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Can too high pressure cause headache/sinus congestion?
#1
I'm a week into using my CPAP and my numbers and stats are still all over the place. Last night my AHI was moderately high (can't remember for sure but I think 8-10ish) and my pressure rate averaged at 15 or so, but was at 19.5 for a very long time. When I woke up this morning I had a headache, and my sinuses have been stuffy all morning. I don't recall waking up breathing through my mouth too much, so the chin strap may have worked better than usual, but I did have a very dry, weird feeling in my mouth, so who knows?? Could this be from pressure that is too high?
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#2
(06-23-2016, 12:01 PM)jen61 Wrote: I'm a week into using my CPAP and my numbers and stats are still all over the place. Last night my AHI was moderately high (can't remember for sure but I think 8-10ish) and my pressure rate averaged at 15 or so, but was at 19.5 for a very long time. When I woke up this morning I had a headache, and my sinuses have been stuffy all morning. I don't recall waking up breathing through my mouth too much, so the chin strap may have worked better than usual, but I did have a very dry, weird feeling in my mouth, so who knows?? Could this be from pressure that is too high?

Actually many people who post on this board have found the opposite. Myself, if my nose is somewhat blocked at bed time the pressure helps me breath through my nose. There is no reason why increased air pressure in your nasal passages should, by itself, cause them to block up.

If your machine was sucking in air laden with stuff you are allergic to this could cause problems, but you can get filters to prevent that.
Ed Seedhouse
VA7SDH

Your brain is not the boss.

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#3
(06-23-2016, 12:01 PM)jen61 Wrote: I'm a week into using my CPAP and my numbers and stats are still all over the place. Last night my AHI was moderately high (can't remember for sure but I think 8-10ish) and my pressure rate averaged at 15 or so, but was at 19.5 for a very long time. When I woke up this morning I had a headache, and my sinuses have been stuffy all morning. I don't recall waking up breathing through my mouth too much, so the chin strap may have worked better than usual, but I did have a very dry, weird feeling in my mouth, so who knows?? Could this be from pressure that is too high?

Hi jen61,
Welcome to the forum! Welcome

I don't use a nasal pillows mask, so I can't comment directly about that, but I usually find that if my nose or sinuses are a little stuffy when I am ready to go to bed, a few minutes on the machine usually opens them up, not the reverse. The dry mouth sensation may come from mouth-leaking, so it would be important to start monitoring leaks and correct them, whatever the cause.

A few observations . . .

First, your pressure range at 4-20 is wide open, and often people find that the starting pressure is too low for comfortable breathing. Do you have a respiratory tech or someone to help you zero in on your settings, or are you needing to handle that on your own? If the latter, I would recommend looking at your data in Sleepyhead and look at what is happening, first with regard to leaks. If you end up adjusting your own settings, plan to do so gradually, changing only one setting at a time, then waiting a week or more to see the effect.

It would be helpful if you could post an image of your SleepyHead data here: then knowledgeable folks can look it over and make more informed suggestions.

Last, since your pressure went up to near the maximum, this suggests that you are having a good number of obstructive events. In my own case, I found that sleeping on my back was very bad - my untreated apnea rate is about twenty times worse when I am on my back. If you had a sleep study, check the results to see if there was mention of sleeping position (usually supine vs other). If so, search the forum for suggestions as to how to avoid back-sleeping. Once I did that, my AHI numbers stopped hovering in the 10-15 range, and now are usually below 1. The pressures also dropped dramatically, from up near 20, down to the 12 - 14 range. This had a huge effect on the leaks and comfort for me. At any rate, this is a simple matter to experiment with, and doesn't require any interaction with Sleep professionals (if you have such).

The means to avoid back-sleeping can range from wearing a snug T-shirt with some pockets on the back containing tennis balls, wedging large-firm pillows behind you, to wearing a backpack to sleep, containing a collection of lumpy objects. The point is to make it uncomfortable to roll onto your back.

Get us more information, and good luck on your journey!!!

A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
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#4
I've found that some pillows masks close up my sinuses. Both the Optilife and the Mirage Swift irritated my sinuses by shooting jets of air directly into my nose. I was only able to use them for two nights before they closed up my sinuses, forcing me to mouth-breathe. I had the same problem with a nasal cannula once when I was i the hospital years ago.

On the other hand, I've been using the Pilairo Q pillows mask as my main mask lately. The air from the Pilairo Q feels calm and does not jet into my nose. It actually opens up my sinuses. I've had very little congestion since I started wearing it 3 months ago, far less than before I started CPAP when I had a chronic problem with nasal congestion. I haven't had to rinse my sinuses with a neti pot as often since I switched masks.
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#5
I don't think I've been sleeping on my back. I'm mostly a side sleeper anyway. As I look at my stats again, it looks like the pressure did go to the max of 20. I believe my behind the scenes tech must have adjusted the starting point a bit, because now when I turn it on at night it automatically starts at 10 instead of 4, and I have to hit the ramp button to get used to it. I'm attaching a couple of screenshots from last night to see if anything looks out of the ordinary.
[Image: J1IJcNJl.png]
Here's another view.
[Image: Ko5ns5rl.png]
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#6
I had headaches for a while, doctor said it was caused by retained CO2. I decreased the exhale pressure (flex settings for your machine) and they went away.

Lots of congestion, both real and pressure miss-understood. Before CPAP pressure has always meant congestion, so I 'felt" congested and was not.

I use breathe right strips and Flonase every night, because some of the congestion was real. Temperature, humidity can cause it. Sometimes I put ice in the water chamber and sometimes I fill it with water, just depends. Don't assume CPAP is like anything before. I used to think I like humidity, then I didn't and now I like some.
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#7
jen61,
From your SleepyHead stats, it looks like your machine is set what we call wide open at 4 minimum and 20 max. You aren't starting at 10, but the Apap is ramping up to that number right away, which indicates you need a higher pressure. Your medium pressure is around 17. Your minimum pressure should not be left at 4.

I have to wonder when looking at your 95% numbers going up to 20 that you should be using a bipap machine. I would check with your doctor and ask about this.

Another thing is your leak rate is a little high. You are probably mouth breathing, especially when you say you have dry mouth. You may not realize you are doing this.

Above anything else right now, you need to focus on leaks, and as was advised in another thread, your minimum pressure at 4 is not optimal. Change it to at least 6 and inch it up slowly. If you don't feel comfortable with this, talk to your doctor.



OpalRose
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#8
I have issues with sinuses in response to pressure, however I have been able to completely mitigate the issues by snorting up some Xlear nasal spray long enough before turn-in to have a nice dry nose. I said Xlear... but actually I got the special spray bottle and now make my own Wink Xlear contains Xylitol along with the saline and makes my sinuses very happy.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#9
Based on Daria's recommendations, I have also started doing a twice daily Xylitol/salt/baking soda nasal rinse and it has helped a lot. Thanks Daria!
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#10
Daria,

If you are not careful, you are liable to start an Xlear cult. That would be the second cult on this board (besides the P10 cult) only I would be a member of this one. Oh-jeez Dont-know Thumbs-up-2

Best Regards,

PaytonA
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