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This is from a correspondence I've been having with Susan McCord, who gave me permission to share it with all you on the forum. Italicized emphasis is my own... Will be interested to hear what you guys think she should do:

"I've been sicker than a dog with this CPAP/sinus stuff since the day after Christmas. Nobody, including my sleep doc will really discuss it with me or else they just dismiss it. This has been going on, off and on, since shortly after I started CPAP in July.

Today I was at my cardiologist for a checkup, and was telling him about all this ongoing. Usually it goes away spontaneously in 2-3 days--this time it's hung on for 10 days so far. Can't stand it.

Anyway, cardiologist, who's also an internist prior, told me it's not uncommon at ALL for pts. on CPAP to have this and that I have an infection. I asked him why the MDs don't tell us about it--he and I have a VERY open relationship and he knows I can't stand having smoke blown up my ass--he told me it's because the sleep docs are so worried about compliance that they don't tell pts. about the possibility of sinus complications AND that it's not uncommon for them to avoid talking about it even if pts. bring it up. They tend to assign the sinus problems to something else.

I was mildly horrified and, frankly, I think he is too. He told me to talk to my PCP and get started on an antibiotic and whatever else PCP recs. He also said people usually stay off CPAP for a week or so till the infection clears. THAT scares me to death. I don't think I'm gonna do it. Internet says to d/c too, but I don't think I can......what do you think I should do???"

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I too, was having horrible sinus problems with my cpap. I attribute it to the mask I was using, the Liberty. It was almost as though the air from the nasal pillows was drying out my sinuses. I had sinus pain all day long. It didn't happen during the summer but started this winter. I increased the humidity and I would wake up with water cascading down my throat from the nasal pillows. I just got through taking antibiotics for a sinus infection that I know is from the mask. Yes, I do clean my machine as directed.

I also have a quattro mask and I have switched back to it. I have had no problems with sinus pain, too much humidity or infections with it. I really believe the problem for some folks lies with the nasal pillows.
Occasionally in our practice we have a patient who gets a sinus infection after starting CPAP. It's usually someone who started CPAP recently. When that happens we let them know that because CPAP essentially opens up the airway more than it had been opened before it can give bugs the opportunity to enter and cause an infection. And, usually once the patient is treated with antibiotics, he/she doesn't continue to get sinus infections with CPAP use. We have never told a patient about this phenomenon before they start CPAP--not because don't want them to know that this can happen, or to make sure they use it despite the possibility. We generally don't think of it as a big concern, so it just doesn't get mentioned. If a patient is experiencing a chronic sinus problem, we would then refer him or her to an ENT for evaluation.

As far as continuing therapy while having an infection, we will usually recommend a patient increase their humidity setting to increase moisture to the nasal/sinus passages and help break up congestion. If they are still unable to breathe effectively through their nose, we recommend using a full face mask during illness so that they still get therapy while breathing through their mouth. We have some patients who have purchased a full face mask just for those times that they have a cold or sinus infection.

I personally have never NOT been able to use my CPAP when I've had a cold or sinus infection. I actually find that the humidity really helps, and getting the sleep that I need while I'm sick is really important for healing.
Dear friend:
I have been on a CPAP since 1988, and I have had to learn some things the hard way that the doctors don't even know, or won't admit it: First and most important of all is this: wash you mask and hose at least twice a week with soapy warm water and let dry before using it again. If you don't keep it washed you absolutely will get a sinus infection or cronic sinusitus. I know, because I have it now. Also keep your filter changed in your CPAP machene. You also need a good nasal spray that is not addictive that you can use often. I don't want to scare you, but you can also get Bells Palsy from an infection; I know, because I have had it twice over the years. If you ever get a pain in the back of your head close to the ear, get to the emergency room for a shot; I know, because that is what happened to me both times Bells Palsy hit me. This is my own personally opinion, so take it for what it is worth: if you are physically able to have the nose surgery to correct your obstruction, then have it; because the longer you stay on a CPAP the more addictive you will become to it. I know, because I cannot sleep without mine, because you get use to feeling the air blowing around your nose and when you don't have it with you, you will feel like you are smothering. Please do not ignore what I have told you, because what I have said comes from my own personal experiences and not what others said. Maybe someone else who has been on a CPAP many years can also give you some good advise.
Sincerely, Evangelist and Christian Author
Clyde C. Parker, Jr.
I had a very similar experience; I took antibiotics, replaced all of my gear (tank,hose, mask) and felt better in a few days.
Admittedly, I was not using Distilled water and I was only rinsing the tank every few days. Now it's distilled water only and rinsing every morning...no more sinus problems. To help get me through the Illness while continuing to use the CPAP; I put just a little Vick's on the outside of my nostrils, this was a nice improvement.
Rich
I personally woke up with a head cold on Christmas morning, not what I expected from Santa but I took my mask and humidifer apart, cleaned thoroughly, and put back together. I also did the sinus rinse taht my doc prescribes regularly as I have dealt with sinus problems for many years. The sinus rinse is really helpful and the nasal spray ocean if you can tolerate it. I have used a CPAP since 1994 and cannot sleep without it. I do not recommend not using it. I recently switched to the newest version and tried to use the heated water but felt I was drowning every night which may contribute if Susan has that option. Turn it off, rest your nose, I sleep so much better without the heat. Try the nasal rinse. I have the recipe if you need it.
Audrey Collins
Have you considered a cpap mask that bypass the sinuses or reduces sinus pressure significantly? The Oracle is an oral mask made by Fisher Paykel, Its a mask only few patients can tolerate but for those who can, the love it , it might help.
And now for something completely different.

