Hello. Need new CPAP. Septoplasty recovery. Afrin. Sleep study

Hi, I’m glad I found you.

I had my first and only sleep study in April 1997 (OSA diagnosis) and have been on CPAP since. I’m on my 3rd machine, a REMstar auto w/CFLEX, about 10 years old. I’m worried my CPAP will fail someday and I have no backup. I’ve been managing with this but recently (months-years) my congestion had gotten worse so I went to an ENT and was diagnosed with a deviated septum. I think he said ‘significant’ or maybe severe. I’m congested during the day (worse on left side) which I thought was caused by my years of nightly use of Afrin (one pump mist spray per nostril, once per day). I think I’m having a little rebound effect (RM) and have been in contact with Rhinostat and bought one of their weaning kits and was going to start using it until the septum diagnosis. They said I don’t really have RM (rhinitus medicamentosa) but some congestion might be related to Afrin dose strength. I recently tried reducing Afrin to 90% strength (dilution with saline water) at the same time I adjusted my pressure down from 11 to 10 and added CFLEX of 1 (of 3). Now I don’t know which of those I should reverse because I felt like I wasn’t getting enough air which makes me almost panic. Either it’s not enough pressure or my nose isn’t cleared enough. The CFLEX set on 2 or 3 felt clunky and seemed to interfere with exhaling or inhaling or something -- the timing?

I’m claustrophobic and the thought of septoplasty RECOVERY scares the poop out of me because the ENT said they would pack my nose with cotton for a week. He had no good answer when I asked how would I sleep? If I can’t breathe through my nose how can I keep my throat open, etc? My anxiety level and blood pressure have been going up. He also said I should stop Afrin before the surgery -- impossible. I’ve seen posts here about mouth-nose masks and mouth-only masks. Would my old CPAP be adequate if I attach a heated humidifier to it and got a full mask? Or should I get a new machine? Do heated humidifiers and mouth masks really work for mouth breathers, or do they have dry mouth all night? Should I get the setup BEFORE surgery and get used to it? I suppose a sleep study is needed before Medicare would pay for any of that. Or would they even pay for it? Sorry some of these are kind of subjective questions but any input is valued.

The idea of a sleep study makes me anxious because I will not be able to fall asleep. After 21 years on CPAP I know if I fall asleep without the mask on I choke and wake up right away. Does anyone think that would be enough evidence to diagnose me? Would they make me keep trying to sleep (i.e. torture me)? Has anyone asked their doctor for a CPAP machine prescription without a sleep study and gotten it?

I never knew about software to look at my machine data until I found this site. I installed Sleepyhead today but haven’t tried it. I don’t know what to look for yet. I know to write-protect my SD card.

I had no healthcare for several years after getting laid off but now am on Medicare. I think they will cover a sleep study if prescribed, yes? And a new machine? Is there a page here that explains what CPAP features are and why they are good/bad, etc?

Sorry if this is rambling - hope you can see where your advice can be useful. Anyway I am glad to be on this forum and hope you can help me! Of course I will try to answer others’ posts if I have anything valuable to add.

pviking9 wrote: ↑

Sun Feb 17, 2019 10:17 pm

Hi, I’m glad I found you.

I had my first and only sleep study in April 1997 (OSA diagnosis) and have been on CPAP since. I’m on my 3rd machine, a REMstar auto w/CFLEX, about 10 years old. I’m worried my CPAP will fail someday and I have no backup. I’ve been managing with this but recently (months-years) my congestion had gotten worse so I went to an ENT and was diagnosed with a deviated septum. I think he said ‘significant’ or maybe severe. I’m congested during the day (worse on left side) which I thought was caused by my years of nightly use of Afrin (one pump mist spray per nostril, once per day). I think I’m having a little rebound effect (RM) and have been in contact with Rhinostat and bought one of their weaning kits and was going to start using it until the septum diagnosis. They said I don’t really have RM (rhinitus medicamentosa) but some congestion might be related to Afrin dose strength. I recently tried reducing Afrin to 90% strength (dilution with saline water) at the same time I adjusted my pressure down from 11 to 10 and added CFLEX of 1 (of 3).

An effective way to ween oneself form Afrin is to stop using it in only one side... and when that one goes back to normal, stop the other side.

pviking9 wrote: ↑

Sun Feb 17, 2019 10:17 pm

If I can’t breathe through my nose how can I keep my throat open, etc?

By breathing through your mouth.

pviking9 wrote: ↑

Sun Feb 17, 2019 10:17 pm

I never knew about software to look at my machine data until I found this site. I installed Sleepyhead today but haven’t tried it. I don’t know what to look for yet.

Read "Pugsy's Pointers" in the announcements section.

If you end up having to have a repeat sleep study....ask the doctor for an order for what is called a "split night sleep study".
That way if you meet criteria to be put on cpap they stop the test and slap the mask on you for the rest of the night.
This will limit your time sleeping without cpap.

Medicare has some specific requirements pertaining to the sleep study before they will pay for cpap...
just an order for cpap without proof per their criteria won't get Medicare to pay for cpap stuff.

And yes...Medicare will pay for sleep studies done in a lab and even at home as long as it meets their criteria.

palerider wrote: ↑

Sun Feb 17, 2019 11:03 pm

An effective way to ween oneself form Afrin is to stop using it in only one side... and when that one goes back to normal, stop the other side.

