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Blockage of right side of nose in middle of night - turbinates? Any ideas to prevent?
#1
Question 
I started CPAP therapy about a month ago. I am finding that I wake up almost every night around 3-4 am and find that I cannot breathe at all through my right nostril. Since I have a nasal mask, this creates a real problem. It's not a matter of needing to blow my nose; I suppose it's from swollen nasal turbinates.

I have been taking my mask off and going back to sleep when this happens, but I need to find a solution.

I am not using a steroid nasal spray.

Thanks for any suggestions you might share to solve this problem.

P.S. This is my first post. I tried doing a search first for other posts on this topic but didn't find any that were useful.
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#2
(02-10-2016, 05:36 PM)green wings Wrote: I started CPAP therapy about a month ago. I am finding that I wake up almost every night around 3-4 am and find that I cannot breathe at all through my right nostril. Since I have a nasal mask, this creates a real problem. It's not a matter of needing to blow my nose; I suppose it's from swollen nasal turbinates.

I have been taking my mask off and going back to sleep when this happens, but I need to find a solution.

I am not using a steroid nasal spray.

I started xPAP in October and had the same problem. Based on some posts I saw on this wonderful board, I went up a size in my nasal pillow. I also used a nasal steroid spray for a week or so to reduce inflammation. No problems since then.

Good luck,

Charlie Sue

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#3
Is it possible that you're doing any mouth breathing during this time? If so, that nasal package may be taking a break, a shut down, as one previous thread mentioned along with a youtube video I remember. I'm just guessing, but wasn't it an indicator of some CO2 build-up along with mouth breathing?

From my own history, I've found CPAP with a humidifier (as long is one's mouth is sealed) is a great unblocker of sinus congestion.

I'm assuming your machine is clean, filters too, and your humidifier is working properly.

Great first-hand experience is probably coming shortly...
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#4
(02-10-2016, 05:36 PM)green wings Wrote: I started CPAP therapy about a month ago. I am finding that I wake up almost every night around 3-4 am and find that I cannot breathe at all through my right nostril. Since I have a nasal mask, this creates a real problem. It's not a matter of needing to blow my nose; I suppose it's from swollen nasal turbinates.

I have been taking my mask off and going back to sleep when this happens, but I need to find a solution.

I am not using a steroid nasal spray.

Thanks for any suggestions you might share to solve this problem.

P.S. This is my first post. I tried doing a search first for other posts on this topic but didn't find any that were useful.

Welcome to the Apnea Board. I just had surgery for nasal turbinates and a deviated septum. I had been dealing with turbinates that swelled up when sleeping on my side for many years. Sleep Doc recommended an ENT who performed the surgery. I still have some swelling and stitches left but I do have some improvement. I am using steroid spray and lots of saline spray. I sometimes have to get up at night to let the swelling in the turbinates go down even now. I hope that I continue to improve because the Docs don't want me to go back on a combination of Afrin and Steroid spray. I had the inferior turbinates reduced. Removing too much can cause "empty nose" syndrome. I think you could try saline spray combined with steroid spray. You might have to sit up or even stand for a while while the turbinate or even both turbinates shrink. If you do a search you will find that a lot of people suffer from clogged nostrils when sleeping on their side. I have zero obstructive events sleeping on my side so I am not about to try sleeping on my back. I hope my experience is helpful to you.

RichB

PS you may want to explore the Apnea Board for other ideas that could help you take charge of your treatment.

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#5
Thank you, RichB. It sounds like I'm going to have to get up when this happens, at least for now. I'm still waiting to see if someone has a miraculous suggestion.

In the meantime, I am going to start using steroid nasal spray daily for a while plus saline spray at night when I wake up congested.

I am insomnia-prone, so my instinct is to avoid waking up fully at night, because then I often can't go back to sleep, but I don't see any around that for now.

I hope that your surgery gives you good results.

(02-10-2016, 08:40 PM)richb Wrote:
(02-10-2016, 05:36 PM)green wings Wrote: I started CPAP therapy about a month ago. I am finding that I wake up almost every night around 3-4 am and find that I cannot breathe at all through my right nostril. Since I have a nasal mask, this creates a real problem. It's not a matter of needing to blow my nose; I suppose it's from swollen nasal turbinates.

I have been taking my mask off and going back to sleep when this happens, but I need to find a solution.

I am not using a steroid nasal spray.

Thanks for any suggestions you might share to solve this problem.

P.S. This is my first post. I tried doing a search first for other posts on this topic but didn't find any that were useful.