I regularly had sinus infections when I was in my 30s. The infections took heavy doses of antibiotics over lengthy periods of time to clear up. One night at a party I told a nurse friend about them. She said, "Let me see you hands. Your knuckles have cracks in the skin that allow bacteria and viruses to enter and I know that in your business you meet a lot of people from all over and shake their hands. Make sure you use moisturizing lotions regularly and keep these cracks healed."

I took her advice and never had another sinus infections.

Did the cracks on my knuckles cause the infections? Did keeping the cracks away prevent further infections?

I don't know, but I will always be careful to keep my hands moisturized.

I am skeptical that CPAP contributes to sinus infections. I would even go the other way and say sleeping without CPAP would result in damage from apneas and a weakening of body and mind that would make one more suceptible to infection.

Good luck Susan with getting the proper medical attention to address your problem.
Banyon said:
And now for something completely different.

I regularly had sinus infections when I was in my 30s. The infections took heavy doses of antibiotics over lengthy periods of time to clear up. One night at a party I told a nurse friend about them. She said, "Let me see you hands. Your knuckles have cracks in the skin that allow bacteria and viruses to enter and I know that in your business you meet a lot of people from all over and shake their hands. Make sure you use moisturizing lotions regularly and keep these cracks healed."

I took her advice and never had another sinus infections.

Did the cracks on my knuckles cause the infections? Did keeping the cracks away prevent further infections?

I don't know, but I will always be careful to keep my hands moisturized.

I am skeptical that CPAP contributes to sinus infections. I would even go the other way and say sleeping without CPAP would result in damage from apneas and a weakening of body and mind that would make one more suceptible to infection.

Good luck Susan with getting the proper medical attention to address your problem.
OK. My first reply to a very lively discussion, but you folks are a diverse and educated crowd.
Here is my spin after twenty years on CPAP. Susan, you WILL notice side effects of CPAP, even with the humifier. I regularly use VICKS, and that means NIGHTLY (after I kiss Deb Good Night, as she hates Vicks [opt.]). The vapor action helps to keep my sinuses clear. This or another Eucalyptus products (or perhaps many others) has become a ritual for me.

I know that we are supposed to keep our equipment clean, but I RARELY clean my stuff: only when it gets a grime film, and Deb fills my humidifier reservoir and she is obsessive/compulsive on cleaning. I use the well water on the farm and have used distilled water only in foreign travels, and even then think it's perhaps a waste, but a good safeguard. The farm water is untreated and I like that. It's 147 feet deep and I've tested it and it's pure.

I DO clean the foam filters every week during the summer when we are at the farm, as there is just so much pollen, and it's even visible, the detritus sucked in! I just use Dawn or Softsoap, soak briefly, rinse in hot or cold, wring out with a washcloth and set aside to dry. Germs cause colds (I just learned over Christmas that there are 151 different viruses which can cause what we see as the "Common Cold" (AARP), so the risk is always there.

