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Chronic cough and sinus congestion
#1
[/font]Hi, I'm new to this forum, been on nasal CPAP for 18months now and having several issues.
Brief history: Am a slim early 40's female paramedic/triathlete with chronic runny nose and 8year history of extreme fatigue - fatigue initially diagnosed as lifestyle problem (shift work/overtraining-I think not true) then diagnosed as depression (also I think not true)
Every night when I lay down, my nose blocks up within a few minutes. 8years later I finally complained to Dr, CT scan (narrow oropharynx) led to sleep study(medarate OSA). Am nose breather only and don't snore.

IssuesSad1) initial CPAP pressure 6, within 6 months return of daytime symptoms, new titration study CPAP pressure 8, 6 months later return of daytime symptoms, now CPAP pressure 10
- does this plateau out?
- how long does it take?

(2) had 7 chest infection within the first 12 months on CPAP - presume it was nasal CPAP blowing bugs straight into my chest, have been infection free for 5 months. Just my immune system adjusting or something else? Any thoughts?

(3) Lastly and most annoyingly - have developed a chronic cough and my post nasal drip is much worse. People look at me like I am contageous with something !! I cough up about 6 clear mucus plugs per day as well as heaps of mucus strings and also constantly coughing to clear my post nasa drip.
-tried stopping CPAP for 5 weeks - reduced coughing up mucus plugs to about 2 per day but made me extremely tired again, not a viable option
-tried decongestants - work immediately on congestion but only for few days then no effect at all
-tried nasonex and all his cousins - no effect really
-tried nasonex plus rhinocrom 4% (a mast cell inhibitor) - some reduction in congestion and mucus volume coughed up!! (to the point where friends have commented that my cough is a bit better)

Have read some posts here and people have talked about sinus congestion but have not seen anyone post about a chronic cough as well, any help???
and any ideas on how to get relief??
Is turbinate reduction and septoplasty (yes broken nose as a kid) the way to go??
Thanks in advance for your input,
Lyndall
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#2
Hi lyndallmaree and welcome to apnea board
I,m going to have septoplasty and turbinate reduction done next week and will post my experience in this thread:
http://www.apneaboard.com/forums/Thread-...um-Surgery

The things I find helpful is to be vigilant with cleaning the equipment and daily nasal washes with Neilmed sinus rinse available from some pharmacy (priceline should stock it) check Neilmed we site for the info
Take your time and go through the nasal breathing videos [Commercial Posts] as dr talk about allergic rhinitis

http://www.apneaboard.com/forums/Thread-...tuffy-Nose


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#3
I second the nasal rinses. I use the bottle, not the neti pot.

And I strongly suggest seeing an allergist. Clear stuff means allergies. Something in your house or environment is having fun with your system. If it is year round, that will narrow it down. Look for mold, some sort of perfume or other inhaled aroma. Even dust.

1) not sure it plateaus. Stuff changes. We get older, we lose weight, we gain weight, we become more active, we become less active...you get the idea. Just like any condition, it is in a state of flux.

2) No, it isn't blowing germs into your lungs any more than breathing is. Unless you have stuff growing in the hose or mask, you're not getting additional germs. However, I can see it pushing that mucus into nooks and crannies and from there it grows nasty stuff. How long have you had your current hose and mask?

3} Nasonex helps some with cough and congestion. Does diddly for me. Nasal rinses and continually changing my hose and filters. I am highly allergic to mold.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#4
Hi Lyndallmaree and welcome. I also could not breathe through nose soon after lying down. After finding the right ENT I had endoscopic sinus surgery. This was about 15 years ago. Two days of hell later I had the packing removed. Since then I have always been able to breathe through the nose. It was a miracle!

Get the NeilMed sinus irrigation kit at any drug store. It will do you a world of good, plus you'll need it anyway after the surgery. When I have a cold, which isn't very often anymore, and am producing lots of mucous, a sinus irrigation will flush it all away so that I don't have to blow my nose for several hours. Then, I just rinse them again. Sometimes I go weeks or months without irrigating, sometimes I have to do it once or twice a day.

Your mucous is clear, indicating perhaps no infection. But you say you've had seven infections, meaning seven rounds of antibiotics? The purposae of sinus surgery is to turn sinuses that don't respond to antibiotics into sinuses that do.

I'm not sure if your CPAP machine is data capable, but if it is you need to look at the data and see if it indicates problems with your therapy. If it shows an increase in AHI, you may need another pressure adjustment.

