Oxygen supplementation

For the last three years I've been having a problem with nasal congestion off and on during the night. I have tried everything from steroid nasal sprays to different types of saline solutions. I am thinking at this point in time in getting some oxygen supplementation that might help me sleep during the night. At this particular time I sleep 2 to 3 hours and then I have to get up and go downstairs and wait for my nose to clear before going back to bed for another 2 to 3 hours yet again. Does anybody out there use oxygen? I am thinking of contacting my doctor tomorrow to see if they could possibly give me a prescription. What is it like to sleep with the oxygen supplementation? I know that surgery is also an option but I'm not a surgery kind of person. That would be a last resort.

Have you used a nasal wash like...NEILMED? It does a great job of clearing your nose before using the steroid spray.

Yes, I have used that. My congestion is due to the off and on swelling of my turbinates. Not a mucus problem.

Unless you have been tested and have significant O2 desaturations at night while on the machine you will probably not need O2. It will not help with nasal congestion. I understand you are willing to try anything at this point.
Good luck.

Mary Z wrote:Unless you have been tested and have significant O2 desaturations at night while on the machine you will probably not need O2. It will not help with nasal congestion. I understand you are willing to try anything at this point.
Good luck.

I know it will not improve the congestion, but I figure if my air flow is 50% or 75% restricted and I can't sleep the oxygen will be a boost enough for me to get thru the night. The ent is supposed to return my call.

newyorknative wrote:Yes, I have used that. My congestion is due to the off and on swelling of my turbinates. Not a mucus problem.

Is the problem primarily on one side at a time, but the sides switch periodically?

Or do both nostrils get severely clogged at the exact same time?

I'm not sure what you think O2 supplementation is going to do. It sounds to me like what you have is primarily a serious comfort problem: When your nose gets sufficiently stopped up, you are too uncomfortable to continue sleeping. So you wake up and then get out of bed to wait for the nose to clear. Since the O2 is not likely do anything to keep the turbinates from swelling and causing you to feel super congested, it seems unlikely that you'll sleep any better with (unneeded) O2 than you do now: My guess is that you'll still wake up when your nose gets too congested to be comfortable.

Questions to provide us with some additional relevant information:

1) Your profile lists a heated humidifier. Do you use your humidifier with your CPAP? If so, what's it set too? Have you tried adjusting it both UP and DOWN? Some folks are very sensitive to the humidity setting and if there's too little or too much moisture in the CPAP air, it causes problems with nasal congestion.

2) Your profile lists a nasal mask. Have you ever tried a nasal pillows mask? It could be that the pillows would provide a more concentrated flow of air directly into your nasal passages and that this would be just enough to help keep your nose from getting uncomfortably stuffed up when you are asleep.

3) Does this same problem ever occur during the daytime? For example, if you take a hot steamy shower, does that help or hurt the congestion in your nose caused by swollen turbinates?

4) Any history of allergies? And do you change the filters on your machine on a regular basis?

Usually one side will stuff up and the other will be partially open.Then over time they switch. I have the same problem during the day as well. but there are times even with my cpap I can be totally clear. I tried the pillows before and it irritated my nostrills and made them sore. I keep the humidity on 2 out of 5. The humidity does not seem to hurt or improve the situation. I used to have hayfever when I was in my teen. I rarely have mucus or a runny nose unless I have a cold.

I think what wakes me up at night is the reduction of oxygen. Not the fact that I have resistance in my nose and my diaphram has to work harer. I am still waiting for my ENT to return my call to see if what I propose is feasable. Since I don't get 100 percent blocked (maybe up to 75%) I think the increase in oxygen will allow me to sleep the whole night.

I use O2 at night...if they feel you are desatting, then they will likely give you a recording oximeter to take home for a night or two to record your levels. If you desat to below 90, then O2 will probably be an option.

If not, then you're probably out of luck on the O2.

ameriken wrote:I use O2 at night...if they feel you are desatting, then they will likely give you a recording oximeter to take home for a night or two to record your levels. If you desat to below 90, then O2 will probably be an option.

