cpap has made my situation worse. now what?

PhotoWolf wrote: ↑

Mon Mar 10, 2025 4:19 pm

... F40 ...

The N95 mask made me feel like my mouth was in a sauna.

It sounds like you are a mouth-breather. Eventually (sooner better than later), you should have a consultation with an ENT. She will examine your airway with an endoscope (painless) on your first visit. You might have some problems in your nasal airway which can be remedied. Nose breathing is healthier and makes using CPAP easier.

PhotoWolf wrote: ↑

Mon Mar 10, 2025 4:19 pm

robysue1 wrote: ↑

Sun Mar 09, 2025 9:25 am

Out of curiosity: Back during the pandemic did wearing a mask when you were out in public bother you in the sense of making you feel like you couldn't breathe right? If so, that was probably caused by some of the same things triggering your problems with trying to breathe normally with the CPAP mask on when you are at very low pressures.

As a matter of fact, yes. Even the cloth masks bothered me; the one time I tried to use an N95 mask, it was just impossible. Wearing a cloth mask, it felt like I could never get enough air when breathing in, while breathing out resulted in air going up around my nose and fogging my glasses, until I figured out how to seal the mask properly. The N95 mask made me feel like my mouth was in a sauna.

Given what you say about other masks that cover your nose or nose and mouth, I think a huge part of your current problem with the CPAP mask making you feel like you suddenly just can't breathe is rooted in a psychological reaction to the idea of having something (anything) covering your nose.

It's worth asking:

During the daytime do you typically breathe through your nose or your mouth?

If you don't spend a lot of time breathing through your mouth when you are awake, then it's reasonable to assume (for now) that you probably don't breathe through your mouth (much) when you are asleep. And if you are still using a full face mask, it may be time to try a nasal mask or a nasal pillows mask. Nasal masks can be less claustrophobic because they don't cover the mouth----i.e. when you "wake up feeling like you can't breathe", you can just open your mouth and take a breath that way to help settle the brain down enough to realize that there's nothing particularly "wrong" beyond the fact that the friendly CPAP monster is still on your face. Nasal pillows and nasal cradle masks are usually the least claustrophobic because they don't cover the entire tip of the nose the way a traditional nasal mask does. So swapping out the mask for a less intrusive one might do you some real good.

Apologies for the delay in responding -- I'm so scatterbrained due to all the stress right now (the rotten sleeping is only part of it) that I didn't even notice the thread had gone to a second page.

robysue1 wrote: ↑

Wed Mar 12, 2025 2:42 pm

It's worth asking:

During the daytime do you typically breathe through your nose or your mouth?

ChicagoGranny wrote: ↑

Tue Mar 11, 2025 5:36 am

It sounds like you are a mouth-breather. Eventually (sooner better than later), you should have a consultation with an ENT. She will examine your airway with an endoscope (painless) on your first visit. You might have some problems in your nasal airway which can be remedied. Nose breathing is healthier and makes using CPAP easier.

I breathe both ways - nose sometimes, mouth sometimes. I have chronic, untreatable sinus issues -- allergies to multiple things, which would take far more money than I have to figure out. Even such a simple thing as very cold, dry air can set it off. I believe there's some permanent damage in my sinuses as well, because I never had sinus problems before I went to college in a town a few miles downwind of a nest of very foul-smelling oil refineries. On days when the congestion is mild, I can breathe through my nose unless I'm physically active, then I have to switch. When the congestion is bad, it's like a bad cold: mouth breathing is the only way I can get close to getting enough air. I can't take most over-the-counter decongestants, because I have a history of atrial fibrillation and the most common decongestants drugs can induce a-fib. I use a plain saline nasal spray most nights, which usually knocks down the congestion for three or four hours (and yes, I've noticed the correlation between that and the maximum length of time I can tolerate wearing the mask).

PhotoWolf wrote: ↑

Sat Mar 15, 2025 7:01 am

I breathe both ways - nose sometimes, mouth sometimes. I have chronic, untreatable sinus issues -- allergies to multiple things, which would take far more money than I have to figure out.

Sounds to me like it would be well worth your time (and a bit of money in the form of co-pays) to figure out if there is someway to treat your chronic sinus issues particularly since you go on to say:

Even such a simple thing as very cold, dry air can set it off. I believe there's some permanent damage in my sinuses as well, because I never had sinus problems before I went to college in a town a few miles downwind of a nest of very foul-smelling oil refineries. On days when the congestion is mild, I can breathe through my nose unless I'm physically active, then I have to switch. When the congestion is bad, it's like a bad cold: mouth breathing is the only way I can get close to getting enough air.

Now when trying to come up with ways to treat those unresolved sinus issues that are leading to congestion which leads to your inability to tolerate the mask for even a few minutes, it's important to note that you also say:

I can't take most over-the-counter decongestants, because I have a history of atrial fibrillation and the most common decongestants drugs can induce a-fib. I use a plain saline nasal spray most nights, which usually knocks down the congestion for three or four hours (and yes, I've noticed the correlation between that and the maximum length of time I can tolerate wearing the mask).

So I've got a few possible suggestions:

1) Since a saline nasal spray typically helps for several hours, it's worth considering doing an honest-to-god nasal rinse---i.e. a neti-pot. Yes, the idea of essentially "pouring" salt water in one nostril and letting it drip out the other seems highly counter-intuitive (and disgusting). A Neil-Med nasal rinse bottle is easier to use than a traditional neti-pot. You can think about a neti-pot or a Neil-Med nasal rinse as putting that saline nasal spray on steroids: Done correctly, a nasal rinse will provide longer relief from congestion than just a nasal spray. I will add this, however: It's a bad idea to do a nasal rinse right before bedtime: It can take some time (30-60 minutes or more) for the last of the water to fully drain, and going to bed before it does is likely to result in a drippy nose that feels just as bad as rainout in the mask does. (I had to learn this the hard way.)

2) Have you ever tried something like Flonase? Flonase is not a decongestant or an antihistamine. But it does provide long term congestion relief for many people with nasal allergies. But it's also not something that immediately treats the symptoms: You have to use Flonase for at least a couple of weeks before you typically see much improvement.

3) Presuming you have a cardiologist who at least follows you for the history of atrial fibrillation, it's worth asking whether there are any antihistamines that are safe for you to take. Again, an antihistamine might not provide the immediate "clear the congestion" relief that a decongestant often does. But if the problem is genuinely allergy based, then the antihistamine may help provide longer term relief than decongestants would any way.

4) It may also be worth consulting an ENT about whether your sinuses do indeed have some permanent damage or a chronic infection in your sinuses. (A chronic infection could probably be addressed through a course of antibiotics.)

My point is: You've just been living with the chronic congestion thinking that nothing much can be done about it and that compared to other things that you are dealing with, the chronic congestion is a "minor enough" problem to just ignore and live with as best you can. But if that congestion is part of the problem keeping you from being able to tolerate the mask, then it's no longer a "minor" problem that you can just ignore.

PhotoWolf wrote: ↑

Sat Mar 15, 2025 7:01 am

I have chronic, untreatable sinus issues

Has an ENT examined your airway (endoscopy) and told you that?