CPAPtalk.com

Just so you are aware about Flonase, it has a preservative called benzalkonium chloride in it. This is from Wikipedia: "There has also been concern that long-term use of benzalkonium as a preservative in nasal sprays may cause swelling of mucosa and lead to rhinitis medicamentosa. Although some studies have found no correlation between use of benzalkonium chloride in nasal sprays and rhinitis medicamentosa,[17] others have found benzalkonium chloride in oxymetazoline nasal spray to worsen rhinitis medicamentosa in healthy volunteers after both long-term use[18][19] and short-term use.[20]"

My personal experience with Flonase was that because of this ingredient I developed severe post-nasal drip. I switched to another brand that did not have the benzalkonium in it and the drip went away.

Sorry if this doesn't address the cpap/nasal stuffiness issue, I don't have any insight there....I just thought you might want to know what you are spraying up your nose.

Not to hijack anything, but just a quick question for Opticalpopsicle. Do you know if that ingredient is in just Flonase, or is it also in the generic, fluticasone propionate? I look on my son's almost-empty bottle of the generic he left here when he headed back to college and I don't see anything listed other than the fluticasone propionate. Thanks!

theoregonlife wrote: i am also using a neti pot with sterilized water to rise out before sleep..

Are you using the correct amount of pickling salt and baking soda mixed with the water?

You might consider using SinusRinse along with their premixed salt packets to be sure you get it right.

If CPAP in the nose is your problem, you might consider an oral (mouth only) mask, and there will be no pressure in your nose or sinuses. They can be a bit of a bear to get used to and may dry out your mouth and throat. They're not necessarily a miracle cure, but they do have a different set of problems from nasal or full face masks.

archangle wrote:

theoregonlife wrote: i am also using a neti pot with sterilized water to rise out before sleep..

Are you using the correct amount of pickling salt and baking soda mixed with the water?

You might consider using SinusRinse along with their premixed salt packets to be sure you get it right.

If CPAP in the nose is your problem, you might consider an oral (mouth only) mask, and there will be no pressure in your nose or sinuses. They can be a bit of a bear to get used to and may dry out your mouth and throat. They're not necessarily a miracle cure, but they do have a different set of problems from nasal or full face masks.

Do you know of different oral masks? I've only seen one listed, and I would be interested in trying one if it looked like a good fit for me. I have a quattro fx which I used daily, and a liberty that I use sometimes. I don't expect to find anything better, as it works pretty good for me most nights. But I am open to improvements.

to give everyone a update, it has come down to the fact that my body and such just cannot tolerate my cpap, not everyone can and it is not the solution for everyone. It may be the gold standard, but even that does not work for us all i tired very hard to make this work but my body screams no. I am in the process of finding a oral surgeon to make an oral appliance, which many of you know is just as effective as a cpap machine (don't believe me check http://www.umm.edu/patiented/articles/w ... 0065_9.htm) anyway thanks so much everyone for your help i appreciate it!

theoregonlife wrote: I am in the process of finding a oral surgeon to make an oral appliance, which many of you know is just as effective as a cpap machine (don't believe me check http://www.umm.edu/patiented/articles/w ... 0065_9.htm) anyway thanks so much everyone for your help i appreciate it!

I did check that article. It says, "Dental devices are not as effective as CPAP therapy."

Good luck with your treatment. If the dental device doesn't do the trick, come back here if you want to live.

zoocrewphoto wrote:Do you know of different oral masks? I've only seen one listed, and I would be interested in trying one if it looked like a good fit for me. I have a quattro fx which I used daily, and a liberty that I use sometimes. I don't expect to find anything better, as it works pretty good for me most nights. But I am open to improvements.

