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richard graham posted a status
"For the first time in a while I got a whole night sleep with my machine but woke up beat and left side of my head feels weird, not sure if"
3 hours ago
Brendan Duffy posted a status
"How did you slhttp://blog.aastweb.org/winners-and-losers-food-for-thought-sleep-and-athletic-success?utm_campaign=subscribers&utm_source=hs_"
Jul 9
Pat Kniel updated their profile
Jul 7
ZolliStar replied to Fred's discussion CPAP - cure worse than the disease
"I'm wondering: what prompted you to consider whether you have sleep apnea in the first place? Also, waking throughout the night isn't uncommon especially as we (*sigh*) age.  I seem to every 90 minutes or so. This pattern probably…"
Jun 27
ZolliStar replied to ZolliStar's discussion New mouth device on the market
"You can try this website:  http://zyppah.com/ I have a MAD (mandibular advancement device). Dr. Steven Park evaluated my mouth and throat (not everyone can use a MAD, it turns out) and pronounced me a candidate for it. The truth?  I…"
Jun 27
Mary Z replied to ZolliStar's discussion New mouth device on the market
"The link didn't work so me so I couldn't see the product.  I do have experience with a supposedly reliable boil and bite device.  I should know by now I have a small mouth and nothing regular size fits.  I don't think…"
Jun 27
richard graham replied to ZolliStar's discussion New mouth device on the market
"If I thought something could work other than this lousy cpap that would be awesome"
May 22
richard graham posted a status
"I moved and have been sick a lot and can't use cpap because of cough and I'm depressed a lot"
Apr 26
Fred posted a discussion

CPAP - cure worse than the disease

It's ironic that before I was diagnosed with sleep apnea in 2000, I had no problem sleeping 8-9 hours a night. If I did wake up during the night, I had no problem falling right back to sleep, and I wasn't tired during the day.From the first night I brought home the CPAP I haven't had one decent night's sleep. Not one. I don't have any problem falling asleep, but I can't stay asleep. At first I was waking up after 4-5 hours and couldn't get back to sleep for a couple of hours. Now it's more like…See More
Apr 13
Fred updated their profile
Apr 13
ZolliStar posted a discussion

New mouth device on the market

I've been hearing advertising for this product over the past few days.  It's sold as something to help snoring, but as I look at the information it seems to me that it would work just as well as my mandibular advancement device (MAD).In other words, this could help some of us with sleep apnea.Read about it here.Anybody have any thoughts about this?  See More
Mar 31
99 replied to Mary Z's discussion AHI finally under five.
"Hi Richard I mainly use an empty humidifier as it reduces noise"
Feb 16
richard graham left a comment for richard graham
"When I can afford it I'd like to get New machine with heated tube"
Feb 10
richard graham replied to Mary Z's discussion AHI finally under five.
"I would like to see this forum active again as well. I will be more aware of what's going on"
Feb 10
ZolliStar posted a discussion

If you have trouble falling asleep....

I thought that when I got my sleep apnea diagnosis, that -- at last! -- all my sleep problems had come to an end.Ha!I have trouble falling asleep. Indeed, I rarely feel sleepy at night although I do feel tired. I even cut back on computer at night, etc., etc. (and installed f.lux on my computer) but I still had trouble. Now I'm doing something different: wearing special glasses (Uvex S1933X Skyper Safety Eyewear glasses). They block out the blue -- and they're making a difference! First I tried…See More
Feb 1
99 replied to 99's discussion colloidal silver
"i have purchased some silver the make my own colloidal silver"
Dec 21, 2014
99 replied to 99's discussion colloidal silver
"just add to the distilled water it is antimicrobial eg cleans your machine and is beneficial for keeping you healthy  from bugs germs viruses you get the picture and when you need to clean the humidifier out, put water on your plants the silver…"
Dec 21, 2014
Mary Z left a comment for richard graham
"If the heated tube works with your machine I would try that.  They also make covers for your tubing which may help some.  I think the heated tube may be your answer.  Keep us posted."
Dec 21, 2014
Mary Z left a comment for richard graham
"Richard, some folks just use the humidifier in a Passover mode.  They just don't turn it on, but let the air pick up moisture without heat."
Dec 21, 2014
Mary Z replied to 99's discussion colloidal silver
"99, where have you been?  Do you add the colloidal silver to your humidifier?"
Dec 21, 2014

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"

Views: 651

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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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