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Re: Should be sleeping, but ...

Posted: Fri Mar 16, 2018 11:21 am
by chunkyfrog
Lucyhere wrote:
Fri Mar 16, 2018 10:29 am
jnk... wrote:
Fri Mar 16, 2018 10:12 am
. . Costco nasal spray . . .
Any reason for the spray instead of the pills?
Local application delivers the drug directly to the point of need,
working faster and requiring less drug--avoiding some side effects.
EX: Steroids can have devastating effects on blood sugar levels in diabetics.

Re: Should be sleeping, but ...

Posted: Fri Mar 16, 2018 11:49 am
by jnk...
chunkyfrog wrote:
Fri Mar 16, 2018 11:21 am
Steroids can have devastating effects on blood sugar levels in diabetics.
Good point. And I am technically a diabetic.
CONCLUSION:
Intranasal corticosteroids seem to have no adverse effects on HbA1c and serum glucose levels in diabetic patients. Their long-term use appears to be safe, provided that the patients are carefully monitored, especially those receiving triamcinolone acetonide. -- https://www.ncbi.nlm.nih.gov/pubmed/23168154
. . . we suggest that clinicians carefully monitor blood glucose control when diabetic patients initiate ICS [inhaled corticosteroid], especially with higher dosages. -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705276/
Although . . .
Steroid inhalers and creams usually don’t raise blood glucose levels. -- https://www.diabetesselfmanagement.com/ ... -steroids/
The main concerns for me, beyond the obvious ones (harm to nasal passages, nosebleeds, etc), were some statistical associations with eye issues: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910615/

But, yeah, thanks for that, Chunkyfrog. Very true. Excellent reminder. For me and others.

@OP: Sorry for the hijack and Costco spam, but you did mention "the air just isn't getting in through my nose." That was the exact experience I had a few weeks ago that led me to this approach for my circumstances.-jnk

Re: Should be sleeping, but ...

Posted: Fri Mar 16, 2018 2:36 pm
by Okie bipap
I had a badly deviated septum and had many of the symptoms you are experiencing. I could only breath out of one side of my nose at any one time, and would often clog up completely at night. I had the deviated septum corrected and had turbinate reduction done at the same time. My nose never stops up now.

Re: Should be sleeping, but ...

Posted: Fri Mar 16, 2018 3:42 pm
by Mogy
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!

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.
Hi SarahB,
Have you thought about raising your min pressure a bit? When I look at your data I don't see it up at 20. When you start out, or stop in the middle of the night, you go down to your min pressure. Currently at 6.

Re: Should be sleeping, but ...

Posted: Fri Mar 16, 2018 5:50 pm
by rick blaine
Hullo again SarahB,

As you know but other members might not, Aberdeen, Scotland is on the coast, and the humidity varies annually between 80pc and 90pc - so some medics might say yese divnae need a humidifier. 8)

But there are two reasons for using a humidifier. One is: it moistens the air. And the other is: it warms up the air. And it may be that it's the cold air that's causing all the trouble.

Where you are, the setting might not need to be very high to give both the right amount of moisture and the right degree of temperature. I certainly think, given the history you've described, a month's trial with a huumdifer is indicated.

Now, as to the Royal Infirmary's readiness to issue you with one (and it is the Royal, isn't it? In Foresterhill?), can I say this:

Seven years ago, almost all foundation trust hospitals in the UK weren't in the habit of issuing humidifiers. But over the last two or three years, the picture in many areas has been changing as clinicians realise there are benefits in terms of fewer side effects and in terms of usage compliance. And from what you say, it's not like the clinic doesn't have any at all. :D

So you should just gie it laldie and ask again. 8)

If they can't or won't issue you with a humidifier, you might think about buying one yourself. The cost is about £150, and the unit will easily last five years - so that's less than 10p a night.

You can call up ResMed UK on 0800 917 7071, and they'll send it express for delivery the next day.

I don't work for them and Ah'm no' getting paid for this, but ResMed currently have an offer on the go - 15 per cent off all products up until midnight on Monday, 2nd April.

Orra best, hen.

Re: Should be sleeping, but ...

Posted: Fri Mar 16, 2018 7:23 pm
by booksfan
Okie bipap wrote:
Fri Mar 16, 2018 2:36 pm
I had a badly deviated septum and had many of the symptoms you are experiencing. I could only breath out of one side of my nose at any one time, and would often clog up completely at night. I had the deviated septum corrected and had terminate reduction done at the same time. My nose never stops up now.
I, too, had a septoplasty and turbinate reduction (in August) and now I can breathe! It truly is wonderful!

Re: Should be sleeping, but ...

Posted: Fri Mar 16, 2018 7:32 pm
by Okie bipap
After I got the splints out, I told my wife I didn't know there was so much air out there. It made a major difference in how well I could breathe.

Re: Should be sleeping, but ...

Posted: Sat Mar 17, 2018 2:37 am
by SarahB
kteague wrote:
Fri Mar 16, 2018 9:17 am
It may be your DME's policy to not offer a humidifier until the patient demonstrates a need for one.

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.
I think you're correct. They probably don't give out equipment unless it's needed. Also, there's quite enough to get used to when first starting on CPAP that they probably try to keep it simple to begin with.

One of the masks I tried was a nasal pillows mask but my face was the wrong shape and with the mouth piece fitted the nasal pillows were pointing forwards instead of upwards. :lol:

Re: Should be sleeping, but ...

Posted: Sat Mar 17, 2018 2:50 am
by SarahB
Wow! So much advice! Thank you all. :D

Yesterday I popped into the supermarket and bought an oxymetazoline nasal spray and some Breathe Right nasal strips. I used them both last night and it was amazing! Just to be lying there taking in air through my nose - both sides at once! - without any effort was wonderful. :D I slept all night and had an AHI of 0.4.

The spray instructions say don't use for more than 7 consecutive days so that's not a long term answer. I think I'll go to the GP and see if they can find the cause of the restriction and do anything about it.

Re: Should be sleeping, but ...

Posted: Sat Mar 17, 2018 3:17 am
by SarahB
Mogy wrote:
Fri Mar 16, 2018 3:42 pm
Hi SarahB,
Have you thought about raising your min pressure a bit? When I look at your data I don't see it up at 20. When you start out, or stop in the middle of the night, you go down to your min pressure. Currently at 6.
It was that bit around 3am where I had woken up and for some reason turned off the machine (I think I was uncomfortable or something) and then turned it back on. The pressure went up from 6 to 20 without any air getting through so I switched off.

My minimum pressure was set at 4 originally but I changed it to 6. I could start with a higher pressure, I suppose. My point was that no amount of pressure was enough to get air in - and I was awake at the time.