That's clever. Never heard that one.

A full face mask will allow you to open your mouth at night. You'll probably need a humidifier for dry mouth. I use a full face mask without a humidifier. I do get dry mouth, but not real bad. The full face mask will sit on the nose bridge area, and my thoughts are that it may interfere with the surgery recovery. You may try a Phillips Respironics Total Face mask. It touches no part of the nose, but is a very intrusive mask. It's like a fireman's mask. I would certainly settle on what my mask I'll use before the surgery and get used to it BEFORE the surgery. The last thing you want to do is to try to recover from surgery and be trying to adjust to a new mask at the same time.

Sheriff

PS: Is Afrin addictive? Do you go nuts if you are addicted to it and you don't have it?

Ask your doctor about using the nasal splints after your surgery. That is what my doctor used after I had mine several years ago. I hardly noticed them being in my nose. When it came time to have them emoved, they slid right out without causing any bleeding. The recovery for that portion of my surgery was very easy.

pviking9 wrote: ↑

Sun Feb 17, 2019 10:17 pm

Hi, I’m glad I found you.
<snip>

welcome to the zoo! glad you found us and here's hoping the experts can help you out.

don't worry about rambling. it's better to have someone come in and tell us stuff rather than have to extract information a bit at a time.

here's the link palerider referred to-

viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

and yeah, sleepyhead software is overwhelming, filled with acronyms and such. but let me let you in on a little secret. lean close, so i can whisper. <i don't know how to interpret sleepyhead graphs and i've been using it for three years. shhh. don't tell anyone!>

but with the graphs that you can post here, you'll get all kinds of advice tailored to your needs.

good luck!

zonker wrote: ↑

Mon Feb 18, 2019 11:23 am

here's the link palerider referred to-

viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

Um, actually, it was this one: viewtopic/t88983/Pugsys-PointersSleepyH ... Hints.html

Just under the one you referred to... which is very important too,

Sheriff Buford wrote: ↑

Mon Feb 18, 2019 4:23 am

PS: Is Afrin addictive? Do you go nuts if you are addicted to it and you don't have it?

Yes but because 1. afrin is scary effective at what it does 2. there’s a nasty rebound congestion period. It’s only cured by time or taking more afrin.

Sheriff Buford wrote: ↑

Mon Feb 18, 2019 4:23 am

PS: Is Afrin addictive? Do you go nuts if you are addicted to it and you don't have it?

You don't go nuts, but your nose does get terribly stopped up when you stop using it, if you use it for more than a few days....

You can avoid that if you only use it once a day, though.

palerider wrote: ↑

Mon Feb 18, 2019 11:42 am

zonker wrote: ↑

Mon Feb 18, 2019 11:23 am

here's the link palerider referred to-

viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

Um, actually, it was this one: viewtopic/t88983/Pugsys-PointersSleepyH ... Hints.html

Just under the one you referred to... which is very important too,

not only is it my job to welcome new users, i also get to confound the hell out of them as well!

I just had septoplasty and turbinate reduction in December. You are not going to sleep very well at all. I napped in a recliner and propped up on pillows in bed. I wasn't able to use my CPAP machine until the splints came out (about a week). I didn't have packing, just splints, with gauze tapped underneath my nose, that had to be changed a lot. You'll breath much better. Best of luck to you.

Okie bipap wrote: ↑

Mon Feb 18, 2019 11:02 am

Ask your doctor about using the nasal splints after your surgery. That is what my doctor used after I had mine several years ago. I hardly noticed them being in my nose. When it came time to have them emoved, they slid right out without causing any bleeding. The recovery for that portion of my surgery was very easy.

My doctor used splints. I was amazed that I could breathe better immediately after surgery than before! Once the splints were removed, my nose was like a wind tunnel. It actually took a little (actually very little ) getting used to! I will admit that the splints were slightly uncomfortable. I mean, you do have a foreign, plastic object up your nose. But they do slide out easily. Clipping the stitches was the worse part and that was really nothing. You know how it is, you worry about it and it ends up being like "Wow, that's it?!" Totally worth being able to breathe!

Pugsy wrote: ↑

Sun Feb 17, 2019 11:25 pm

If you end up having to have a repeat sleep study....ask the doctor for an order for what is called a "split night sleep study".
That way if you meet criteria to be put on cpap they stop the test and slap the mask on you for the rest of the night.
This will limit your time sleeping without cpap.

Medicare has some specific requirements pertaining to the sleep study before they will pay for cpap...
just an order for cpap without proof per their criteria won't get Medicare to pay for cpap stuff.

And yes...Medicare will pay for sleep studies done in a lab and even at home as long as it meets their criteria.

Thanks for this great info. I'll ask for a split study.

Okie bipap wrote: ↑

Mon Feb 18, 2019 11:02 am

Ask your doctor about using the nasal splints after your surgery. That is what my doctor used after I had mine several years ago. I hardly noticed them being in my nose. When it came time to have them emoved, they slid right out without causing any bleeding. The recovery for that portion of my surgery was very easy.

Thanks and I was thinking this too. I might still have cotton packing for a day or two I guess, for bleeding or preventing bleeding. NOT looking forward to that.