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Intro Plus A Question [nasal restriction]
#1
Intro Plus A Question [nasal restriction]
Hi, My name is Mike. I am new here. I am 66 years old and live in NW California. My hobbies are hiking & camping.

I was recently diagnosed with moderately severe sleep apnea and received a Respironics Dreamstation bipap auto machine two days ago. I am very happy with the machine.  like I am very motivated to use it. The therapy is quiet and reasonably comfortable when it works. However I have come up with a snag with the treatment. After some time on the machine, my nasal airways restrict to the point that I have to switch to mouth breathing. Since I am only equipped with nasal type  masks, I have to quit the machine therapy for the night. Last night, I managed to get 6 hours in with the machine. The night before (1st night on the machine) only about three. I want to stick to the nasal pillow that I am using as I have warn a beard for most of my adult life.

I know that I have had restricted narrow airways for years. Most of the time, I have just enough space to get a breath through the old tubes but none extra. I have emailed my sleep doc requesting a referral to an ear, nose, throat specialist. Am I on the right track?

Thank You, 
Mike
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#2
RE: Intro Plus A Question
Before you give up on the pillows for the night, give them what will be a very hard 10 minutes.  Try to breathe thru your node, with CPAP pressure.  For me the pressure always wins.

The Mask I'm wearing in my avatar is the Amara View.  It seals around the mouth and under the nose.
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#3
RE: Intro Plus A Question
(03-10-2019, 06:09 PM)NorthCoastLocal Wrote: ...my nasal airways restrict to the point that I have to switch to mouth breathing. Since I am only equipped with nasal type  masks, I have to quit the machine therapy for the night. Last night, I managed to get 6 hours in with the machine. The night before (1st night on the machine) only about three. I want to stick to the nasal pillow that I am using as I have warn a beard for most of my adult life.

I know that I have had restricted narrow airways for years. Most of the time, I have just enough space to get a breath through the old tubes but none extra. I have emailed my sleep doc requesting a referral to an ear, nose, throat specialist. Am I on the right track?

Thank You, 
Mike

Yes, I think you may have to consult a specialist, even if is to be that he/she hands you a mask or appliance that keeps your nostrils sufficiently open.  However, have you trialed, or considered, the occasional use of a decongestant? I have no history of this, but I have followed a few threads where people report congestion and have to resort to occasional, even nightly, use of them.  Is it possible that some of what you are experiencing might be related to congestion?  I know that I never have congestion except perhaps just after a sneeze, or the one that 'gets away'.  That lasts for a second or two.  Otherwise, I do get congested for a bit every other morning just about waking time.  It's what gets me awake.  By then I don't need to medicate, whereas you might benefit from a single spritz into each nostril at bedtime.  Something else to discuss with the ENT.
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#4
RE: Intro Plus A Question
Mike, make sure you're not using too much humidity as that may increase congestion, as can too dry. Moisture in the Airfit P10 nasal pillows mask can obstruct the exhaust vent, so make sure this is not the case for you. When the events become obstructed, you may get the feeling you don't get enough air, or that it is hard to exhale. I have always been able to relax and let the pressure open my sinuses. I suffer from some congestion and post-nasal drip and the nasal pillows usually keep me open.

A quick question on your machine. Based on a pressure range of 8 to 12 and diagnosis of moderately severe apnea, you most likely have the Dreamstation Auto CPAP (model 500) rather than the BiPAP auto (model 700). If you are using the BiPAP, what is your pressure support setting? Be sure to download the free #Sleepyhead software and we will be able to take a look at your charts and know better what is going on.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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
RE: Intro Plus A Question
Thank you for your replies. I don't think that I have much of a congestion problem. I have had what seams like a plugged up nose for years. I constantly feel a need to blow my nose to clear it but unless I have a cold, come up with a relatively dry tissue. I was once told by a GP that I may have a deviated septum. I have recently heard of swollen terbinites as a possibility as well. i also learned that terbinites can be reduced in a 10 minute office procedure by an ear, nose, throat physician. Fixing a deviated septum is a little bit bigger deal. If I can get my nose to efficiently flow air, my nose pillow works beautifully.
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#6
RE: Intro Plus A Question
(03-10-2019, 06:09 PM)NorthCoastLocal Wrote: After some time on the machine, my nasal airways restrict to the point that I have to switch to mouth breathing.

Whatever is clogging your nasal passageway might be addressed with nasal sprays. There are simple saline sprays, nasal washes, antihistamine nasal sprays such as astelin, or other nasal sprays such as flonase.

The other thing you can try is a chin strap.

A long time ago, way before CPAP, I had sinus surgery and it was the only thing that allowed me to breathe through my nose when I was lying down.
Sleepster

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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#7
RE: Intro Plus A Question
I checked the machine. The tag on the bottom says Dream STN  BIPAP Auto. I also checked the pressure settings. I was mistaken. It is set at 8 on the low side and 11 on the high side. I have edited my profile to reflect that. I will keep an eye on the humidification. Haven't seen excess water in the exhaust screen so far. I have tried to download Sleepyhead in my iPad but haven't yet been able to get it open. I am writing this post on a Chromebook. I have never been able to do anything with it but surf the net and write emails. Thanks all for the help.
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#8
RE: Intro Plus A Question
(03-10-2019, 10:10 PM)NorthCoastLocal Wrote: I checked the machine. The tag on the bottom says Dream STN  BIPAP Auto. I also checked the pressure settings. I was mistaken. It is set at 8 on the low side and 11 on the high side. I have edited my profile to reflect that. I will keep an eye on the humidification. Haven't seen excess water in the exhaust screen so far. I have tried to download Sleepyhead in my iPad but haven't yet been able to get it open. I am writing this post on a Chromebook. I have never been able to do anything with it but surf the net and write emails. Thanks all for the help.

It sounds like you might be setup in S-mode.  This is a fixed pressure bilevel, and your machine is producing an inhale pressure (IPAP) of 12.0 and exhale pressure of 8.0 cm (EPAP). We would notate this as 12/8 BiPAP pressure.  The difference between IPAP -EPAP in this case is 4.0 which is the "Pressure Support (PS).  You still have the option to change to BiPAP Auto mode.  In auto mode, the BiPAP will self-adjust like an auto CPAP. You define a minimum EPAP, a Maximum pressure and specify the PS, and the machine will operate in that range.  For example with EPAP min 8.0, PS 4.0 and IPAP max 16.0, the machine would self-adjust between 12/8 and 16/12.  The reason to do this would be if there are events that are untreated at the fixed pressure, or for comfort.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#9
RE: Intro Plus A Question [nasal restriction]
Had pretty good progress last night. I got in a 7 hours and 37 minutes of therapy. A CPAP couch from company that supplied the machine called this morning. She was pleased with mu initial progress. While she had me on the line, she talked me through turning down the humidity one notch. We'll see how it goes tonight. She will be calling back again tomorrow to check in.  Thanks
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#10
RE: Intro Plus A Question [nasal restriction]
(03-11-2019, 09:27 PM)NorthCoastLocal Wrote: She will be calling back again tomorrow to check in.  Thanks

That's awesome! The CPAP machine may actually help you keep your nasal passageways open once you get the humidity and mask fit tuned in.
Sleepster

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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