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CPAP Sinus Infection?
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???"
"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???"
Tags: cold, cpap, infection, sinuses, upper-airway
Replies to This Discussion
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Permalink Reply by Rock Hinkle on -
Well I just got home from the doc. I have the flue and a sinus infection. Lucky me.
Yes it is the same at my work Mary. Everyone else is also out sick. I was the only one that did not call in this week. Had I felt as bad on Sunday as I did last night I probably would have. everyone in my family has this "bug" that is going around. My daughters are the only ones that do not have it. They were already on antibiotics though.
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Permalink Reply by Jackie S. on -
I noticed since working overnights it takes a long time to heal. If i go into work with a lil cough or sore throat it's a full blown thing the next day. If i don't work at the onset of symptoms I'm ok. I love my job but working overnight really isn't all that healthy for several reasons as you know. Feel better!
Rock Hinkle said:Well I just got home from the doc. I have the flue and a sinus infection. Lucky me.
Yes it is the same at my work Mary. Everyone else is also out sick. I was the only one that did not call in this week. Had I felt as bad on Sunday as I did last night I probably would have. everyone in my family has this "bug" that is going around. My daughters are the only ones that do not have it. They were already on antibiotics though.
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Permalink Reply by susan mccord on -
Hi Kevin--I haven't been on SG for a couple of weeks, at least. Wanted to tell you I'm so sorry about your dad's death. Had he been ill? Was his death expected?
Losing parents is tough, regardless of how old you are. Both of mine are dead, for many years now, and there are many days when I'd give anything to be able to talk to one of them, especially my dad.....so, my thoughts and prayers are with you and your family, and I just wanted you to know.
Susan McCord
Kevin Barthelemy said:I find it interesting that you brought up fungal infections...the house we're still (after 2½ months) trying to finish moving out of, has so much mold in it, we couldn't help but recognize the fungus as a health issue. The primary reason for it being so full of mold was that the house had a hole in the roof for the first five or six years we were there. Once we discovered the hole (had to stand down the block to see it), the landlord had it repaired, but that lovely black mold was already all through the place. On top of that, the basement had flooded three times in the last 13½ years, resulting in most of our belongings stored in the basement getting moldy. Everything we pick up in the basement kicks up clouds of spores...and aside from my health issues, my wife is asthmatic, too.
I had an appointment scheduled with my doctor on Monday, but managed to forget (not difficult - my father just died), and will now have to get a new appt. I had intended to bring the subject of fungal infection up. It wouldn't be a surprise, if some of my problems stem from breathing in too much fungal material.
susan mccord said:Kevin--Hi! I don't think you and I have cyber-talked before. At any rate, I'm the one who started this whole sinus topic, way back early in January. I'm still in active treatment after all this time, but finally making progress.
The reason I'm inserting myself into this at the moment is this: you mentioned having sinus infections ever since you were in boot camp. This just occurred to me, so please don't take it as a suggestion or a diagnosis--I'll NEVER do that to anybody again after what I've been through!
What I want to say is that somewhere in my endless search for answers for myself, I ran across something about people getting fungal infections that need to be treated differently than a bacterial infection. I know NOTHING about this other than that. But for whatever reason, it made me wonder if you've ever been tested for fungus involvement.
Interesting that you can pinpoint the origin of your infections to being in boot camp. I can do the same--my sinus problems (which I've NEVER had in 67 years!) began within a week of starting CPAP.
Hope you have an MD that you trust to help you climb through all this--it can be exhausting trying to deal with so much every day. I'm gonna send you a friend request which you can accept or not, as you prefer. Take care....
Susan McCord :-)
Kevin Barthelemy said:I'm not nearly as good about cleaning my gear as I ought to be, however, there doesn't appear to be any direct relationship between my cleaning of the CPAP, and my having sinus infections. For one thing, the pattern hasn't changed much, since I began using the CPAP; ever since Navy boot camp, I've had sinus infections on a regular basis.
Much of my problem with infection, currently, is likely to stem from our long, drawn out process of moving. It's been, pretty much, work really hard, to the point of exhaustion, then several days of not being worth a copper dime, before another round. Moreover, I've just started seeing a new psychiatrist, and he's had me drop a couple of meds, without tapering off - then he added another mood stabilizer, which I took for the first time last night. While it is true that I didn't manage to start my CPAP before crashing, it's never caused me to be totally wiped out, like I've been all day today.
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Permalink Reply by Daniel Quarberg on -
I also have had sinus problems that I attribute to my CPAP. Take note; 90% of the time is because of my not keeping up on the cleaning of the machine and parts.
I have been told by more than one RT that I should not use the machine while dealing with a sinus infection. I do find it difficult, however, I do have a full face mask and then it is not so bad as long as I keep the humidity on almost full volume.
