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Mary Z replied to ZolliStar's discussion Non-invasion approach that can relieve mild sleep apnea
"Hi ZolliStar, I've heard before that speech therapy, or singing lessons can help sleep apnea.  The problem at that time was there was no way to determine which exercises help.  Getting research done, rather than anecdotal would be…"
Jul 28
ZolliStar posted a discussion

Non-invasion approach that can relieve mild sleep apnea

Some people report that singing -- singing! -- really helps their sleep apnea. Dr. Stephen Park said that myology (which are exercises to strengthen muscles around the inside of one's mouth area) helps some. I think singing would be better.  If you read all the FAQs on this (click below), I think you'll agree that it makes sense for some. Maybe you.http://www.singingforsnorers.com/index.htmSee More
Jul 28
ZolliStar posted a discussion
Jul 20
liz4cps commented on liz4cps's group Prince William Co, VA support group
"I talked to Kimberlie at the Novant Sleep lab last week (at Prince William Hospital) and she said they would not be holding any meetings this year but are planning to start holding meetings again next year.  I'll let you know when we have…"
Jul 14
richard graham posted a status
"I just have mask called the Wisp. Hope it works. Anybody have experience with it. I have an ultra mirage nasal mask and get leaks at brid"
Jul 9
Andy posted a discussion

Resmed S8 AutoSet II - No Longer Collecting Data??

Hi All,First off, my apologies for not checking in for a long time.I've been using my Resmed S8 AutoSet II for almost 3 years! I feel great, have lost almost 30 lbs, am no longer sleepy during the day, sleep through the night, and have my short-term memory back.Yay!I've told my doctors that I'm the "poster child" for Sleep Apnea and CPAPs! It's been, and continues to be, such an amazing experience that I want everyone to know!Everything has been going well in CPAP-land, but in the last few…See More
Jul 7
hifay replied to richard graham's discussion mouth breathing
"What type of chin straps?"
Jul 6
Ginny Edmundson replied to Ginny Edmundson's discussion Scheduled for evaluation and possible procedure next day
"No real improvement in sleep study.  Just not having to use cervical neck color.  What a bummer. Surgeon wants another sleep study in about a month or so (home one) Not sure if will do or not. "
Jun 22
Mary Z replied to Ginny Edmundson's discussion Scheduled for evaluation and possible procedure next day
"Ginny, how are you doing after the tongue procedure?"
Jun 22
Mary Z posted a discussion

AHI finally under five.

I have been on CPAP since March 2008 and had a good AHI when I started therapy (under 5).Then my AHI started getting worse- for a while it stayed in the 20's, then we got it to the high teens.  Nothing we did would help.  My doctor said it was due to the meds I take.  For a couple of years I just tolerated the high AHI.  I did another sleep study and changed to an ASV machine.  For two years I still had a AHI around 11-13.  Then all of a sudden - a month ago I noticed my AHI was running five or…See More
Jun 22
ZolliStar replied to richard graham's discussion mouth breathing
"FWIW, I've been alternating between my mouth device and my APAP. I haven't used humidity at all when I use the APAP -- and don't miss it, either. "
Jun 14
richard graham replied to richard graham's discussion mouth breathing
"I still use humidity but less of it. It seems to be working OK.."
Jun 14
ZolliStar replied to richard graham's discussion mouth breathing
"I rarely use the humidifier. I think it's less necessary during the summer when there is humidity.   I also switch between my mouth device and the APAP.  I like each for different reasons. Not sure with which I sleep better, though.…"
May 21
Mary Z replied to richard graham's discussion sick again
"I've been doing well.  I think you were going to try the cpap without humidity- did that help at all?  I haven't had a cold for a couple of years."
May 14
Ginny Edmundson replied to richard graham's discussion sick again
"CPAP seems to cause stuffiness in many of us.  ANother reason I hate it so much!Do you rinse your nose with saline once a day…maybe before you go to bed for the night? "
May 5
richard graham replied to richard graham's discussion sick again
"I do wake up stuffed up most days"
May 5
richard graham replied to richard graham's discussion sick again
"I do have non allergic rhinitis. Now I'm thinking that's probably it because I only feel that way for a day or 2. Thank you"
May 4
Ginny Edmundson replied to richard graham's discussion sick again
"I have been lucky.  Not one cold past three years. Could some of your problem be allergies?"
May 4
richard graham posted a discussion

sick again

It seems like I am sick with colds more often when I'm on the CPAP. Anybody experience that.
Apr 30
Ginny Edmundson replied to Ginny Edmundson's discussion Scheduled for evaluation and possible procedure next day
"As of now I no longer have to use a chin strap.  I am anxious about the sleep study.  Wondering if I will be able to sleep WITHOUT the CPAP….even thought I hate it it is a part of every night now and is what I am used to.  "
Apr 20

CPAP May Make Nasal Spray Ineffective at Night?

came across this tip online and wanted to see whether others agree.

