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Connection of OSA to Rhinitis, and Sinusitis
#1
Hi, new to the forum. I searched through, and didn't see this brought up before.


Can Sleep Apnea be a secondary condition to Sinusitis/Rhinitis?

Weather is be from swelling of the nasal area causing sleep apnea to be worse than it would normally be? Mucosal inflammation, or just mucus from sinuses draining to throat?

Technically, OSA is when something is restricting or blocking your airway. Commonly caused by your tongue pushing on your soft palate. However, what if that were minor to the point where you didn't have sleep apnea, but inflammation commonly found in people with sinusitis and rhinitis restricted the airways further causing it to become mild OSA?

The reason I ask this is because it may seem pretty possible, and there are tons of doctors who have written about the connection. I have been to several ENT doctors, and they say it's impossible for there to be a connection. Even though my rhinitis was why they sent me to do a sleep study which found out I had mild OSA. Looking around, it seems there is a 50/50 split between Doctors of whether it's possible or not and wanted some more opinions from other people. Maybe someone else has gone through the same thing.


I can't post links since I'm new, and have less than 4 posts. There are plenty of articles online talking about the connections, and studies that have been done.
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#2
The long background story. Decided to post it separate for people who felt like getting straight to the main question.

Background: I'm an Iraq War Veteran who spent time around burn pits, and the not so fun stuff found in the sand over there. I immediately had breathing issues upon returning in Dec 2008. Didn't think much of it, as many people said it was just from breathing the crud in the sand and would pass. A year later it didn't pass. Went to the VA doctors starting later 2009, and began the painful process of trying to figure out what's going on.

From 2009-2015, I only had issues while laying down. If I was standing up, I was fine. If I laid down, my head was always stuffed up like I had a head cold. I had multiple allergy tests that came back negative. This would happen every night, no matter where I was and symptoms would clear shortly after getting up. I had two in hospital sleep studies done, which came back negative for sleep apnea. I question these as being hooked up with all the wires, and trying to sleep in an unfamiliar place was not working. I barely even fell asleep, and even the technicians conducting the tests said the same. The doctors responses were "you didn't snore, so you don't have sleep apnea".

For years, I kept getting the "we don't know what's wrong with you" from the VA till about early 2015. I had been diagnosed before with non-allergic rhinitis, and allergic rhinitis which they always discussed. I tried many nasal sprays, but they had minor effects. Reviewing my records it shows I have had chronic sinusitis for years, and it was noted as being present in multiple MRIs (Ethmoid, and Maxillary). The VA ENT doctos never said a single thing about it, and after 7 years they still have never checked me while laying down when I said the symptoms are primarily present.

I had turbinate reduction surgery in August 2015. While air flows through my nose better, the head stuffiness while laying down became much worse. I get a runny nose constantly, and usually wake up with crust in my nose (sometimes bloody). By Jan 2016, it became to where I started getting the symptoms while standing up. I can't go running anymore, because I get instant headaches, and feel pressure between my eyes. I told this multiple times to the ENT doctors, and the answer I received was "we cleared your nose out, we don't know what it is". Doing my own research, looking at the symptoms and area I highly suspect it's the ethmoid sinusitis. Everything seems to match up as far as the pressure.

I had another sleep study in May 2016 (take home study), and was diagnosed with mild OSA. The VA gave me a CPAP machine. Now, the whole reason I had the sleep study done was of because of how the Rhinitis (and Sinusitis) affected my sleeping, not a concern for snoring. The CPAP actually helps my symptoms. While using it, it keeps my head from becoming stuffed up. I've tested it, some nights with others without, and some nights where I use it on and off. Every result is exactly the same. Using the CPAP, no symptoms and stuffed head without it. Which is very contrary to what I found online. Every other post people seem to get sinusitis because of the CPAP. I had it before, and it clears it up.

I tried talking to the VA ENT doctors, and one outside DR (who I found out was trained by the same VA DRs). I asked them if my rhinitis and sinusitis is possibly causing my sleep apnea. They say it's completely impossible, and there is absolutely no way they can be connected. To be clear, this wasn't specific to my case. This was in general, that it's impossible for anyone to have rhinitis or sinusitis linked to sleep apnea.

I don't have any way to test for sure, but what I believe happened is that I had rhinitis, sinusitis and no OSA. All my nose issues were because of the rhinitis, and since it was swelling it was restricting the air (and other things) from going too far back. After the turbinate reduction, it fixed my rhinitis but allowed much more air and whatever causes my problems to fill my head a lot more. This caused my ethmoid sinusitis among other things to become worse, which lead to mild OSA.
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#3
Very interesting. Don't know a lot about all the other problems but I do know I am allergic to cats and going through the desensitizing shots. This means I have a built "flow limit". I own a cat.

My GP says allergies can affect sleep apnea and my allergist says no. There's your 50/50 split.

Some how a lot of what you are saying is familiar with me.
HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#4
I dunno either - but I have a long term "non allergic rhinitis". I'm not even allergic to anything* (that they test for) .... and yet my nose is always runny; always cloggy when I lay down. So much so, that I had to get a wedge pillow 3 months ago, because I was sooo clogged everytime I lay down to sleep.

* I used to have some allergy to mold, but after years of shots, that went away. Now I test allergic to nothing. Still my nose runs ...
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#5
I do not have the degree of problem that you do but some of the things that you mentioned rang a bell. When I was fighting nasal congestion all of the time and using nasal sprays much of the time because I hated being stuffed up, ass soon as I would lie down my nose would stuff up unless I had recently used nasal spray. I do have allergies. Allergies to cats. I have 2 of them. Allergies to bird feathers. I have 2 birds.