I have been on CPAP since 2002 and in January 2009, I was diagnosed with pulmonary sarcoidosis. The sarcoidosis is in my lungs and left eye so far. This also causes difficulty in breathing and even more so when lying down. I look forward to bed time because with the CPAP on, I can breath easier than any time of the day.
I am a firm believer in the CPAP. It makes a world of difference in everyday living.
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Permalink Reply by Jeanne Berry on -
I live in the high desert, and my sinus infections started when I got my CPAP. I went to my PCP many times, and I don't want to live on antibiotics forever....and I began to believe that the humidity well addition to my CPAP might have been part of the reason that I kept getting infections...so I took the water well off my machine, and started using a sinus irrigation daily. This works VERY well, is really easy, and I have not gotten an infection since.
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Permalink Reply by Barbara Zarrella on
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I am just getting over a sinus infection. In my case, it is my sinuses telling me the pressure is too high in combination with the mask. I need to have the air diffused a bit, hence I cannot use nasal pillows. A nasal mask is OK. I had to go from the softgel back to the Active LT, as there is more interior space to diffuse the pressure of the air. I also lowered the pressure one whole point from 14 to 13. When things improve, I will try going up again.
When I started CPAP I was using the Swift mask and had 3 infections in 4 months. I have 'sensitive' sinuses!!
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Permalink Reply by David Bruskin on
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I haven't used the humidifier on my CPAP in maybe three or four years. I don't want to say how often I clean my CPAP -- okay, never -- but because the only moisture in the facemask is from my lungs, and most of that is vented, and I live in a dry climate, I've never had a problem. However, I'm sure what also helps is that, for chronic allergic rhinitis, I take daily Claritin D (used to take Allegra D before my insurance stopped covering it; one 12-hour pill at night is enough for me) along with Nasocort and Astelin sprays to keep my sinuses clear. Keeping breathing passages free is the key. When I have a cold, I use a lavage system to help clear the sinuses, and sometimes plain saline spray helps a lot to loosen dried mucus there. I don't use Afrin anymore; I don't want to risk the bounceback effect, but neither do I need it, not only because because of the Claritin D's decongestant, but also -- here's the irony -- if your sinuses (or even just one side) is at least partially open, the CPAP (which, remember, I always use without a humidifier) keeps the sinuses open while you sleep! For this reason (in addition to the usual vital ones), I always use CPAP during a cold. The downside is that all that stuff gets blown back, but you wake up unstuffed, and a morning shower helps loosen the blownback stuff quicker than the two hours or so it takes normally to drain. Also, the dryness of the air can harden post-nasal drip mucus into small plugs that you try to cough up, but Mucinex (Guafenisin) loosens this up and should be taken throughout a cold, as well. The only consequence of this methodology that I've observed is a cough that occasionally needs antibiotics to get rid of, but I'm not sure it's because of what I personally do because most (non-CPAP) folks around me with the same cold will frequently have the same persistent cough that needs antibiotics. In sum, I have found that keeping everything dry instead of moist -- including the CPAP (i.e. no humidifier) -- seems more likely to inhibit infection, especially in the sinuses.
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Permalink Reply by Steven Y. Park, MD on -
I don't want to contradict what everyone's saying about CPAP and sinus infections, but if you were to undergo a CT of your sinus every time you get an infection, over 90% of the time, the sinuses will be completely clear. It's been shown that in most cases, what may feel like a sinus infection (pain, pressure, nasal congestion, headaches, eye pain, and even colored mucous) is actually a variation of a migraine that's happening in your sinuses. The nerve endings in your sinuses are extra sensitive to any kind of stimulation. This is why it can be aggravated by allergies, weather changes, chemicals, irritants, and even CPAP pressure. It's also the reason why decongestants and allergy medications can help sometimes, but not fully. Later on, when swelling and sinus blockage continues, the bacteria that normally inhabit your nose can begin to multiply. This situation doesn't happen too often. Unfortunately, it's impractical to get x-rays every time you feel sinus pain, and you have to give antibiotics empirically.
Interestingly, certain antibiotics (called macrolides) have an anti-inflammatory property that's been well described. It's been used successfully in the past to treat chronic sinusitis. One way these medications work is by stimulating your stomach to empty it faster. So with less stomach juices lingering, less can come up into your throat every time you stop breathing, causing less inflammation and swelling in your throat and nose. A Z-Pak is a common antibiotic in this family that's commonly given out by doctors. This is why many patients that take Z-Pak feel better within 1-2 days, rather than the typical 3-5 days that it takes for most antibiotics.
