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Problems with sinus pain with CPAP
I'm a fairly new user to the CPAP. I've been using the Resmed S-9 auto adjust CPAP machine for about 2 weeks now. The pressure is set to go as high as 16 at night. I've gone through three masks. I tend to have a hard time breathing through my nose so the first mask was a full face mask. The issue with that was leakage and I could never get it to fit right. I switched to a nasal mask with the same problem...too much leakage and poor fit. There is a humidifier on my machine which miraculously opened my nasal airways to allow me to breathe through my nose through the night. I was so happy about this because I've been a mouth breather at least 75% of the time for years. The mask I'm using now is the swift LT with nasal pillows. I LOVE the fit! It fits perfectly with no air leaks.
Now the downside. Since using the pillows, I have started waking up daily with sinus pain in my forehead and below my eyes at the top of my cheekbones. I've also started experiencing sore throat, along with congestion, runny (actually goopy) nose. This morning I had a sneezing fit after waking up. The headache is awful and causes pressure in my eyes. At first I thought I was coming down with a cold but then I realized that it's not getting any better and it doesn't seem to be getting worse. So my only conclusion can be it's the CPAP or mask causing this.
Could it be the directness of air coming through those little pillows (more direct or forcefull?). Could it be my humidifier is too high or low? I'm not sure if I should adjust it higher or lower! I've tried it between 80 and 86. I try not to go too low because cold air bothers my nose and throat. I just don't know what to do! I feel miserable. I took an ibuprofen yesterday morning because my head hurt so bad... but it really didn't do much to take away the pain. So now I'm sitting here trying to ignore the pain.
Any suggestions? I'm desperate for the cpap therapy to work for me. I was thinking finally I will get a good night's sleep instead of dragging through my days. Finally I will feel good and have energy. Instead I'm stuck with pain and congestion and sore throat.
Thanks!
Views: 13154
Replies to This Discussion
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Permalink Reply by Molly Olson on
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Oh, one other thing I find is strange. The congestion occurs AFTER I take my mask off in the morning. Is that strange? I breathe fine through my nose in the pillows all night long. But as soon as I take the mask off my nose stuffs all up so I can't breathe through it.
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Permalink Reply by tushygalore on
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Oddly enough, I logged on today to post about my similar issues. I've had my CPAP for about two years and it's been literally a life-saver.I use it religiously and have adapted to many of the problems associated with it.
My biggest issue is that on nights (like last night) when I can't face the full mask (last night I lost one of the clips that fasten the strap to the mask)I reached for the nasal pillow.
But I knew it would be a problem (as it always is). What happens to me is that no matter if I use the humidifier or not I end up sneezing my fool head off the entire next day.I'll sneeze 14 times in a row sometimes and go through half a box of tissue blowing my nose.
The sneezing and irritation doesn't start until I take the mask off and start my day but it's miserable. The only way to stop it is to take a couple of Benydril and that leaves me groggy or knocks me out.
I forgot to use it last night but in the past I feel like I've gotten some relief by using a saline moisturizing sinus spray before I put the mask on and use it during the night when I wake up for a drink.
The nasal pillow is so comfy, I really hope you and I can figure out how to make it work for us.
-Elissa-
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Well it's good to know I'm not alone. I was overjoyed after all the frustration of the other masks, finding the nasal pillows were comfortable, less constricting and claustraphobia inducing as well as leak-free for me. I can't live everyday with this sinus/head pain and drippy/stuffy nose though. I think I'll contact my DME and if they don't have the answers, I'll call my sleep specialist. Being new to this is confusing enough!
It's strange to me that while I'm wearing the pillows, I have free-breathing through my nose.... but then, taking it off causes all this to hit me.
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I have a friend with apnea that also suggested I use Ayr or Ocean saline spray before bed to help with that. She said it would prevent dryness though, and I have the opposite effect. My nose has been dribbling all day long!
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When the people I see tell me of similar symptoms, I tell them the following,
1. Assure that your interface is not leaking. At home, it requires a family member to look in on you to see if the interface is leaking.
2. Assure there is no mouth leak. If your mouth is leaking, the machine tries to compensate, providing more airflow (that goes in your nose and out your mouth) This in turn is drying regardless of your humidifier setting and will cause the nasal drip. You may need a chin strap, properly adjusted, or if the mouth leak persists, a full face mask.
3. If 1 and 2 above have been addressed, and fixed, and the situation continues, increase the humidifier to full scale.
4. If the situation continues, or you get rainout in the tubing that is bothersome, warm the room slightly (1-2 degrees). The room temperature may need to be adjusted several times until the situation resolves, or the rainout stops.