If not, then you're probably out of luck on the O2.

I think you are probably right. They have to cover their butts. I just got a call from my ENT'S receptionist. What a dumb bunny. She said the doc did not prescribe the cpap so I have to go to my primary care physician. I told her I was prescribed the cpap when I lived in Florida. So I said, "if I go to my primary care doc and he refers me back to the ENT he will deal with it?" she just repeated that sentance again. Then I said does Dr. XXXX deal with cpaps at ALL? She repeated the line again like a robot. So I guess I am back to square one.

newyorknative wrote:Usually one side will stuff up and the other will be partially open.Then over time they switch. I have the same problem during the day as well. but there are times even with my cpap I can be totally clear.

Have you ever hear of something called the nasal cycle? (Google "nasal cycle" and you'll get hits.) It's actually pretty common for folks to have one very stuffed nostril and one more-or-less clear one. And the "open" one switches ever 4-6 hours or so. The "nasal cycle" is actually a normal phenomenon. But you just seem to be more aware of it than most folks are---maybe because your "clear" nostril never gets as clear as you'd like it to get.

I tried the pillows before and it irritated my nostrills and made them sore. I keep the humidity on 2 out of 5. The humidity does not seem to hurt or improve the situation.

If you'd like to try the pillows again, use Lasinoh on the irritated nostrils until they toughen up a bit. I think it's probably worth playing around with the humidity setting to see if it makes a difference. The thing is, however, that you need to make one change at a time and leave the new change in place for at least four or five days before deciding that it made no difference. I'd first try bumping the humidity all the way up to 5 for four or five days to see if you notice any change.

I think what wakes me up at night is the reduction of oxygen. Not the fact that I have resistance in my nose and my diaphram has to work harer. I am still waiting for my ENT to return my call to see if what I propose is feasable. Since I don't get 100 percent blocked (maybe up to 75%) I think the increase in oxygen will allow me to sleep the whole night.

Do you have any idea what your O2 levels are when you are AWAKE?

Did your diagnostic study show any serious desats?

Did you titration study show desats even with the CPAP at a therapeutic pressure?

Because if you are NOT desaturating at night, then I seriously doubt that a doc will prescribe O2 at night for you. And, quite frankly, if you're not desaturating at night, then I don' see how your arousals could be fixed by supplemental O2.

If you want to read the AASM guidelines about adding O2 supplementation to a CPAP titration study, you can find them in section 4.4.5 Supplemental Oxygen in the Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea. The guidelines are pretty strict about insisting that there be a documented need for O2 supplementation in the form of abnormally low O2 levels while awake OR abnormally low O2 levels while asleep AND in the absence of apneas.

The docs will be able to tell if you need O2.
Using it otherwise could do more harm than good.
Good luck in getting a solution to your congestion.

I know it will not improve the congestion, but I figure if my air flow is 50% or 75% restricted and I can't sleep the oxygen will be a boost enough for me to get thru the night. The ent is supposed to return my call.

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Out of curiosity where do you get this 50% or 75% number If you a...never mind. Keep us posted what your ENT says

newyorknative wrote:I just got a call from my ENT'S receptionist. What a dumb bunny. She said the doc did not prescribe the cpap so I have to go to my primary care physician.

Well, if he doesn't really know how to setup CPAP and isn't willing to learn, maybe it's a good thing he doesn't go ahead and prescribe them. That's better than the dumb doctors who don't know enough to prescribe full data machines and think auto CPAPs are the work of the devil.

YOu have absolutely NO IDEA of just how expensive oxygen therapy is!!!!!!! None whatsoever. No insurance is going to pay for 02 for you w/o absolute proof of need.

I like Slinky's answer best. Just look what's happening: the OP on his/her own has decided that he/she needs more oxygen b/c of a nasal turbinate interference. But instead of encouraging the OP to see a doctor a plethora of advices are rendered.