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Permalink Reply by liz4cps on
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Since going on CPAP, I find I have a lot fewer colds, etc. Before CPAP, I breathed thru my mouth more and that would trigger a sore throat which would develop into a cold and encourage more mouth breathing. Frankly, I did not believe colds only lasted 7 days back then.
These days, things are much approved. I am a bit lax at cleaning my tubes and stuff though I do empty my humidifier and hang up my hoses to dry every day. I also use our well water (and occasionally tap water when traveling) instead of distilled water, yet I continue to rarely get colds. When I first went on CPAP in '97, I had a lot of adjustments (the masks were not like today's!), but I don't remember having more colds than usual during that time. I do continue using CPAP when I'm stuffed up, simply doing what I can to reduce the congestion before I go to bed. The machine normally keeps it open during the night. I do sometimes take lotradine to help that, especially in the spring.
When I have had colds, I have found that the CPAP can blow stuff down further than it normally would be and I can cough a lot in the morning. I don't like this and worry if my immune system were not so effective, it could cause me problems. Thankfully, the CPAP prevents colds enough that I only have this problem rarely, not even once a year.
I did once have a cold or something that hung on and hung on -- until I soaked everything every day so that I could recover. I don't know what it was about the bug I had but at first, I just figured it was one of my rare colds that would go away shortly. However, when I put the CPAP on in the evening, there was a smell in the tube that I associate with sickness (not throwing up, but a smell that sometimes occurs in a room where there is someone that is sick). Breathing air thru the tube all night apparently bolstered the infection in my body. I began cleaning the tubes more frequently and eventually realized that the smell was there unless I actually cleaned the tubes every day. When I did that, I was then able to shake the illness.
The doctors say you can't get an illness that way and you're not supposed to be able to re-infect yourself, but that's what happened to me. Once I cleaned the tubes daily, the smell went away and I finally healed.
My takeaway is, normally, you're not going to have problems with getting an infection from CPAP but it's not impossible.
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Permalink Reply by RL on -
There are many good tips and discussions on this thread for anyone dealing with sinus issues, so if this is a problem for you, I encourage you to review it all.
Another aspect that I have been dealing with lately is therapy and monitoring of my vitamin D levels. This requires a blood test which can be done along with a regular physical at a doctor's office, but there are also now some at home tests you can do and mail it to the lab yourself. (current prices I found on this range from $50-135 on various websites) I am bringing this up because there is a lot of recent research and a lot of buzz about vitamin D right now and the effects of it on many health conditions and diseases, including immunity. My doctor initiated this test and therapy for me, and I asked my mother's doctor about testing her, which he agreed to. Both of us were in the "insufficient" range and are prescribed therapeutic doses to improve our levels over time. I encourage anyone reading this to do your own research on Vitamin D and talk to your doctor about getting tested. If you don't have insurance right now, do the research anyway and the home test if you can afford it. This affects many disease processes including heart disease, many types of cancer (treatment and prevention), diabetes, bone health, and others. It is one thing that may help your overall and long term health. Anything you can do to prevent sinus infections will make your CPAP therapy easier.
I also have the condition described by Dr. Park, just now. That is Migraine, causing sinus inflammation and pain. I thought I had chronic sinusitis for years, until my doctor figured out it was probably a migraine condition. This has affected my CPAP use, making it difficult to breath at times, with or without the CPAP. I am learning to manage this with medications and lifestyle. I use a corticosteroid nasal spray every night, and sometimes antihistamines; also nasal rinses, migraine medication - Maxalt (a "triptan" Rx medication), vitamin & mineral supplements and medicinal herbs. If your sinus problems don't go away, it may be worth considering if you also have a migraine condition.
I imagine most people have multiple health conditions affecting their overall health and CPAP use. Understanding each of them and managing them well is the challenge we all face.
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Permalink Reply by Banyon on -
Much has been posted here, but in the OP the only thing that I considered significant was one doctor's statement, "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."
So I guess this is his way of saying it is common for CPAP patients to have sinus infections and they are caused by CPAP.
From personal experience using CPAP and talking to hundreds of fellow CPAPers, I see no evidence for his statement.
In my own case, the number of colds and the severity of allergies declined with the start of CPAP therapy. Also, I have had no sinus infections in the five years I have been using CPAP.
How often do I clean my equipment? It has been two years since I cleaned the hose; mask gets cleaned about every two weeks; and when I use the humidifier, I just top the water off every night for weeks at a time.
When I am fighting a cold, I would not dare discontinue CPAP. With a cold, the CPAP is needed more than ever to keep the body in "fighting shape".
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Permalink Reply by loren wolsh on
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i use nasal washes every night using a syringe and salt solution. no infections yet after several years of this.
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