Remember, the heat on the humidifier is primarily meant to heat the water in the humidifier, causing it to evaporate more easily. A passover humidifier does not appreciably increase the temperature of the air supplied by the CPAP machine. Also, the ability of the air to carry the water is limited by the temperature of the air.
Everyone is different in this regard. Some need to work at it harder than others. You need to experiment. Some people do need to also use saline sprays as well.
I am convinced that most people using CPAP are experiencing issues just because they do not have enough humidity.
John Krainik, CRT,RPSGT
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Hi Molly, Are you using distilled water? What are you using to clean your stuff with? Do you have an air purifier ? Good Sleep,Chris
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There is no air leak from the nasal pillows. I do need to get a chin strap because I tend to mouth breathe the majority of the time, either awake or asleep. I will wake up at night with the corner of my mouth open or my entire mouth open. It's hard to mistake the noise it makes, not to mention the strange feeling. I have tried the humidity up to 86, which is the highest setting. I have also tried lower, hearing from others that cooler air can actually help if you are experiencing stuffiness due to illness or allergy. Neither way seems to make a difference. The warmer air does make for less of a sore throat in the morning.I'm pretty sure I have a cold at this point... I'm having body aches as well as some coworkers who are ill right now. I guess I will keep at it and see how I feel in the next couple days. It could be coincidence that I get sick right after getting the new mask.
Now I'm wondering how in the world I'm going to wear the mask tonight when I can't even breathe through my nose!
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Yes I use distilled water in the humidifier. I was told to use a mild soap to clean my tubing and mask so I picked up some johnson and johnson's baby soap and rinse well and let air dry. I don't have an air purifier.. but that is something I have been considering for some time now... especially with a wood stove insert heating our house. We keep a pan of water on the stove to keep the air from getting too dry but someone told me it would take a lot more than one little pan to keep the air from drying out.
chris h said:Hi Molly, Are you using distilled water? What are you using to clean your stuff with? Do you have an air purifier ? Good Sleep,Chris
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Molly,
I would suggest from your comments above, that you persue the chin strap ASAP. No matter how much humidity you add, as long as you have a mouth leak, you will have the issues you describe.
Also, just adding a chin strap will not stop eveyone's mouth leak. If you still have a mouth leak with the chin strap applied, you will need a full face mask. A mouth leak unresolved will cause problems that are very difficult if not impossible to resolve. Fix the mouth leak first.
Your cold/flu like symptoms you describe aren't helping either.Are you cleaning your interface daily? Especially with nasal pillows, you can reinfect yourself if you do not wash the interface daily. Use of any soap, shampoo etc necessitates rinsing very thoroughly. Many people are sensitive to these products, no matter how gentle. Thorough rinsing under running water is the only way to remove the residue that remains from these products. I suggest to people that I see, if they appear to be sensitive to these products, is to rinse daily, the interface under running hot water. Rub the pillows with your fingers gently to remove the body oils that cling to the pillow surfaces. If you do this daily, in most cases, soaps, detergents or shampoos are not necessary.
Again, from your comments, your priority now is to fix the mouth leak.
John Krainik,CRT,RPSGT
Molly Olson said:
There is no air leak from the nasal pillows. I do need to get a chin strap because I tend to mouth breathe the majority of the time, either awake or asleep. I will wake up at night with the corner of my mouth open or my entire mouth open. It's hard to mistake the noise it makes, not to mention the strange feeling. I have tried the humidity up to 86, which is the highest setting. I have also tried lower, hearing from others that cooler air can actually help if you are experiencing stuffiness due to illness or allergy. Neither way seems to make a difference. The warmer air does make for less of a sore throat in the morning.I'm pretty sure I have a cold at this point... I'm having body aches as well as some coworkers who are ill right now. I guess I will keep at it and see how I feel in the next couple days. It could be coincidence that I get sick right after getting the new mask.
Now I'm wondering how in the world I'm going to wear the mask tonight when I can't even breathe through my nose!
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Permalink Reply by Shoshana on
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I, too, am having a lot of these same issues. I was using a nose only face mask (sorry, I don't know the correct terminology here). Due to mouth leaks, I was assigned a full face mask. That didn't work for me either, nor did the chin strap in combination with the nose mask. Because of my facial bone structure, I couldn't get the full face mask to seal correctly without pulling the straps so tight, it caused a lot of pain, and off would go the mask.
