Irritated nostrils from extended CPAP usage

Hi all,

Currently I use the P10, with fixed pressure around 6.5 + EPR 3, humidity at 5 and tube temp at 28C. I have no issue with falling asleep with cpap but I do wake up from it feeling my nostrils is getting more irritated overtime. I have read somewhere that because of the constant blast of air into your nostrils from cpap usage, your nasal pathways will gradually tighten/swollen (get inflamed) during the course of the night to compensate for the air blast, which ends up blocking your nose overtime ( https://www.youtube.com/watch?v=7DDgIuEtew8) . If thats the case, is there any muscle relaxant I can take to keep my nasal passage relaxed? Doesn't sound like anti-histamine would help, because thats specific to allergy relief? thanks

I would say it's likely that a majority of us use nasal pillow, nasal cradle or nasal masks FOR DECADES without any tightening, swelling, inflammation or nose blockage.

If you are having issues, you can adjust the humidity up or down to see if it helps, or perhaps try a different mask. Long term use of antihistamines can cause cognitive issues in the elderly and decongestants are a very BAD idea which can lead to rebound congestion and other issues.

Janknitz wrote: ↑

Mon Oct 31, 2022 12:00 pm

I would say it's likely that a majority of us use nasal pillow, nasal cradle or nasal masks FOR DECADES without any tightening, swelling, inflammation or nose blockage.

If you are having issues, you can adjust the humidity up or down to see if it helps, or perhaps try a different mask. Long term use of antihistamines can cause cognitive issues in the elderly and decongestants are a very BAD idea which can lead to rebound congestion and other issues.

My doc prescribed me Avamys Fluticasone spray (mostly for allergen control)- never mentioned any restrictions on long term usage?

I know your message meant well- but I would also argue that a "majority" of people who were prescribed CPAP gave up- because of lack of support and also on how complex a journey can take for a patient to truly get used to a CPAP. Changing humidity and tube temp on the go is too difficult for me with all the seasonal weather changes thats affecting my bedroom. I have probably tried about 10 to 15 different styles of masks by now... would only consider exploring new mask if Resmed/Bleep release a a new minimalist nasal pillow product. Context- the mask and my cpap settings can give me a beautiful long sleep when all the stars lines up for the night, unfortunately seasonal change (and the addition of furnace into the equation for fall winter months) tend to reduce the success rate.

If the irritation is inside the nostrils consider using some Lanisoh creme to reduce the soreness. A little bit goes a long way.

https://www.amazon.com/dp/B00FNZQHJA?r ... fix=lanish

I know your message meant well- but I would also argue that a "majority" of people who were prescribed CPAP gave up-

i didn't read that as a "majority of cpap users" but rather as "the majority of us on the forum".

let's see what she has to say.

Ayrs nasal saline gel may help.

Humidifier turned up a bit should help. Do you breathe better after hot shower?

My allergies have been horrible the last 10 days and i’m inflamed. Stuffy nose causing air to come out through mouth so throat hurts. Maybe you’re experiencing same and has nothing to do with mask. Maybe it’s the leaves creating mold? maybe the baseboard heat?

if you turn up the humidity, it will help if you have the heat on in the hose. I was doing pretty well with the humidity set at five, but decided to turn it up to six instead last night. beware. The cold air in the room and the super moist mask and hose left me waking up in the middle of the night with a puddle of water at my elbow where the small hose is attached to the heated hose.

just some thoughts and potential relief.

other things that might help is to use a Netty pot before bed, a saline spray, vicks inhaler, or something similar.

[/quote]

i didn't read that as a "majority of cpap users" but rather as "the majority of us on the forum".

let's see what she has to say.
[/quote]

Yes, majority of us on the forum --most of us here USE our CPAP's consistently over long periods of time. I don't think there would be many old timers here if our noses were blocked and inflamed all the time because of CPAP.

More precisely, I should have said some OTC oral antihistamines used long term can have negative effects. Benadryl, which is inexpensive and easy to buy OTC, for example https://jamanetwork.com/journals/jamain ... cle/649062 So I wouldn't rush out to buy some OTC antihistamine based on that article. But you can talk to your doctor about whether there might be any long term concerns about Fluticasone spray. Is it helping at least some of the time???

Jlfinkels wrote: ↑

Mon Oct 31, 2022 12:36 pm

If the irritation is inside the nostrils consider using some Lanisoh creme to reduce the soreness. A little bit goes a long way.

https://www.amazon.com/dp/B00FNZQHJA?r ... fix=lanish

This is dangerous due to the risk of developing lipid pneumonia. There is a thread on this subject currently active.

I only put Ayr Gel inside my nostrils.

CowFish wrote: ↑

Mon Oct 31, 2022 2:47 pm

Jlfinkels wrote: ↑

Mon Oct 31, 2022 12:36 pm

If the irritation is inside the nostrils consider using some Lanisoh creme to reduce the soreness. A little bit goes a long way.

https://www.amazon.com/dp/B00FNZQHJA?r ... fix=lanish

This is dangerous due to the risk of developing lipid pneumonia. There is a thread on this subject currently active.

I only put Ayr Gel inside my nostrils.

Lansinoh is a lanolin product and NOT a petroleum product. There's a difference.
Lansinoh is used by breastfeeding moms on the nipple and babies inhale and suck....if it was prone to cause lipid pneumonia it wouldn't be safe for babies.

Proper CPAP usage doesn't involve any air blasts, just mild pressure.

The constant venting of the air from the mask may cause some drying for some, which is what humidifiers are for.

