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CPAP and sinus pain
#1
CPAP and sinus pain
I have been using a CPAP for almost 2 years. Over the last few months I’ve been having a couple of problems with my nose. First, it gets congested and runs constantly.  Second, it is painful to inhale through my nose. To the extent that sometimes I have to turn off the machine in the middle of the night. Normally I don’t use the humidifier on the machine because I don’t notice a difference other than increasing maintenance. I went to see an ENT, who said I have a problem with rhinitis but didn’t say much more other than to use Zyrtec and Flonase for the running nose, and saline for dryness.  Hasn’t helped.  Has anyone else experienced anything like this and been able to find some sort of relief? I use the machine religiously despite the pain but it getting to be too much. Thanks. 
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#2
RE: CPAP and sinus pain
Does it hurt to inhale through your nose during the day as well, or just at night when you're wearing your mask?

I tried at least half a dozen varieties of nasal pillows masks, but all of them caused me pain or made congestion worse. I have a really big head, and my best guess is that the headgear, even at maximum extension, was just too tight and made the mask push in to my nose. It does get irritating after a while.

I went back to a full face mask (F&P Vitera) and have slept comfortably since. The other things that really helped my congestion:

Humidifier usage and heat. I have the tube manually at 82 and the humidity level manually at 4. Auto caused rainout.

Finally, and I cannot recommend this strongly enough, Xlear xylitol packets in a neti pot. They also make a spray, available at CVS, Whole Foods, and Amazon. I know it sounds weird, but I have struggled with sinus congestion for my entire life and these things are the most effective product out there for me behind Afrin.

I have heard anecdotally that if you're having a bad night of congestion, you can simply hold your breath for like 30 seconds after you're hooked up to your machine, and the surge of adrenalin will cause your sinuses to open up. Haven't ever tried it since it seems counterproductive to the goal of calming down and falling asleep.

Good luck, my ENT was also of minimal help.
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#3
RE: CPAP and sinus pain
It does hurt during the day as well, especially if I breathe in deeply through my nose. I have never tried a full face mask. I may have to look into that. I also need to experiment more with the humidifier. I have read elsewhere about the Xlear.  I should give that a try also. Thank you for your suggestions.
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#4
RE: CPAP and sinus pain
As much as your dislike the humidifier and the upkeep (which really isn't that bad when comparing to your comfort level), you should try to use it. The air blowing into your nostrils without humidity can be extremely drying. I know some here don't use humidity, but in your case, it sounds like you need it.

I also use XLear nasal products. The daily nasal sprays keep the nostrils clean and moist and helps with congestion, and the nasal rinse (the squeeze bottle with premixed packets) are a necessity for me.

Also, try AYR saline nasal gel before putting your mask on.

Good luck, hope this clears up for you as it can be miserable.
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#5
RE: CPAP and sinus pain
I will give the humidifier another try. I have never heard of saline gel, but I will look it up to see where I can find it. Thanks.
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#6
RE: CPAP and sinus pain
I tried using the humidifier last night. I am not sure if I set it too high, but my AHI was triple what it normally is. Just quickly looking at the machine it’s because I was mouth breathing for part of the night because my nose was congested. It doesn’t hurt as much to breathe through my nose though, using the humidifier.
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#7
RE: CPAP and sinus pain
Have you been evaluated by an allergist? I have a dust-mite allergy, and for relief of symptoms I am using Flonase spray, Azelastine spray, and Singulair. She also recommended Ceterizine, which I tried but have now discontinued. I use NeilMed sinus rinse from time to time as well.

I hope you find relief!
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#8
RE: CPAP and sinus pain
Thanks. I didn’t go to an allergist but I went to an ENT who recommended the cetirizine and Flonase.  I tried both but I haven’t found that they work for me. Sudafed works for the runny nose but makes me nervous and also I have high blood pressure so I can’t take that either. I should try the nasal rinse. I will ask my doctor about the azelastine. Thank you.
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#9
RE: CPAP and sinus pain
I watched these videos: https://www.apneaboard.com/sleep-apnea-i...nea-videos and the doctor in one of them stated the Astelin (Azelastine) spray was the best nasal spray for non-allergy rhinitis which I have suffered from for years. I am (was) a mouth breather so when starting CPAP it was difficult, but since I asked my doctor to prescribe Astelin, along with CPAP, and heated humid air, I now can breath through my nose like I haven't in 40 years! My sinuses are almost clear, and my post nasal drip has subsided.
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#10
RE: CPAP and sinus pain
The ENT I saw was a waste of $300. I went to an allergist who didn't find any allergies but suggested prilosec.
Something about silent Gerd(heartburn without the burning sensation) being more common than many people realize causing the chronic rhinitis.
Not feeling heartburn bad enough where stomach acid was splashing into my sinuses seemed like a stretch to me.
His attitude was try prilosec for a month. If nothing changed then it isn't silent gerd. If my rhinitis cleared up then it was silent Gerd.
My rhinitis cleared up.
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