 stars. R
Item #1028472
Member Only Item

Your Price22.99$
Price Per OUNCE: $8.07
Free Shipping
Shipping & Handling: $0.00*

Features:
Compare to Flonase Allergy Relief Active Ingredient
Fluticasone Propionate(Glucocorticoid) 50 mcg.
Indoor/Outdoor Allergy Relief
Non-Drowsy
5 Bottles, 120 Sprays Each

jnk... wrote: ↑

Fri Mar 16, 2018 10:12 am

Not quite on topic, but for allergies, I seem to be having some success with nasal corticosteroid sprays, which is what I'm gonna use instead of allergy pills this year.

Costco has an amazing price for it, $23 for five(5) bottles of 120 sprays each . . .

Kirkland Signature Aller-Flo, 5 Bottles
★★★★★
★★★★★ 4.5 out of 5 stars. R
Item #1028472
Member Only Item

Your Price22.99$
Price Per OUNCE: $8.07
Free Shipping
Shipping & Handling: $0.00*

Features:
Compare to Flonase Allergy Relief Active Ingredient
Fluticasone Propionate(Glucocorticoid) 50 mcg.
Indoor/Outdoor Allergy Relief
Non-Drowsy
5 Bottles, 120 Sprays Each

Any reason for the spray instead of the pills?

Good for you meeting with them for an hour and trying every mask! It shows you really value your health and want to succeed! Don't worry about contacting them too frequently. Most of us have an adjustment period and then the number of questions settles down. I personally have developed a great relationship with my doctor's office/supplier by calling her often. And I mean often.

Just remember there are many, many masks available online from multiple manufacturers. If you are not finding a good match (there is no such thing as a perfect mask), chances are the good members of this forum will point you in the right direction. Keep asking questions of us too. That's why we are here.

Lucyhere wrote: ↑

Fri Mar 16, 2018 10:29 am

Any reason for the spray instead of the pills?

My doc has been on me to try it since even back in the days when they all required an Rx. I finally relented this year after reading some studies and articles. I live in a rural area surrounded by nature now, instead of NYC, and my nasal troubles were starting to interfere with my PAP therapy, even on pills. After a few weeks of spray, my nasal passages seem a LOT better. I am both seasonal AND year-round, but there is too much going on this spring for me to be down.

Admittedly, finding it that cheap is what pushed me over the edge. The branded versions in department stores are often that price and more for ONE bottle.

Here is a summary/explanation of recent thinking from clinicians on these types of sprays:

http://www.abc.net.au/news/health/2017- ... es/9199820
http://annals.org/aim/fullarticle/26643 ... 2017-joint