"Hold the Spray Until Morning
Advise patients who are receiving continuous positive airway pressure (CPAP) therapy and who use a corticosteroid nasal spray for allergies to spray in the morning rather than at bedtime. If the spray is used in the evening, CPAP may dry it out, making it less effective.
—— Richard A. Honaker, MD
Carrollton, Tex"

Tags: corticosteroid, cpap

Views: 484

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Replies to This Discussion

What does corticosteroid mean?
Corticosteroids are a class of medication developed to reduce tissue inflammation (swelling) -- looks like Flonase is one such product. here's some more info: http://www.aanma.org/2009/03/news-for-your-nose-nasal-corticosteroids/

susan mccord said:
What does corticosteroid mean?
So it's like OTC nasal sprays? I (rarely) use a mild 4-hour spray before I go to sleep if I feel stuffy, which I hardly ever do anymore. One shot of it qhs is sufficient for me to get to sleep.

Is Flonase Rx or OTC? Am wondering if he's talking about a prescription spray that Rx'd for specific conditions.

McCord
Corticosteroid nasal sprays, such as Flonase, require a prescription in the US. Corticosteroids are steroidal anti-inflammatories and reduce swelling. OTC nasal sprays are considerably different and contain oxymetazoline or a related chemical. Both are used as general purpose nasal decongestants.

One major difference is that corticosteroid nasal sprays are suitable for long term daily use, and OTC nasal sprays can only be used for a few days at a time. Over-use of OTC nasal sprays can cause rebound and dependency. Even though corticosteroid nasal sprays are steroidal, they are not absorbed and are in very low concentration, so they have very little systemic effect.
NOT TRUE, with the humidifier, I used Flonase a long time,( Ivax Labs ,here in San Diego makes a generic, but it has a different steroid, and isn't the same, even though Kaiser substituted it til I caught them) it's MORE effective, the air disperses it thru ur sinuses & now I use saline nasal spray occasionally, same thing, it's MORE effectively pushed thru.

Tim said:
Corticosteroid nasal sprays, such as Flonase, require a prescription in the US. Corticosteroids are steroidal anti-inflammatories and reduce swelling. OTC nasal sprays are considerably different and contain oxymetazoline or a related chemical. Both are used as general purpose nasal decongestants.

One major difference is that corticosteroid nasal sprays are suitable for long term daily use, and OTC nasal sprays can only be used for a few days at a time. Over-use of OTC nasal sprays can cause rebound and dependency. Even though corticosteroid nasal sprays are steroidal, they are not absorbed and are in very low concentration, so they have very little systemic effect.
"If the spray is used in the evening, CPAP may dry it out, making it less effective.
"


Mike,

I disagree with the doctor's statement, but cite some caveats. A properly working CPAP process does not cause more air flow through the nasal passages than in normal unassisted breathing. Properly working means no excess mask leak and either use of a full face mask or a nasal mask/pillows with no mouth breathing. In such a situation CPAP delivers air pressure not air flow compared to normal breathing.

But I do maintain that it is a good practice to use these types of sprays in the morning because some very few people are extremely sensitive to the corticosteroid to the point it will interfere with sleep if used in the evening.

In my own case, morning is a good time to use a neti pot just before a warm shower and clear my nasal passages of excess mucus then use the spray. If you use the spray when excess mucus is present, the spray will not be distributed as well. Also, and more importantly, when excess mucus is present, the spray will not be as well absorbed into the mucus membranes.

So, by default, I would say the doctor's advice is good.

Ciao.
i'm not clear on the distinction you're making between between air flow and air pressure.

Banyon said:
"If the spray is used in the evening, CPAP may dry it out, making it less effective.
"


Mike,

I disagree with the doctor's statement, but cite some caveats. A properly working CPAP process does not cause more air flow through the nasal passages than in normal unassisted breathing. Properly working means no excess mask leak and either use of a full face mask or a nasal mask/pillows with no mouth breathing. In such a situation CPAP delivers air pressure not air flow compared to normal breathing.

But I do maintain that it is a good practice to use these types of sprays in the morning because some very few people are extremely sensitive to the corticosteroid to the point it will interfere with sleep if used in the evening.

In my own case, morning is a good time to use a neti pot just before a warm shower and clear my nasal passages of excess mucus then use the spray. If you use the spray when excess mucus is present, the spray will not be distributed as well. Also, and more importantly, when excess mucus is present, the spray will not be as well absorbed into the mucus membranes.

So, by default, I would say the doctor's advice is good.