Both Deb and I have gone through periods of allergies with MULTIPLE meds and inhalers plus sinus infections for the past thirty-five years. As with most folks, allergies thankfully do seem to come and go. Deb currently has sinus troubles for three years now and I am symptom free!

OK. I believe in accupunture and we use accupressure (plus do yoga) nightly to ease aches and pains and accupressure is INCREDIBLY good for relieving SINUS PRESSURE. I leared accupressure in the early '70's and you can find good books everywhere! It's just standard Chinese and universal medicine/self treatment. PLEASE TRY SINUS MASSAGE and POINT PRESSURE for relief. It really DOES work, and Deb was not a believer until I used it for her sinuses and now her back. I just zoom in naturally and you can clear your head, relieve headaches, etc. all in five minutes. NOTE: Buy book on ACCUPRESSURE or visit your local library.

Indian Medicine uses "Nati", which is really NASTY! It's a salt water daily nasal douche! Some of the members in our Yoga group do this, but most folks only try it once or in my case three or four times! If you want a horrible, buring sensation throughout your head and nasal cavities, try Nati. I guess that it's a cultural thing, and I've spent two summers in India (many years ago) and they have many good things, but I would SKIP the Nati! Good Luck to you! Duane in North Dakota
I'm a big believer in nasal washings.
I've been on CPAP for over 10 years now and will say that I have definately had more sinus / lung issues than at any time prior.

As for stopping use of CPAP mask while I have an infection.... That is not an option. I CANNOT SLEEP without wearing my mask anyway, unless I want to end up making people think I'm laying there having a seizure (from all of the snorting and jerkiness if my body!)

I've just had to get myself to the Dr. and get on some antibiotics and then TRY to wear the mask as long as I can inbetween waking up and clearing the "snot locker". It's then back on with the mask and limited sleep until the next "cleaning" session.

My problem initially was convincing my Dr. to write the prescription for these "recurring" infections. As you know, so many Doc's now days are reluctant to prescribe antibiotics.

Anyway, just thought I'd add some feedback to the topic from a long time CPAP user.
OK. Duane in North Dakota again here. No, I simply could NOT sleep without my CPAP, and as mentioned, I've used mine for nearly twenty years! Use any prescribed meds as recommended, but your CPAP I firmly believe actually HELPS clear your airways when you have a cold. I have NEVER had a cold so bad that I couldn't wear my mask.

And the Doctor who told you to lay off doesn't fully understand Sleep Apnea. The last time that I forgot my CPAP in Minot when we went to the farm I woke up 232 times during the night and was totally exhausted! Needless to say, we finished our work early and returned to Minot. Many is the time we have turned around five miles out of town and checking to see that we have the CPAP packed is and has become so routine that, yes, sometimes, it's packed and we still forget it!

I am of the mind that Sleep Apnea is SO SEVERE for so many people that it's nearly a matter of LIVING to have your machine with you ALWAYS! As I have written, I've travelled in 73 countries, and take my machine everywhere. For a few years I even had a spare at the farm, when they changed models and let me keep my old one. We are REALLY remote so there are always electrical fluctuations and I've had my CPAP crap out on me a dozen times. Then it's back to Minot (after placing an urgency call!) to pick up another machine.

Get a really GOOD Doctor or PA who understands Sleep Apnea. To most, it's just junk science and unfortunately I really DO feel that the medical communitiy sometimes treats it as such. However, it's so PROFITABLE to them these days that they DO staff a separate clinic, even here in MInot, North Dakota. In the end, it's up to YOU to know well what really works and that you must use your machine FOREVER!

Good Luck! Duane in North Dakota

TJ said:
I've been on CPAP for over 10 years now and will say that I have definately had more sinus / lung issues than at any time prior.

As for stopping use of CPAP mask while I have an infection.... That is not an option. I CANNOT SLEEP without wearing my mask anyway, unless I want to end up making people think I'm laying there having a seizure (from all of the snorting and jerkiness if my body!)

I've just had to get myself to the Dr. and get on some antibiotics and then TRY to wear the mask as long as I can inbetween waking up and clearing the "snot locker". It's then back on with the mask and limited sleep until the next "cleaning" session.

My problem initially was convincing my Dr. to write the prescription for these "recurring" infections. As you know, so many Doc's now days are reluctant to prescribe antibiotics.

Anyway, just thought I'd add some feedback to the topic from a long time CPAP user.

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