I stopped using the self=adjusting BiPap (heated humidifier) entirely for over a year due to this. I was getting my supplies from the VA's sleep clinic. Then at the strong recommendation of my PCP outside the VA system, I went to a private care sleep clinic. They felt nasal pillows would be a good fit for me. Right away severe allergic rhinitis kicked in. I had already had turbinate reduction through radio therapy. But my turbinates had since closed up again.
It has been one thing after another. I really like the nasal pillows and my machine shows that I am getting at least 4 hours of sleep a night with it. But along with the allergies, which is a 10 on the misery scale as soon as I take off the mask in the a.m., I have also developed strep throat, bronchitis and sinus infection. I am at my wits end! Can't even use the machine due to the congestion now.
I am cleaning everything vigorously with a white vinegar/water solution. Clean my mask daily with CPAP Mask Wipes. Changing filters, put a bacterial filter on the hose. Bought a brand new bed for the allergen factor, made my room as pristine as possible, using Flonase. It's very frustrating, indeed! These things help for a short while, and then I'm back to the beginning with the respiratory issues.
They have said that if this doesn't work, we will try a mouth appliance or have an upper and lower jaw advancement surgery as the problem is not my palate, but the structure of my jaw. I have other challenging health conditions (TIA's / blood pressure / digestive, etc.). The machine does help to almost eliminate the continuous round of TIA's that I have, so it's important to find a solution!
Sorry for the rant! I'm new here! Frustrated!
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Shoshanna,
You don't indicate if you still have the mouth leak with the nasal pillows. From the rest of your post, it sounds like you do. Remember, any significant leak will affect the humidity delivered to you throught the BiPAP circuit. Too little humidity causes many of what you describe is happening to you.Taking care of the mouth leak is a primary importance. If you are not able to solve the mouth leak with a chin strap, then a properly fitting full face mask is necessary. You stated that you tried one, but there are many out there. I would suggest that you go back to your DME supplier and ask that they try more full face masks with you. You should take your machine with you as masks need to be fit with the machine running. You cannot tell how tight the mask will need to be to get a good seal. I don't usually recommend specific masks with out seeing someone directly, but from what you are saying, you have an anatomical issue. You might ask your DME to try a Hybid interface which I believe is made by Puritan Bennett, or a Fit Life or a Total Face Mask by Respironics. These masks seem to work better for people with anatomic issues such as yours.
You also mention that you are cleaning your interface daily with vinegar. Are you rinsing thouroughly after you use the vinegar? if you don't, the salts of the vinegar that remain in your tubing/interface will be redissolved with the use of your BiPAP, especially if you are humidifying it properly. Vinegar fumes produced will irritate your sinuses and respiratory tract and will cause issues. If you are rinsing properly, this is not an issue.
Again, taking care of the mouth leak, and finding the proper interface sounds like they are the primary issues. Once you fix these issues, then you can talk to your docs about treating the other issues, if they exist afterwards.
Keep me posted.
Shoshana said:
I, too, am having a lot of these same issues. I was using a nose only face mask (sorry, I don't know the correct terminology here). Due to mouth leaks, I was assigned a full face mask. That didn't work for me either, nor did the chin strap in combination with the nose mask. Because of my facial bone structure, I couldn't get the full face mask to seal correctly without pulling the straps so tight, it caused a lot of pain, and off would go the mask.
I stopped using the self=adjusting BiPap (heated humidifier) entirely for over a year due to this. I was getting my supplies from the VA's sleep clinic. Then at the strong recommendation of my PCP outside the VA system, I went to a private care sleep clinic. They felt nasal pillows would be a good fit for me. Right away severe allergic rhinitis kicked in. I had already had turbinate reduction through radio therapy. But my turbinates had since closed up again.
It has been one thing after another. I really like the nasal pillows and my machine shows that I am getting at least 4 hours of sleep a night with it. But along with the allergies, which is a 10 on the misery scale as soon as I take off the mask in the a.m., I have also developed strep throat, bronchitis and sinus infection. I am at my wits end! Can't even use the machine due to the congestion now.
I am cleaning everything vigorously with a white vinegar/water solution. Clean my mask daily with CPAP Mask Wipes. Changing filters, put a bacterial filter on the hose. Bought a brand new bed for the allergen factor, made my room as pristine as possible, using Flonase. It's very frustrating, indeed! These things help for a short while, and then I'm back to the beginning with the respiratory issues.
They have said that if this doesn't work, we will try a mouth appliance or have an upper and lower jaw advancement surgery as the problem is not my palate, but the structure of my jaw. I have other challenging health conditions (TIA's / blood pressure / digestive, etc.). The machine does help to almost eliminate the continuous round of TIA's that I have, so it's important to find a solution!
Sorry for the rant! I'm new here! Frustrated!
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