Welcome to the Apnea Board. I just had surgery for nasal turbinates and a deviated septum. I had been dealing with turbinates that swelled up when sleeping on my side for many years. Sleep Doc recommended an ENT who performed the surgery. I still have some swelling and stitches left but I do have some improvement. I am using steroid spray and lots of saline spray. I sometimes have to get up at night to let the swelling in the turbinates go down even now. I hope that I continue to improve because the Docs don't want me to go back on a combination of Afrin and Steroid spray. I had the inferior turbinates reduced. Removing too much can cause "empty nose" syndrome. I think you could try saline spray combined with steroid spray. You might have to sit up or even stand for a while while the turbinate or even both turbinates shrink. If you do a search you will find that a lot of people suffer from clogged nostrils when sleeping on their side. I have zero obstructive events sleeping on my side so I am not about to try sleeping on my back. I hope my experience is helpful to you.

RichB

PS you may want to explore the Apnea Board for other ideas that could help you take charge of your treatment.

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#6
Thanks for your reply. I don't think I'm mouth-breathing right before I'm waking up, because I don't wake up with a dry mouth. I just had my sleep studies done about three months ago, and the report for those said "no mouth-breathing observed".

I can't be 100% sure that I'm not.

I agree that the humidifier helps nasal congestion. My nasal passages feel great before I fall asleep then I'll wake up around 3-4 am and they feel very dry and I can't breathe out of the right side of my nose. I have only managed to use the CPAP all night one time.

Everything is clean and the humidifier chamber is filled with distilled water.

(02-10-2016, 06:05 PM)WakeUpTime Wrote: Is it possible that you're doing any mouth breathing during this time? If so, that nasal package may be taking a break, a shut down, as one previous thread mentioned along with a youtube video I remember. I'm just guessing, but wasn't it an indicator of some CO2 build-up along with mouth breathing?

From my own history, I've found CPAP with a humidifier (as long is one's mouth is sealed) is a great unblocker of sinus congestion.

I'm assuming your machine is clean, filters too, and your humidifier is working properly.

Great first-hand experience is probably coming shortly...

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#7
I used to have a similar issue with alternate blockage of nostrils all thru the day and night. I started using the neti pot once a day, an hour before going to bed. It took a couple of weeks for me to perfect the technique. Over the course of next 3 months, the blockage problem disappeared. Now, I only use the neti pot of I feel a sinus attack is coming.

Nasal lavage with an isotonic solution does reduce the inflammation and swelling gradually. I would try this before any sprays or surgery.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#8
Thanks, Charlie Sue. Did you use Flonase nasal spray? Just wondering if I need that or if NasaCort is adequate.

Your comment about nasal pillows is interesting. I have a Respironics Wisp mask. I started off with the large pillow. It was too large for my face in the area between the bottom of my nose and the top of my upper lip.

I switched to the S/M nasal pillow, and it fits my face better and seals well, but it feels like there's not enough room inside it. If I just hold the nasal pillow alone up to my face and breathe, there is quite a lot of resistance. I have to work hard to pull the air in. I've been assuming the positive pressure from the CPAP would take care of this problem, but maybe that's incorrect.

How do you know if you need a larger nasal pillow?

The original mask that I got fitted by the DME did not work. I've never had any assistance with my current mask.

I have been appalled at the bad customer service from my DME. At least I know I'm not alone after reading posts on this board.

(02-10-2016, 06:00 PM)Charlie Sue Wrote:
(02-10-2016, 05:36 PM)green wings Wrote: I started CPAP therapy about a month ago. I am finding that I wake up almost every night around 3-4 am and find that I cannot breathe at all through my right nostril. Since I have a nasal mask, this creates a real problem. It's not a matter of needing to blow my nose; I suppose it's from swollen nasal turbinates.

I have been taking my mask off and going back to sleep when this happens, but I need to find a solution.

I am not using a steroid nasal spray.

I started xPAP in October and had the same problem. Based on some posts I saw on this wonderful board, I went up a size in my nasal pillow. I also used a nasal steroid spray for a week or so to reduce inflammation. No problems since then.

Good luck,

Charlie Sue

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#9
Hi green wings,
WELCOME! to the forum.!
Much success to you with your CPAP therapy.
trish6hundred
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#10
Green Wings, I decided to change my nasal pillow size because I was a little desperate and many people on the board talked about changing sizes to avoid nasal irritation. I thought that maybe the smaller size just went too far up my nose. I had quite a bit of surgery on my sinuses in April, including turbinate reduction and really did not want to go back to the constant inflammation. I messed with my humidification some, but got poor results. For me the change in pillow size was a relatively inexpensive and successful experiment. I was glad I didn't have to go to an entirely new mask.

I just use nasacort when needed for inflammation. I also regularly use a saline rinse--but that did not improve my turbinate problem.

I too have gotten no guidance from the doc or DME with any of this and so am grateful to this board for having a place to go for information.

Charlie Sue
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