Ciao.
Mike said:
i'm not clear on the distinction you're making between between air flow and air pressure......

flow -noun: movement of a volume in or as if in a stream
pressure -noun: the exertion of force upon a surface by an object, fluid, etc., in contact with it

If you think CPAP provides more air flow (as compared to normal breathing), then state where the additional air goes.
gordon nelson: When you say that what somebody said is not true, you had better show why it is not true. Other than a couple of spelling errors, I believe that the information that I provided is accurate, and you said nothing that would refute it. I said nothing about the effect of CPAP on decongestants.

gordon nelson said:
NOT TRUE, with the humidifier, I used Flonase a long time,( Ivax Labs ,here in San Diego makes a generic, but it has a different steroid, and isn't the same, even though Kaiser substituted it til I caught them) it's MORE effective, the air disperses it thru ur sinuses & now I use saline nasal spray occasionally, same thing, it's MORE effectively pushed thru.
Tim said:
Corticosteroid nasal sprays, such as Flonase, require a prescription in the US. Corticosteroids are steroidal anti-inflammatories and reduce swelling. OTC nasal sprays are considerably different and contain oxymetazoline or a related chemical. Both are used as general purpose nasal decongestants.

One major difference is that corticosteroid nasal sprays are suitable for long term daily use, and OTC nasal sprays can only be used for a few days at a time. Over-use of OTC nasal sprays can cause rebound and dependency. Even though corticosteroid nasal sprays are steroidal, they are not absorbed and are in very low concentration, so they have very little systemic effect.
Tim said:
gordon nelson: When you say that what somebody said is not true, you had better show why it is not true. Other than a couple of spelling errors, I believe that the information that I provided is accurate, and you said nothing that would refute it. I said nothing about the effect of CPAP on decongestants.


OK Tim, Gordon can defend his own posts, but let me "pick" for a brief moment on two statements you made. You said, "....... OTC nasal sprays are considerably different and contain oxymetazoline or a related chemical. ........".

That statement is not correct. While there are OTC sprays that do contain oxymetazolone, there are also many types of OTC nasal sprays that do not contain oxymetazoline or any similar chemical. There are simple salt solution sprays, Zicam sprays, various sprays purporting to contain vitamins, "natural substances", and I even see one containing honey and another containing pepper (!), but all contain no oxymetazoline.

You also said, “Even though corticosteroid nasal sprays are steroidal, they are not absorbed and are in very low concentration, so they have very little systemic effect.” Now I am being picayune, but this statement is not true. Some very small amounts of corticosteroid spray is absorbed by most users and in some very sensitive users side effects such as mood change have been observed. But I agree with your statement that they have very little systemic effect.

I believe the main point of your post was to point out, “Over-use of OTC nasal sprays containing oxymetazoline can cause rebound and dependency” and to emphasize that corticosteroid sprays used properly are very safe. On these main points, I am in violent agreement with you.

Have a good one
sorry Tim- all that's true what you said. I was only stating mu .02 , that I have a positive affect using both Flonase and saline at night, it enhanced it, it's not my imagination because I used Flonase habitually, to my detriment, but I found on my #4humidity it seems to have a vaporizing affect w/ CPAPon those sprays, I don't see the point of using Flonase in the morning when you need it to breath at night. You can use it 2-3 times a day.

Banyon said:
Tim said:
gordon nelson: When you say that what somebody said is not true, you had better show why it is not true. Other than a couple of spelling errors, I believe that the information that I provided is accurate, and you said nothing that would refute it. I said nothing about the effect of CPAP on decongestants.


OK Tim, Gordon can defend his own posts, but let me "pick" for a brief moment on two statements you made. You said, "....... OTC nasal sprays are considerably different and contain oxymetazoline or a related chemical. ........".

That statement is not correct. While there are OTC sprays that do contain oxymetazolone, there are also many types of OTC nasal sprays that do not contain oxymetazoline or any similar chemical. There are simple salt solution sprays, Zicam sprays, various sprays purporting to contain vitamins, "natural substances", and I even see one containing honey and another containing pepper (!), but all contain no oxymetazoline.

You also said, “Even though corticosteroid nasal sprays are steroidal, they are not absorbed and are in very low concentration, so they have very little systemic effect.” Now I am being picayune, but this statement is not true. Some very small amounts of corticosteroid spray is absorbed by most users and in some very sensitive users side effects such as mood change have been observed. But I agree with your statement that they have very little systemic effect.

I believe the main point of your post was to point out, “Over-use of OTC nasal sprays containing oxymetazoline can cause rebound and dependency” and to emphasize that corticosteroid sprays used properly are very safe. On these main points, I am in violent agreement with you.

Have a good one
gordon nelson said:
........I used Flonase habitually, to my detriment, ....... I don't see the point of using Flonase in the morning when you need it to breath at night. You can use it 2-3 times a day. ...

Such misinformation about Flonase, how to use it, and how it works. Flonase is prescribed for use once per day. It has a build-up effect that provides relief for 24 hours or longer. It is often prescribed for daily use for indefinitely long periods of time.

From the Flonase website: "For best results, use FLONASE daily. Your nasal symptoms may begin to improve in as few as 12 hours. Maximum relief may take several days."

This forum is great, but like all forums (and all of life), people should be wary and verify from several soruces that they have found to be reliable in the past. And yes, this precaution includes everything I post here.

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