I presume you've seen an ENT since you're getting a CT scan. ENT's are also good at prescribing the right medicines to help relieve your symptoms. Are you taking antihistamines? Decongestants?
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
Have you seen an ENT? They can tell if surgery may help and also with your post nasal drip/runny nose issues. Are you on any blood pressure medicines (I doubt this because of your lifestyle, but OSA can cause hypertension)- some of these can cause a chronic cough. We do hear from people who have an increase in chest infections, sinus infections and such after beginning CPAP. I don't think there is a causal relationship, but it does happen. Experiment with your humidity- may need to run higher or lower. A night in the sleep lab for titration is just one night and as far from a typical night as you can get. It's not unusual to have trouble getting titrated. Do you have a data capable machine, are you checking your leak and AHI? Use the machine 100% of sleep time? OSA does cause depression which should reverse with good therapy. Good luck.
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#6
Lyndallmaree, for many years I have gotten a runny nose and post nasal drip when I went to bed. Discovered it was the pets (or at least that was what I was told by the allergist) which abound in my home, and was told to keep them from the bedroom. Fat chance - they don't know my pets! Anyway, while the same condition continues, since I went on apap with the hypoallergenic filters it no longer continues throughout the night. Within a very short time on filtered air, it is amazingly ameliorated. Don't know about your other issues, but more frequent filter changes might be of some help. Good luck.

Oh, yes. I also use a humidifier on a fairly high setting.
Breathing keeps you alive. And PAP helps keep you breathing!
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#7
Which makes me wonder if I should run the humidifier again during allergy season...
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#8
(04-16-2012, 12:10 PM)PaulaO2 Wrote: Which makes me wonder if I should run the humidifier again during allergy season...

Can't hurt.

Breathing keeps you alive. And PAP helps keep you breathing!
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#9
You guys and gals are sooooo awesome for your quck replies,
I have 2 machines:
-renting a resmed S8 auto spirit (under warranty - needs a service) and I'm led to believe it has all the bells and whistles
-and a Fisher paykel SleepStyle 200 qiven to me for free by the Queensland Department of Health which has NO bells and whistles
Did not know I could monitor my own data until this forummentioned it - will investigate getting necessary software and stuff

I've used NeilMed Sinus Rinse during head colds and major congestion - it works a treat. My sinuses don't like it on a daily basis, so I now only use when I am sick.
Read all the "Un-stuffing Your Stuffy Nose" posts - they were awesome - thanks.
Am waiting to see another ENT (appt in June), last one was a #$%#&.
Am on waiting list to see an Allergist - no appt date as yet.
Not on blood pressure meds but notice my blood pressure starting to creep up slowly (both parents have hypertension)
Comparing initial CT scan in 2010 with one in 2011 after being on CPAP for 12 months-sinuses were soooo much worse, much more swollen and congested!!
Over the counter Antihistamines don't help at all (not sure about prescription ones??), decongestants work for only 2-3 days then no effect, best combination i've had is nasonex and rhincrom 4% sprayed one after the other (a steroid and a mast cell inhibitor)
No pets at home but could work on the dust situation :-)
Have filters onmy machines. What effect does turning the humidifier up have???? its set about 2/3 high?
Yes use my machine 100% sleep time - actually thats not true- its more like 90%
Yes 7 lots of antibiotics for green snot- was not a happy camper. but am clear at ther moment :-)

Thanks for your feedback so far. Am off to investigate software stuff.
cheers
Lyndall
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#10
(04-16-2012, 06:33 PM)lyndallmaree Wrote: I've used NeilMed Sinus Rinse during head colds and major congestion - it works a treat. My sinuses don't like it on a daily basis, so I now only use when I am sick.

Are you using the pre-mixed packets or rolling your own? It could be that if the solution is too strong your sinuses can't take it.

Quote: Am waiting to see another ENT (appt in June), last one was a #$%#&.
Am on waiting list to see an Allergist - no appt date as yet.

Been there. Finally found a ENT clinic that also does allergy therapy.

Quote: Yes 7 lots of antibiotics for green snot- was not a happy camper. but am clear at ther moment :-)

That should go towards making you a candidate for the surgery.

The reason the humidifier should be turned up higher is the humidity helps soothe the sinus and lung tissue. That's why doctors recommend humidifiers for their patients.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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