I have cleared most of that up But what I have noticed is that during sleep even with quite a bit of humidity from my CPAP heated humidifier my nasal mucous dries up or becomes very viscous but out of the way so I do not have any congestion. When I awake and get up in the morning my nose will drain clear mucous for half pf the day.I have found that a salt water nasal rinse helps a lot and am currently thinking about doing it more often than I have in the past.

I would recommend that you might want to read a book called Sound Sleep, Sound Mind by Barry Krakow MD. Much of the book is directed at people with insomnia but the last part of the book relates to breathing and sleep. Krakow makes some interesting observations and results of his research and I think that some of it may bear on your case. I find the whole book very interesting but especially the last part of the book.

Best Regards,

PaytonA
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#6
That's why you were diagnosed with non-allergic rhinitis, because they determined it wasn't allergies. Non-allergic rhinitis is when you have all the symptoms of someone with allergies, but do not show up for an allergic reaction.

Allergic rhinitis is when it's a known allergy causing it.

I have been diagnosed with both, but non-allergic is the one they go with the most. It's interesting that you only have it when you lay down like me. That seemed to boggle the VA ENT Doctors, but then again it's the VA (setting the bar low). They tried blaming it on pets, allergies, conditions, dust, ect. I didn't have pets for the first 2 years I had the problem. I was also in the reserves after active duty, and stayed in a hotel once a month. Not too mention numerous foreign travel around the world after my deployment, even up to 3 months. Exact same symptoms no matter what condition I was in, and always when I layed down and gone when up (pre-surgery).

I even had one doctor say I should go down to the Caribbean, the weather will clear me up after 2 days. I happened to have just got back 2 weeks before from a 6 day trip in the US Virgin Islands, didn't work. I go so annoyed with one Doctor who played the "I don't care if you've had this problem 5 years (at the time), you're not a Doctor, so automatically that means you are clueless and I won't listen to you". He was one of those 'what I learned 35 years ago in medical school is still fact, and nothing new has been discovered' types. He wouldn't even look at my previous (5 years worth at time) medical records before making assumptions based off his personal feelings at the time. He kept playing the lets blame everything without looking at the actual problem, so I just got up and said "I guess am allergic to air" and walked out.

(01-11-2017, 07:44 PM)BadGoodDeb Wrote: I dunno either - but I have a long term "non allergic rhinitis". I'm not even allergic to anything* (that they test for) .... and yet my nose is always runny; always cloggy when I lay down. So much so, that I had to get a wedge pillow 3 months ago, because I was sooo clogged everytime I lay down to sleep.

* I used to have some allergy to mold, but after years of shots, that went away. Now I test allergic to nothing. Still my nose runs ...

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#7
Long term use of nasal sprays will cause a rebound effect making symptoms worse, and causing you to think you need more. Plus nasal sprays are made differently with different types, which will cause an effect.

I stayed off nasal sprays for over a year to make sure that wasn't a factor in my problem. While on them, they only provided mild help, and I've gone through at least 8 different types.

I've used the salin rinse a bunch, and it has very little affect. Unless I'm getting cold like symptoms from say breathing in a bunch of dust while working in the garage or something. I also get the clear runny discharge in the mornings, and sometimes throughout the day.

I'll check out the book when I can. Thanks!

(01-11-2017, 08:14 PM)PaytonA Wrote: I do not have the degree of problem that you do but some of the things that you mentioned rang a bell. When I was fighting nasal congestion all of the time and using nasal sprays much of the time because I hated being stuffed up, ass soon as I would lie down my nose would stuff up unless I had recently used nasal spray. I do have allergies. Allergies to cats. I have 2 of them. Allergies to bird feathers. I have 2 birds.

I have cleared most of that up But what I have noticed is that during sleep even with quite a bit of humidity from my CPAP heated humidifier my nasal mucous dries up or becomes very viscous but out of the way so I do not have any congestion. When I awake and get up in the morning my nose will drain clear mucous for half pf the day.I have found that a salt water nasal rinse helps a lot and am currently thinking about doing it more often than I have in the past.

I would recommend that you might want to read a book called Sound Sleep, Sound Mind by Barry Krakow MD. Much of the book is directed at people with insomnia but the last part of the book relates to breathing and sleep. Krakow makes some interesting observations and results of his research and I think that some of it may bear on your case. I find the whole book very interesting but especially the last part of the book.

Best Regards,

PaytonA

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#8
My personal feeling is that rhinitis can cause, or at least worsen, apnoea. I have suffered from rhinitis since 2005; and like a previous poster my apnoea was diagnosed as a result of the investigations into my rhinitis. The doctors initially told me it was allergic rhinits, then they said I have no known allergies. The problem started after my doctors started me on a disastrous course of new hypertension medication, Lisinopril (an ACE inhibitor known to cause persistent coughing).

Unfortunately, the doctors will not believe that this caused my rhinitis, which I think has sensitised my airways to certain chemical irritants, particularly (some) perfumes and some of the chemicals found in household cleaning products. Although I've not been able to pin down exactly what chemicals or chemical groups are problematic, I've restricted the range of products we have in the house (much to my wife's dismay) and use unscented products where possible, and that certainly helps, as do corticosteriod nasal sprays and saline washes. Having my depleted haemophilus B levels boosted back to normal (by vaccination) and taking 1000IU vitamin D every day has also helped a little as well.

Nevertheless, my symptoms do worsen from time to time (often after I've been out to a restaurant etc. and exposed to someone's perfume or aftershave), and this definitely seems to worsen my sleep apnoea. To be honest, I don't think my apnoea and snoring are bad at all when my rhinitis has subsided, but my wife tells me that I snore like a drowning hippo when I'm having a 'bad-nose day'.
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#9
Hi ac555,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy, hang in there for more responses to your post.

trish6hundred
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#10
Have you tried a daily neti pot rinse?
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