For most, that drying goes away over time with or without use of additional humidity, so it could be argued that extended use of CPAP makes the irritation better, not worse.

On the other hand, failure to use CPAP can cause nasal irritation from snoring; gasping; and with extended failure to use CPAP, stomach acid migrating all the way up into nasal passages.

Antihistamines tend to make someone dry out. And nasal application of corticosteroids are now often considered the frontline approach to allergy treatment, anyway.

Not sure if this applies to your situation.
I live in a high mountain dry climate. When our heater and wood stove are running and sucking the little moisture there is out of room air I find I need to run humidifiers in our house. It’s brutal on my nose to go from the nice warm humidified air my CPAP provides to the dry room air and I find the big changes in humidity can cause lots of nasal irritation.

Also wondering, have you tried a size smaller pillow? If you can use a size down without creating tons of leaks it could solve the problem, perhaps worth a try if you haven’t tried it already.

colomom wrote: ↑

Mon Oct 31, 2022 4:02 pm

Not sure if this applies to your situation.
I live in a high mountain dry climate. When our heater and wood stove are running and sucking the little moisture there is out of room air I find I need to run humidifiers in our house. It’s brutal on my nose to go from the nice warm humidified air my CPAP provides to the dry room air and I find the big changes in humidity can cause lots of nasal irritation.

Also wondering, have you tried a size smaller pillow? If you can use a size down without creating tons of leaks it could solve the problem, perhaps worth a try if you haven’t tried it already.

Thanks- can I ask why you would suggest sizing down the pillow? I currently use medium. Wouldn't sizing down means smaller opening at the pillow so the air would be more "concentrated"?

ronragus wrote: ↑

Mon Oct 31, 2022 12:29 pm

Changing humidity and tube temp on the go is too difficult for me with all the seasonal weather changes thats affecting my bedroom.

Changing the humidity and/or tube temp is not difficult---if you know how to do it. As in it takes all of 30-60 seconds (at most) to do it.

But it may require getting into the clinical menu to change those settings. (And if so, shame to the person who set the machine up that way.) Learning how to get into the clinical menu is not that difficult. If you don't know how to do that, just ask.

And here's why you ought to consider changing the humidifier and/or temp "on the go": As you yourself say, all the seasonal weather changes affect your bedroom and your sleep. Many people find that once the central heating is on, they need more humidity from the CPAP to keep the nasal passages happy. When the house heat is off? Less humidity might be more comfortable for your nose.

Likewise, if there are seasonal differences in the ambient humidity and temperature in your bedroom, that may mean changing the humidifier or temp setting will make a difference in your comfort. If your bedroom is already warm, there may be no need to add additional heat through the heated tube. If your bedroom is really chilly, turning the hose temp up may increase your comfort.

You also write:

Context- the mask and my cpap settings can give me a beautiful long sleep when all the stars lines up for the night, unfortunately seasonal change (and the addition of furnace into the equation for fall winter months) tend to reduce the success rate.

And the fact that you have problems only in the fall/winter after the furnace is turned on points to the fact that you probably do need to play with the humidifier and tube temperature settings to find one that works in the winter just as well as your current settings work in the summer. Changing the humidifier setting and the tube temp may become a semi-annual habit that takes you all of 60 seconds to do---once you figure out what settings you need in the winter time.

As others have said, you need to figure out whether your nose is wanting more humidity or less humidity. If your breathing is better after a nice hot shower, your nose may want more humidity in the winter months than it does in the summer. (The air in the house is likely much drier when the furnace is on.). On the other hand, if you get stuffy when taking a hot shower, maybe your nose would rather have less humidity, but the combination of the hose temperature at 28C and the humidifier set at 5 is delivering a higher relative humidity in the hose that your nose wants in the winter time.

ronragus wrote: ↑

Mon Oct 31, 2022 4:57 pm

colomom wrote: ↑

Mon Oct 31, 2022 4:02 pm

Not sure if this applies to your situation.
I live in a high mountain dry climate. When our heater and wood stove are running and sucking the little moisture there is out of room air I find I need to run humidifiers in our house. It’s brutal on my nose to go from the nice warm humidified air my CPAP provides to the dry room air and I find the big changes in humidity can cause lots of nasal irritation.

Also wondering, have you tried a size smaller pillow? If you can use a size down without creating tons of leaks it could solve the problem, perhaps worth a try if you haven’t tried it already.

Thanks- can I ask why you would suggest sizing down the pillow? I currently use medium. Wouldn't sizing down means smaller opening at the pillow so the air would be more "concentrated"?

My suggestion on experimenting with a smaller sized pillow was simply based upon my thinking that perhaps if your current pillow is creating discomfort there’s a small chance it could be a bit to big for your nostrils.

I’m no expert, but I doubt if changing from a medium to small pillow would make your airflow significantly more concentrated.

Here’s my 2c and sorry if I posted some or all of this already.

I jacked up humidity 2 nights ago. Worked well but nose still stuffy so I jacked it up one more from 5 to 6. Turns out in the cool room even with the hose heat on 82 which is normally comfy it was TOO MUCH. I woke with so much rainout my arms and bed were soaked.

I fixed humidity but turned heated tube up to try to dry things out. Uncomfy breathing air that hot. Amazing what 2 degrees can do. Set it back down so I could sleep and eventually the whole tube dried out when humidifier dried out. I know that isn’t so good for machine.

Went in tonight to be sure I turned heat back down. I looked everywhere for the settings. Guess what- hose has to be plugged in to see hose heat settings. lol

I need sleep!

hth