CPAP rhinitis?

This is a concept I came across last night. I suspect it might apply to me.

Two or three weeks ago I had what I first thought was a streaming cold, then decided it was hayfever, although I hadn't had it for years, but it didn't respond to the three antihistamines and two nasal sprays that I tried. My nose is tickly, I sneeze explosively during the day and my eyes are watery. It's been getting worse instead of better.

Last night was the limit! I managed four hours of sleep but woke up with my nose totally blocked and streaming like a tap, and a sore throat. I didn't manage to sleep after that as the mask was off every minute because of the runny nose. My eyes were bloodshot and watering - lovely!

Today I got a doctor's appointment. By the time I got there my throat was so swollen that I could hardly speak. The insides of my nose were also swollen. The doctor has put me on steroid tablets, a steroid nasal spray and more antihistamines. He's not sure whether it's a viral infection or an allergic reaction.

Last night I heard about CPAP induced rhinitis for the first time. It made sense that this might be the cause. I've been on CPAP for three months, using a nasal mask but I don't have a humidifier. All that dry cold air being blown up the nostrils at pressure every night might have an effect. I suggested this to the doctor and he agreed that I should contact the sleep clinic to see if they would advise the use of a humidifier. I wasn't given it when I got the machine - the nurse showed me it and said I wouldn't be using it. Presumably they wait and see if you need one before giving them out.

I might even go back to using the dreaded face mask which I don't find comfortable. I had a nap with it this afternoon to try to catch up on some lost sleep and it wasn't too bad.

SarahB wrote: ↑

Thu May 03, 2018 2:35 pm

All that dry cold air being blown up the nostrils at pressure every night might have an effect.

Only, there's *NO* air being "blown up the nostrils", dry, cold or otherwise.

It's like the water under pressure in your pipes at the house, nothing is moving, nothing is flowing... until you open one of the taps.

The same thing happens in your cpap, you've got air pressure in the mask, but until you inhale (open the taps), nothing flows into your nose.

Think about it, if it was blowing air into your nose... WHERE IS IT GOING? Unless you've got gills, or a hole in your chest, there's nowhere for that air to blow.

Sometimes thinking about these things in a more correct way helps.

I am sorry that you are not feeling well. I hope that a humidifier helps.

palerider wrote: ↑

Thu May 03, 2018 3:00 pm

SarahB wrote: ↑

Thu May 03, 2018 2:35 pm

All that dry cold air being blown up the nostrils at pressure every night might have an effect.

Only, there's *NO* air being "blown up the nostrils", dry, cold or otherwise.

It's like the water under pressure in your pipes at the house, nothing is moving, nothing is flowing... until you open one of the taps.

The same thing happens in your cpap, you've got air pressure in the mask, but until you inhale (open the taps), nothing flows into your nose.

Think about it, if it was blowing air into your nose... WHERE IS IT GOING? Unless you've got gills, or a hole in your chest, there's nowhere for that air to blow.

Sometimes thinking about these things in a more correct way helps.

Even when I'm not inhaling the pressure is there. It just bounces back out and leaves by the vent. Actually, a lot of it ends up in my stomach. Don't ask me how. I'm not a plumber.

I sincerely hope it's going into my nose otherwise how am I breathing? And my point is that there must be a difference between the air I breathe without a humidifier and the air with a humidifier. When the air flows through my nose it is dry. There is a pressure - the machine is adjusting it all the time.

Hi SarahB,

If you remember, I said a while back that you might be better off with a humidifier.

Give the sleep medicine department a call and tell them it's now a clear and present medical necessity. (A call to your GP can confirm that.)

And if they can't give you one off the shelf, or without a month of paperwork, you can always call ResMed UK direct, and buy one from them. Roughly £120 (and no VAT). They will messenger service it to you for delivery next day.

They're on 0800 917 7071.

Some people just need some extra moisture in the cpap air.....and some people don't.

At this point since you haven't even had a chance to try using a humidifier to see if it helps with your nasal issues or not...it's way past time to try it.

Though I will warn you, considering the length of time you have had this going on it's not likely to be something that gets fixed quickly.
When I have had it happen just 1 night forgetting to add water and the chamber goes dry the reaction in the nasal mucosa can take 3 to 5 days to abate. I have no idea how long it might take for your nasal mucosa to get over the effects.

In the meantime get something like Simply Saline and use it frequently and copiously.

rick blaine wrote: ↑

Thu May 03, 2018 3:32 pm

Hi SarahB,

If you remember, I said a while back that you might be better off with a humidifier.

Give the sleep medicine department a call and tell them it's now a clear and present medical necessity. (A call to your GP can confirm that.)

And if they can't give you one off the shelf, or without a month of paperwork, you can always call ResMed UK direct, and buy one from them. Roughly £120 (and no VAT). They will messenger service it to you for delivery next day.

They're on 0800 917 7071.

They're not given out as a matter of routine and I didn't feel the need for one before. However, it sounds as if I may need one now.