I thought there used to be two different oral masks, but now I only see one. I thought there was one that's sort of like the hybrid masks, but without the nasal pillows. I can't find anything about it now. Maybe I just had some bad info or misinterpreted a picture of the hybrid mask.

theoregonlife wrote:I have had this machine (resmed s9 auto) for less then 23 days in that time frame i have had 2 upper respiratory infections near constant congestion and chest pain that is always worse after a long nights use of the machine. I have tried flonase to deal with the congestion as well as a neti pot nothing is helping, and it has done nothing to rid my persistent tightness and and pain. Before this machine i have NEVER had brocitus or any lung issues, I am currently at my wits end with this machine and am ready to take my chances without it. Have any of you been in or seen anything similar to this? Also does anyone have any advice as i am getting a bit desperate. Thanks

Hi and welcome theoregonlife,

Anyone who will endure three weeks of congestion, infections, chest pain and all - well - my hat is off to you. That is a lot of good effort and I believe you should be strongly commended for that.

When I hear:

Constant Congestion
Chest Pain
Respiratory Infections
All worse with long nights CPAP use

I think:

Likely, pressure is too high

That a strong "first night effect" and/or "white coat effect" along with the simple time based "one super expensive snapsot in the dark" time limitation of the standard in lab sleep study has yeilded a set of PAP parameter settings which are not working for you.

That you were not instructed to take some quality time with the PAP prior to use - getting the right mask fit - learning to breath very quietly with the machine - taking time with the machine during the day -- quietly by yourself during the day -- quietly in bed during the day -- also taking time with distractions such as non-violent TV or radio or music or a book during the day --- taking time to get familiar with the machine before you actually use it at night - and to start the night breathing very quietly.

That you did not set up feedback!! I consider the use of daily feedback (the data from the PAP downloaded and analyzed using good software) essential to making PAP work! How can you know what happend during the night without it - and - how will changes in your body and life effect how your PAP is working for you. You must have feedback!!!

That your breathing reflexes are affected by the PAP settings and so you breath a lot more than you should. In my experiance the urge to breath way too much can become quite strong. When this was bad for me I would actually wake up breathing quite hard. I would breath out as gently as I could, stop for a slow count of ten, breath three slow relatively shallow breaths, and repeat with the pause and three breaths two more times. About the end of the second or perhaps third time the crazy super strong urge to breath too much would evaporate. Along with this I would feel the circulation return to my feet and a feeling of warmpth would cover me.

If you breath too much you will congest. If you breath too much you may well hurt your lungs. If you breath too much you will wash out your necessary CO2 which will cause your blood vescles to close down and frustrate oxygen transport. In short your cells will start to starve. I have learned to do several things to help with this problem.

If I were you I would:

Go back to your doctor with this article in hand: http://www.ncbi.nlm.nih.gov/pubmed/21206741 (read it first yourself of course).

Work with your doctor to come up with a strategy to go to strait CPAP doing an initial trial with a seemingly low perssure - and then use daily feedback from the machine to make decisions to zero in on useable numbers for you. Keep in mind that your breathing reflexes are adapting to anything you give them so an initial bad night might become something quite differant in a few days or a week or three. This is no race - it is an ongoing process of using feedback to make first changes in your lifestyle and then changes in your PAP only if really necessary.

Try doing some optimal breathing training as I call it. Simply I use a $50 pulse oximeter I keep in a pouch on my belt to help me zero in on the breathing rate which produces the lowest heart rate for a given rate of exertion (held constant). The blood oxygen reading becomes useful in finding the lowest heart rate fast after you initially find it by what I would call amazingly long trial and error sessions watching the pulse rate. I think you will be amazed by how little air you actually need and how much happier your lungs and nose will be processing that less ammount. For the first summer in decades I really did get to smell the flowers this summer when usually I would have been running to the drug store for allergy drugs. Now, if I get a stuffy nose the first thing I do is stop breathing (and my urge to breath now does not kick in for 20 to 30 seconds). The increased CO2 levels bringing more circulation along with the warmpth of no air cooling quiet the nose almost immediatly. It is very rare I sneeze and much more rare that I sneeze more than once at a time.

