sleep study/sinus infection

susaninct · Post by **susaninct** » Sun Aug 21, 2005 9:25 pm

I am very worried about something and not sure what to do. I am scheduled for my 2nd sleep study tomorrow night (monday). I had my first one on May and this is the first date they had for the follow up titration study. I have apnea but more problematic is my overall underventilation.

The problem is that I have a sinus infection and am having a hard time breathing normally and even though I have a full mask, I cannot wear it all night (for the past two days with infection) because of extreme sinus pain from the pressure. I use a bi-pap. Also, I am sleeping very fitfully since I got this infection (my family doc started me on antibiotics).

Has anyone here gone for a sleep study when sick? I hate to cancel because they take so long to reschedule (as I need MSLT - 24 hour test for day time sleepiness). Don't want this infection to effect the results of the study so I feel like I should postpone, but don't want to miss it if this is not big deal. Any feedback will be appreciated. Susan

capt · Post by **capt** » Sun Aug 21, 2005 9:38 pm

I would call the people that are going to do the study and explain your condition. Even though it seems to take a long time for a study to be scheduled, I would leave the decision to them. I would take this action even if I did not already have the equipment like you do. You are lucky that you can continue your treatment with the equipment you have.

Dan01 · Post by **Dan01** » Sun Aug 21, 2005 9:39 pm

Maybe call them first thing in the morming and find out what they think?

neversleeps · Post by **neversleeps** » Sun Aug 21, 2005 10:00 pm

I know this isn't what you want to hear, but IMHO you should call your doc tomorrow morning and tell them about your sinus infection. I understand your frustration at not wanting to wait 3 months for another test, but with a sinus infection, CPAP is contraindicated. Also, if you did decide to go through with it and suffer in silence, the titration results would be based on your 'sick' breathing patterns, not your normal ones.

It is interesting you were given a bi-pap following your sleep study in May, but prior to a titration study. Do you know what the pressure settings are on your bi-pap? Other than recently when you became sick, have you been using it nightly since May?

susaninct · Post by **susaninct** » Sun Aug 21, 2005 11:33 pm

MY setting are 80/40. Because of the underventilation I was sent to a pulmonary doctor. I didn't qualify for bi-pap out of the gate so started with c-pap but it was so hard to exhale (muscular weakness on exhale is the cause of underventilation).

Yes, I have used it every night since I got it in June. I was taking the mask off during the night for awhile - still do but have been starting with it every night. I am not feeling better - even more tired if possible and very hard time not falling asleep in the daytime.

I will call tomorrow morning. I agree about the titration maybe not being accurate since it would be based on sick breathing. Also, not so sure day time sleepy test would be accurate since I am sick. Thanks to everyone for responding. It is so great to have a place to come with others dealing with the same things. Susan

It is interesting you were given a bi-pap following your sleep study in May, but prior to a titration study. Do you know what the pressure settings are on your bi-pap? Other than recently when you became sick, have you been using it nightly since May?[/quote]

WAFlowers · Post by **WAFlowers** » Mon Aug 22, 2005 6:21 am

susaninct wrote:I am very worried about something and not sure what to do. I am scheduled for my 2nd sleep study tomorrow night (monday). I had my first one on May and this is the first date they had for the follow up titration study.

WOW! The sleep lab here has openings almost every night. For my initial sleep study and the followup titration my problem wasn't finding an opening to get in, it was rearraning my schedule to get in as soon as they wanted me.

When I was setting up my titration appointment I was asked if I could come in that night!

Janelle · Post by **Janelle** » Mon Aug 22, 2005 9:30 am

It takes 48 hours for antibiotics to make you feel better. I would think the same would be true for a sinus infection. In other words, after 48 hours you should be feeling better and that is about now. If you aren't they need to put you on something different.

I've never heard about CPAP being contraindicated in the presence of a sinus infection. Don't they have you inhale warm vapor for that? Saline flushes? Do they have you on any kind of sinus decongestant? Or do you even have any congestion?

As others have said, call the sleep lab and/or the doc and get their take on this.

You've never said you weren't titrated, so I'm assuming you had a split night session and were titrated during the second half of your FIRST sleep study and this is a second study to see why the titrated pressure isn't working for you. Am I wrong?

ozij · Post by **ozij** » Mon Aug 22, 2005 11:08 am

Precautions for use
Clinical research indicates that CPAP therapy may be contrainidicated for patients with any of the following pre-existing conditions:
<snip>
Acute sinusitis (inflammation of the sinus cavity),

Page 2 of the Puritan Bennett GoodKnight 420E manual
My emphasis
O.

snork1 · Post by **snork1** » Mon Aug 22, 2005 1:33 pm

ozij wrote:
Precautions for use
Clinical research indicates that CPAP therapy may be contrainidicated for patients with any of the following pre-existing conditions:
<snip>
Acute sinusitis (inflammation of the sinus cavity),

Page 2 of the Puritan Bennett GoodKnight 420E manual
My emphasis
O.