Thanks for the information. I have left a message with them and said that the doctor has suggested I contact them (after I suggested it to him ). I would expect them to reply within a week or less. I can't see that there should be a problem. I'll avoid the £120 bill if I can!

Pugsy wrote: ↑

Thu May 03, 2018 3:38 pm

Some people just need some extra moisture in the cpap air.....and some people don't.

At this point since you haven't even had a chance to try using a humidifier to see if it helps with your nasal issues or not...it's way past time to try it.

Though I will warn you, considering the length of time you have had this going on it's not likely to be something that gets fixed quickly.
When I have had it happen just 1 night forgetting to add water and the chamber goes dry the reaction in the nasal mucosa can take 3 to 5 days to abate. I have no idea how long it might take for your nasal mucosa to get over the effects.

In the meantime get something like Simply Saline and use it frequently and copiously.

Oh help! It could take some time then. If I'd realised what was causing it I would have contacted the sleep clinic before now but I didn't connect my symptoms with CPAP as I'd already been using it for over two months without these problems. I still don't know for sure that this is the cause but it sounds likely and it's certainly worth trying the humidifier. I wonder why the clinic doesn't explain at the beginning what it's for and when you might need one?

I have a saline nasal spray in my collection so will use it. Thanks!

lamar2217 wrote: ↑

Thu May 03, 2018 3:08 pm

I am sorry that you are not feeling well. I hope that a humidifier helps.

Thank you!

I have suffered from exercise induced rhinitis, and it's no fun. Usually it is just that your nasal tissues, mucosa, are getting too dry, often simply due to insufficient ambient humidity, or even hydration...or medication. I can't add anything more useful than what has already been made very plain, and that is that you may need even temporary relief of your current humidity levels going through the machine. Where I live, the humidity rarely goes below 45%, and it's often north of 90% during the cooler winter months with lots of rain and win...not at all unlike Scotland. So my setting is on the lowest positive level that the machine can deliver. But I still run it, and run my two cups of water in the reservoir almost dry over three nights.

Hang in there.

mesenteria wrote: ↑

Thu May 03, 2018 4:17 pm

I have suffered from exercise induced rhinitis, and it's no fun. Usually it is just that your nasal tissues, mucosa, are getting too dry, often simply due to insufficient ambient humidity, or even hydration...or medication. I can't add anything more useful than what has already been made very plain, and that is that you may need even temporary relief of your current humidity levels going through the machine. Where I live, the humidity rarely goes below 45%, and it's often north of 90% during the cooler winter months with lots of rain and win...not at all unlike Scotland. So my setting is on the lowest positive level that the machine can deliver. But I still run it, and run my two cups of water in the reservoir almost dry over three nights.

Hang in there.

So you would say that my symptoms are similar to yours? While the outside air humidity may be high I think indoors is quite a dry atmosphere although we have our bedroom window open a little at night. Certainly whenever I'm camping I find the night air very damp. Maybe I need to be outdoors. I shall put that theory to the test next week when I go off in my hammock. I'd like to prove that it's helpful. Good excuse to go more often

SarahB wrote: ↑

Thu May 03, 2018 3:20 pm

Even when I'm not inhaling the pressure is there

Of course it is, if the pressure wasn't there, then it wouldn't do any good. But "pressure" isn't "blowing in your nose".

SarahB wrote: ↑

Thu May 03, 2018 3:20 pm

. It just bounces back out and leaves by the vent.

It doesn't bounce back out, it never goes in, (except when you're breathing... out of the hose, and right out the vent.

SarahB wrote: ↑

Thu May 03, 2018 3:20 pm

I sincerely hope it's going into my nose otherwise how am I breathing?

Of course it goes in your nose when you're inhaling... and out of your nose when you exhale. but it's not *blowing into your nose*

Why the bickering over the person’s problem. Help her solve it. Thanks.

lamar2217 wrote: ↑

Thu May 03, 2018 6:34 pm

Why the bickering over the person’s problem. Help her solve it. Thanks.

Do shut up. If you don't have anything actually KNOWLEDGEABLE to say, then just don't. The forum already has an official nanny, and you ain't her.

As to why I'm attempting to clarify the situation, it's quite simple.

When people don't know anything about cpap therapy, they get *incorrect* ideas in their head about what's going on, and those ideas can be detrimental to SUCCESS.

Ideas like "gale force winds" blowing out of the machine, or really high pressure, or "20 PSI" ... or... air blowing up my nose all night long.

All of those things are wrong, and all of them set up mental roadblocks that make it harder to succeed.

Cpaps only blow a lot of air when the mask is off, they slow down tremendously when you put the mask on.

The pressure is *GENTLE* far less than it takes to blow up a balloon.

No air is blowing up your nose, it's a gentle pressure holding your airway open so that your lungs can suck air in and push it out, just like happens all day long when you're awake.

The list goes on. Education and *understanding* helps people down the road to SUCCESS.

Thanks for your clarification. Please enjoy the rest of your evening. Bless you.