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Sinus infection
#1
This week marks two months that I've been using APAP, and overall it's been very successful. Most nights my net AHI is under 1.00, and the "high" nights are in the ~2.00 realm.

The only thing that's an issue at this point is that I've had a pretty major sinus infection on and off for the past month. It started when I was on APAP for about a month -- it manifested as a strong infection with headache/toothache, fluorescent nasal discharge, etc. It eased off, but has returned on and off. Today it was bad enough that I had to come home from work early and put my face over a pot of hot steam to alleviate things.

Now, I can't say that there is necessarily a connection between getting the infection and being on APAP. On the other hand, this is the first sinus infection I can recall in more than 10 years, so it seems coincidental. From reading threads like this one, it seems as though many of you are skeptical that PAP can cause a sinus infection, whereas others like me have gotten one when first using the machine.

I've been using a neti pot nightly for many years. Right now I'm increasing that to 4x/day, along with the steam, to see if either or both help.

I'm currently wondering about the following:

-- Usually I leave my machine on humidifier setting 4, and let it decide when to turn on. It doesn't seem to go on that much even though the air has been very dry. If you were me, would you try increasing the humidification level to 5, or setting it so it's manually on?

-- Does pressure level seem like it could be a factor? Mine is set to 4-20 cm, and seems to spend most of the time in the 4-6 cm range.

-- Anything else you'd try? I sleep 100% on one side or the other now (not on my back); the sinus infection is just on the left side. I wonder if it would be better to elevate that side?

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#2
it is going around. I had it start in November and went to the doc at the end of November and they did nothing but give me a nasal spray script which did not address all of my symptoms. They told me to start back on the metoprolol b/c my pulse of 60 was way too high and they were concerned about tachycardia (sp?). I said well, if you are concerned what about doing an EKG. Oh no, if I think you need that, I will order it (I have 2 siblings and a bad family history of heart attacks). Did not get better and went to the doc today b/c my right ear became very painful. Yep, you have the crud that is going around and some people are getting pneumonia from it. One of the things I do have is symptoms of a sinus infection among other symptoms. Probably a coincidence but worth checking out.
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#3
I have been on APAP for 101 days now. I started using a Neti Pot religiously (once a day), 30 days into it. Then I got hit by a sinus infection. First, I realized I was doing Neti a bit wrong. I corrected that. Then, I needed to reduce my System One humidification level from 90% to 70% and tube temp from setting of 4 to a 3. That worked for me. Now I have been sinus infection free for the last 50 days which have been colder than earlier.

The xPAP is subjecting your nostrils to a new standard of breathing (humidity and temp wise). It takes some time for it to adjust. For some, lower humidity may work. For some, a higher humidity will work. You just need to experiment with the settings to see what works for you.

My 2 cents. YMMV.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#4
(01-05-2015, 09:02 PM)AshSF Wrote: I realized I was doing Neti a bit wrong. I corrected that.

Thanks. What did you conclude was wrong in how you were doing it, and how did you change it?

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#5
Even if CPAP doesn't do anything like harbor germs or "push the germs" into you, it can affect your airway tissues by drying them out, or making your passages more or less clear of germs, so it might affect your potential for infection.

As for the neti, consider the same thing. Mucous is there to protect you from germs. If you wash it out too much, you might have more chance of infection because you've washed away your infection protection.

Sometimes more humidity is better, sometimes, less.

If you want to, you might get some Control III disinfectant and use it to clean all your CPAP equipment as soon as you get well. Read the directions. It's nasty stuff until you dilute it.

Doctors are getting too reluctant to dispense antibiotics. While I don't like to see overuse, a course of antibiotics once a year or so isn't going to go breeding superbugs. You may need to insist on antibiotics if you go see your doctor.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#6
yeah my doctor ordered antibiotics for me and I wasn't happy about it and asked why I couldn't just have antibiotic ear drops and I was told that it was more than just my ears and I needed an antibiotic so I filled the prescription and fortunately my doctor was nice enough to answer my questions knowing that I am NOT trying to tell him how to treat me when I am not feeling well I do believe that if my doctor that I went to in November when all of this first started would have treated me at that time I wouldn't have gotten sicker and had a need for the antibiotic but from what I was told today from my doctor this is going around and there have been lines and lines and lines of people going into the urgent care facilities for treatment
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#7
Usually when you have a sinus infection, you aggressively treat it with a complete course of antibiotics. I've never failed to clear it up with that, and I have had sinus infections that felt like an ice pick being driven into my head. Terrible! I've been doing APAP therapy since 2008 so I've been around the block with that and every thing from sinus infection to an incredible case of Lyme's Meningitis that paralyzed my face, abdomen and put me on disability for months. I don't get sick often, but I guess when I do, it's a doozie.

Through it all I've use APAP with nasal pillows, heated humidification as needed and a heated hose. Normally I'm more comfortable at night with the pressurized air than during the day when I'm sick. Never used a neti pot, but have occasionally used sterile nasal spray. I think it's not a great idea to do anything like that routinely. YMMV and there are pros and cons.

I have doubts XPAP caused an infection, but it's not out of the question, especially if you experience leaks that cause dry irritated tissues in the sinus. If you haven't already done so, get proper treatment and take all the medication, even if you're feeling better. It sounds like you are self-diagnosing and treating, and I disagree that is an effective way to deal with sinusitis. A heated hose in addition to your humidifier is a wonderful thing this time of year, especially when your sinuses are painful.
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#8
I agree with the above that dry tissues could become a landing strip for bugs that are in the air that we breathe. Another thing that might be worth considering is one of the results of DocWills testing. He found that after a while without cleaning the mask there were some not so nice bugs that took up residence in the mask although there were none in the tubing. Has this finding got me washing my mask every day? Nope, but it is worth consideration.

Best Regards,

PaytonA
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#9
(01-05-2015, 09:25 PM)Dyssomniac Wrote:
(01-05-2015, 09:02 PM)AshSF Wrote: I realized I was doing Neti a bit wrong. I corrected that.

Thanks. What did you conclude was wrong in how you were doing it, and how did you change it?

My body posture wasn't correct. If you don't do it in the right way, it makes you more susceptible to sinus attacks. Also, I was doing it with cold water. Now I do it with lukewarm distilled water. There are multiple yoga related websites which describe the correct posture. You should google "neti technique" and read up.

Also, doing it 4x a day is overkill on a daily basis and may remove too much mucus. I only do it once a day.

If you are in the middle of an acute sinus infection, then 4x a day makes sense. I have never been able to control a sinus infection with antibiotics. I have always gotten a good result by aggressive Neti during acute sinusitis.

YMMV.


Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
Post Reply Post Reply


#10
(01-05-2015, 10:46 PM)me50 Wrote: yeah my doctor ordered antibiotics for me and I wasn't happy about it and asked why I couldn't just have antibiotic ear drops and I was told that it was more than just my ears and I needed an antibiotic so I filled the prescription and fortunately my doctor was nice enough to answer my questions knowing that I am NOT trying to tell him how to treat me when I am not feeling well I do believe that if my doctor that I went to in November when all of this first started would have treated me at that time I wouldn't have gotten sicker and had a need for the antibiotic but from what I was told today from my doctor this is going around and there have been lines and lines and lines of people going into the urgent care facilities for treatment

Ear infections should almost always be treated with antibiotic pills not just drops. The bugs are often on the inside of the ear and will cause a lot of pain and maybe ear damage if not treated quickly.

I learned that lesson when some stupid doctor treated my ear infection with some kind of #84&@* vinegar based ear drops instead of pills. After a few days of excruciating pain, I went back and got antibiotic pills and it cleared up.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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