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Hi, all, first post.  Glad I found this forum.

Here's my history in brief:  Up until about a year and a half ago, my sleep apnea was a significant but not destabilizing issue.  I had a sleep study done a bit more than 2 years ago, with a reported AHI of 15.9.  After an initial period of experimentation with CPAP and an oral appliance, I decided that fixing my severe deviated septum would probably help me no matter which direction I ended up going in the future.

The surgery went well, but 3 weeks afterwards, I started having trouble breathing.  I had a number of tests (lung, heart, etc.), but they all came back fine.  My sleep got really, really bad, and my life started falling apart.  I was a walking zombie. 

I tried CPAP, the oral appliance, and CPAP with the oral appliance.  Nothing doing.  In 6 months, I never managed more than 2 hours of sleep with the CPAP.  I had a repeat sleep study, and now my AHI was 31.7.  I was in danger of losing my job and my family.  I had jaw surgery, and now my airway is huge (I am not overweight and don't have any fat in my throat).  But I still have about the same AHI.  After the surgery, I can now sleep 5-6 hours with CPAP, but I'm still waking up more than I'd like to go to the bathroom.

I'm a pretty industrious person, and I believe I've done everything I can to make CPAP work.  I've chased down mask leaks, taped and used a chin strap, and tried many different pressures.  Nothing works consistently.

As I was trying to chase down every possible cause of my problems, I went to see an ENT to see if I could have sinus problems.  I feel congested and fatigued, but I don't have what would be considered typical sinus issues.  She was skeptical but decided to do a CT scan just in case.  Lo and behold, I have a sinus infection.  I was on augmentin for 3 weeks and felt I had my life back.  It was the first time I'd been happy since these problems started.  Then I went off the antibiotics and my symptoms returned.  This repeated itself with another antibiotic.  I recently had another CT scan, and the sinus infection was still there.  I'm currently on my third round of antibiotics, together with Prednisone.

What I'm asking myself is: how much of my problems are due to sleep apnea, and how much to the sinus infection (which I might have picked up in the hospital)?  And is it normal to need such a long course of antibiotics?

Any thoughts would be most appreciated.

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Some other points I didn't mention earlier:  

My AHI was the same during REM and non-REM sleep, and it was the same whether I slept on my side or my back.  I'm wondering it this means that there's something beyond throat relaxation involved in my AHI.  I also had no apneas, only hypopneas.

I was a poster child for Dr. Steven Park's theories about UARS.  I have a thin face and neck, and until my jaw surgery, I had to sleep with socks on (otherwise, my feet would sweat).  Since the surgery, my feet never sweat.

I had my sleep surgeon perform a sleep endoscopy on me, and he said that my airway is not easily collapsable.  I have been seen by very well respected and accomplished sleep doctors, and I'm a mystery to them.  My surgeon suspects that I have floppy throat muscles due to damage from apneas, but I'm not convinced.  If this were the case, CPAP should be helping more.

Well, that's enough of a rant for now.  Thanks for reading!

Thomas, there was a thread a while ago about a person having a bad sinus infection.  It took her multiple rounds and longer than usual rounds of antibiotics to get well.  I think she did not use her machine at the docs recommmendation through most of this. 

Good luck

Also, Thomas, you mention you were having a lot of trouble with the machine and had not managed more than two hours a night with the machine.  It's hard work, but until you get used to the machine and use it all night, every night it's not going to help. Two  hours a night is not enough.

Sorting out if why you feel so bad is due to the sleep apnea or the sinus infection- I guess you just have to get over the infection to see.

 

Now, how can we help you learn to sleep with CPAP?  Are you interested?

I cannot report about your sinus or sleep apnea, but do know that I have read that sleep apnea because it makes you stop breathing, therefore causing your heart to sort of jumpt start your breathing, creates fluid around your heart, which then makes your kidneys try to get rid of the fluid, which then makes you have to go to the bathroom too many times at night. So if your AHI is high, that is why you most likely need to use the bathroom more than you would like. I know for me, once I got the AHI down, so did the trips to the bathroom.

Hi, Mary,

Thanks for your replies and offer of help.

The two hours of sleep with CPAP per night was before surgery.  Now I sleep all night with CPAP.  Unfortunately, that's only 5-6 hours per night, and I wake up feeling exhausted.  I systematically tried varying everything I could think of--type of mask, pressure, humidity, exhale pressure relief.  Nothing helped consistently, even though my numbers have always been good.  After doing everything I could think of, I began to consider the possibility that there might be something else going on.  That's when it occurred to me that I might have a sinus infection.

Now I'm on and off antibiotics.  When I'm on them, I feel fine; when I'm off, I don't.  It may just be that I need a long course, like the person you mentioned.  My second CT scan did show that there's still an infection.

Am I interested in sleeping better with CPAP?  You bet!  I'm just not sure what to do, beyond what I'm doing now.  My fervent hope is that resolving the infection will help and I'll be able to have a normal life again.

Mary Z said:

Also, Thomas, you mention you were having a lot of trouble with the machine and had not managed more than two hours a night with the machine.  It's hard work, but until you get used to the machine and use it all night, every night it's not going to help. Two  hours a night is not enough.

Sorting out if why you feel so bad is due to the sleep apnea or the sinus infection- I guess you just have to get over the infection to see.