Recently I moved and lost some weight. This brough some breathing instability into the picture. It was helpful to do optimal breathing training with the machine during the day but eventually I go my pressure reduced. Nightly feedback told the story as I went along.

I do hope you try PAP again.

May we never forget to have a lot of fun when we can!

Todzo

I'm no doctor either but I use Flonase and I use 1-2 sprays in the morning only. It could be that using so much Flonase is causing you problems. Check with your doctor on when to use it and the recommended dosage. I use it in the morning regularly so it has done its job by the time I go to bed. Let us know how it goes.

WearyOne wrote:Not to hijack anything, but just a quick question for Opticalpopsicle. Do you know if that ingredient is in just Flonase, or is it also in the generic, fluticasone propionate? I look on my son's almost-empty bottle of the generic he left here when he headed back to college and I don't see anything listed other than the fluticasone propionate. Thanks!

The fluticasone propionate has to be mixed with flow enhancers and preservatives and water and other things....in every kind of spray. Generic versions of medicines only have to have the same active ingredient as the brand, none of the other ingredients have to match. So I suspect if all it says is "fluticasone propionate" that you are looking at the "active ingredient" list and not the rest of the ingredients. Find the rest of the ingredients and if it does not say "benzalkonium chloride" in that list then it does not contain it. I hope that answers your question!

theoregonlife wrote:let me spell this out, cpap causes constant drainage in sinus which goes into the lungs which in turn causes infection and possibly pneumonia source my dr

Since CPAP treatment in itself does not do that (though you may have other problems that might do it), it sounds like its time to find a new doctor

Even though there could be a physical cause for your symptoms, it is very much NOT likely caused by cpap.
Aside from physical causes, anxiety comes to mind. Frustration doesn't help much either. Have you read this thread?
viewtopic/t61785/Especially-for-newly-d ... hange.html
Give yourself a chance, see your doctor and share all your concerns there--we are not doctors.

archangle wrote: come back here if you want to live.

I find this comment almost comical, you people are so stuck on the fact that a cpap is the only option available, that your forget that it's not. Do you know pal that that cpap put me in the ER? Do you have any idea the problems it has caused me? You are being one sided and biased towards what you think is the only thing people can do for OSA. The ER dr and my pulmolnologist both have now said CPAP is not now nor will ever be an option for me.. Nothing frustrates me more then people who refuse to admit that there is more then one way to treat something. Good grief check your facts and know what you are talking about before damning me....

billbolton wrote:

theoregonlife wrote:let me spell this out, cpap causes constant drainage in sinus which goes into the lungs which in turn causes infection and possibly pneumonia source my dr

Since CPAP treatment in itself does not do that (though you may have other problems that might do it), it sounds like its time to find a new doctor

As for you your comment makes me wonder if you got your phd from the Internet.. Oh thats right I bet you don't have one and you are just bloviating based on what you think you know.. The persantat drainage that a cpap does cause in some users such as my self, caused me pneumonia and landed me in the hospital and you the know the dr aka the one with a phd said it was caused from the drainage which was started by guess what the CPAP. But go ahead and keep on bloviating in the meantime ill listen to the pulmolnologist and not u.

Unfortunately, cpap is the only treatment with a good success rate.

Most of the other treatments have a poor success rate. Their idea of success is 50% reduction in ahi, which means only mild osa can be cured. Everybody else still gets moderate to severe sleep apnea while being told they were a success story. I have an ahi of 79, so if the surgery was successful for me, I could still have an ahi of 38 and still be severe. And I believfe they usually say that only 50% of patients actually have success (50% reduction). So, I wonder how many actually achieve an ahi below 5, and how many years it stays that way.

And many people who have had the surgery or used a dental device get worse later and still need to do cpap, assuming they get retested. Some assume they are cured, and don't realize they are still suffering more long term damage.

I do wish you well. Maybe you will be one of the lucky ones.