MaskedMan · Post by **MaskedMan** » Mon Aug 22, 2005 2:07 pm

O - contrainidicated? got a link to dictionary.com handy

Snork, I too have had constant nasal congestion - worse at night with one nostril 75-90% blocked every night even before I ever received CPAP treatment. My sleep doc was also not in the least concerned about it, nor was my regular doc who I've been badgering for years to help get something fixed there. Flonase, rhinocort, nasacort, etc have no impact for me. So, I've been using CPAP for a year with pretty much one nostril mostly to all blocked every night. I can see that it could impact the therapy and testing, but at least in my case there is nothing I can do about it.

I'm in Wisconsin and perhaps things have changed since I went in for my sleep study, but there like someone else mentioned they sleep lab here is ready for appointments pretty much instantly. I guess different parts of the country either have smaller labs or more demand than my area though. (and my guess is that there is more demand elsewhere)

snork1 · Post by **snork1** » Mon Aug 22, 2005 2:37 pm

My sleep study place has almost no backup too, but its a fairly new place.

In my opinion, based on my own experience (enough disclaimers?):
If your nose doesn't work, CPAP doesn't REALLY work. I battled CPAP for a year trying EVERY trick in the book. It was a disaster until I had my surgery.

Do choose an ENT carefully though. If they don't at a minimum do the alien nose probe down to your throat, and a CT scan before mentioning surgery, run, do not walk for the door.

I was very lucky to find a good ENT. She won't even proceed on any further surgery unless CPAP doesn't work following the 3 hour surgery I had to fix my nose and sinuses. And since it works just fine, all she asks is that I refer OTHER people that have a need, NOT go with any further surgery for my throat or tongue myself.

WillSucceed · Post by **WillSucceed** » Mon Aug 22, 2005 3:10 pm

I've never heard about CPAP being contraindicated in the presence of a sinus infection. Don't they have you inhale warm vapor for that? Saline flushes?

I have read, as others noted, the contraindication if one has a sinus infection. Further, having one "inhale warm vapour" is quite a bit different as a passive event vs. having the warm vapour forced into your sinuses under pressure.

One the flip side, I get ear infections if I just walk near a pool and periodically, these come with a sinus infection. I talked with the Respirologist Dr. at work who told me that a sinus infection is not reason enough to not use your CPAP treatment UNLESS you are having pain. He is also one of the professionals who cautioned against not dumping your humidifier water every morning.

Regarding the thread about machine humidifier and bacteria which was started by (I think) GaryML, despite what Fisher-Paykel says, a warm, moist environment is paradise to bugs, including moulds and fungus, that, should you inhale this mix into your lungs (and they DO travel in water vapour) you could end up with a lung infection that you don't want.

So, do whatever you think is best; each of us is our own keeper. I think, however, that the quotation that the origional poster referred to has to do with water in the tank while your are asleep, using the machine. It is not, I believe, a blanket statement that alludes to leaving the same water in the tank day in and day out. I'm going to fish out the manuals that came with the RemStar and PB humidifiers that I have. I bet they will say to dump the water daily.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, CPAP, Travel

ozij · Post by **ozij** » Mon Aug 22, 2005 10:05 pm

Snork1 and WillSucceed
There's a difference between acute sinus infection, and chronic ones.

see: Acute sinusitis

Chornic sinusitis

By the way Will, you win the be about the PB manual, I know it recommends daily emptying (even washing...).

O.

snork1 · Post by **snork1** » Mon Aug 22, 2005 10:22 pm

ozij wrote:Snork1 and WillSucceed
There's a difference between acute sinus infection, and chronic ones.

see: Acute sinusitis

Chornic sinusitis

O.

OK, if we are going to get all technical about it.....
The difference really is just duration according to those links and seems pretty fuzzy and misdiagnosed by doctors regularly, according to my experience, so I don't feel bad about over generalizing on this one.

Soooo...if it is "acute" then hit the antibiotics and come back in a month or so for a new sleep study and life is easy.

If it is "chronic" (a label non-ENT doctors seem hestitant to apply) THEN you need to get THAT problem under control, yes ideally through non-surgery methods as a first choice, before CPAP will ever be less than a major battle. (all my previous disclaimers apply)

sleep study/sinus infection

sleep study/sinus infection

Re: sleep study/sinus infection