 

Now, how can we help you learn to sleep with CPAP?  Are you interested?

Hi, Mary,

I accept what you're saying, but my AHI on CPAP is around 1-2.  I still have terrible sleep.  That's what's been mysterious to me.

Mary Callahan said:

I cannot report about your sinus or sleep apnea, but do know that I have read that sleep apnea because it makes you stop breathing, therefore causing your heart to sort of jumpt start your breathing, creates fluid around your heart, which then makes your kidneys try to get rid of the fluid, which then makes you have to go to the bathroom too many times at night. So if your AHI is high, that is why you most likely need to use the bathroom more than you would like. I know for me, once I got the AHI down, so did the trips to the bathroom.

Hi Thomas, Infections are frusterating I have had difficulty also. Antibiotics steroids and sprays till the cows came home. Antibiotics not only get rid of bad bugs they kill good ones also. Have you tried to repopulate the good ones with something like Kefir or Greek yogurt?Infection control ,What do you clean your humidifier mask and hose with??Do you use distilled water in your humidifier? Do you have an allergen cover on your pillow? Good Sleep,Chris  

Thomas, Do you take any other medication other than the antibiotics? I take antidepressants and my sleep is around 5-6 hours per night, it is better than the 1-2 hours I was getting before CPAP. Tomorrow I start to reduce my dosage of the antidepressant. I also take Valerian Forte or Melatonin to help me to sleep (both herbal). I found that if I can reduce my stress levels I can get more sleep. Also I believe age, temperature and what we eat can play a part.

Hi, Chris,

You might be right--it may simply be a matter of keeping on the antibiotics for a really long time.  I'm up to about 6 weeks total, but maybe I need more.

I love Kefir and have been drinking it regularly for quite some time.  Perhaps because of this, I haven't had any serious gastrointestinal issues.  I'm also taking probiotics--better safe than sorry.  They're pricy, but my understanding is that they won't cause any harm.

Regarding keeping the equipment clean, I could probably stand to be a bit more diligent.  But the thing is, I don't think I picked up this infection from using CPAP.  I think I had it before I ever got started with CPAP; I suspect it started somehow when I had my deviated septum fixed.

Allergen covers are a good idea I hadn't thought of.  Thanks for your suggestions


Chris H said:

Hi Thomas, Infections are frusterating I have had difficulty also. Antibiotics steroids and sprays till the cows came home. Antibiotics not only get rid of bad bugs they kill good ones also. Have you tried to repopulate the good ones with something like Kefir or Greek yogurt?Infection control ,What do you clean your humidifier mask and hose with??Do you use distilled water in your humidifier? Do you have an allergen cover on your pillow? Good Sleep,Chris  

Hi, Terry,

No serious medications.  I, too, sometimes use valerian root and melatonin.  I also have some trazodone that I use now and then in low doses (25mg).  I try not to eat or drink within 3 hours of sleep, and that definitely helps.  I agree that stress and psychological issues matter--one good thing that came from all the problems I've had is that I was finally motivated to leave a job that's definitely been dragging me down.  Not sure what effect it'll have on my sleep, but a good thing nonetheless.



Terry Vella said:

Thomas, Do you take any other medication other than the antibiotics? I take antidepressants and my sleep is around 5-6 hours per night, it is better than the 1-2 hours I was getting before CPAP. Tomorrow I start to reduce my dosage of the antidepressant. I also take Valerian Forte or Melatonin to help me to sleep (both herbal). I found that if I can reduce my stress levels I can get more sleep. Also I believe age, temperature and what we eat can play a part.

Hope you're ok in reducing your dosage Terry and if all goes well, look forward to knowing the difference.  Will you post it on the UK site too please?

Terry Vella said:

Thomas, Do you take any other medication other than the antibiotics? I take antidepressants and my sleep is around 5-6 hours per night, it is better than the 1-2 hours I was getting before CPAP. Tomorrow I start to reduce my dosage of the antidepressant. I also take Valerian Forte or Melatonin to help me to sleep (both herbal). I found that if I can reduce my stress levels I can get more sleep. Also I believe age, temperature and what we eat can play a part.


Thomas, the Trazodone is an anti-depressant like Terry's on, and these are known to attribute to apneas.  Having said that, you will need to talk to your doc about your need for them, as sometimes the benefits outweigh the negatives.


Thomas Edison said:

Hi, Terry,

No serious medications.  I, too, sometimes use valerian root and melatonin.  I also have some trazodone that I use now and then in low doses (25mg).  I try not to eat or drink within 3 hours of sleep, and that definitely helps.  I agree that stress and psychological issues matter--one good thing that came from all the problems I've had is that I was finally motivated to leave a job that's definitely been dragging me down.  Not sure what effect it'll have on my sleep, but a good thing nonetheless.



Terry Vella said:

Thomas, Do you take any other medication other than the antibiotics? I take antidepressants and my sleep is around 5-6 hours per night, it is better than the 1-2 hours I was getting before CPAP. Tomorrow I start to reduce my dosage of the antidepressant. I also take Valerian Forte or Melatonin to help me to sleep (both herbal). I found that if I can reduce my stress levels I can get more sleep. Also I believe age, temperature and what we eat can play a part.

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