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[Treatment] Sleep Apnea + Asthama + Nasal Allergy
#1
Hi All,

This board has been really helpful in coping up with my recently diagnosed sleep apnea and asthma. And I am going through a tough phase now. Hoping the guidance of fellow board members will help.

Brief History :
I am 30 Year Old, male residing in India. Height 5'10" and weight is 85 Kg.
I have been suffering from severe nasal allergy from last 12 years.

Around an year back, i was travelling and suddenly became too breathless. On visiting the doctor i was told that it's a severe asthma attack and i was advised to undergo a sleep study as well. In sleep study the AHI came around 53 and I was ask to start cpap therapy.

Initial months were really difficult and my nasal allergy coupled with asthama made it really tough. Finally after trying multiple machines and masks I zeroed in on Resmed Airsense 10 with resmed airfit P10 nasal pillows.

I took a long time to adjust but perseverance paid off and some nights when I was able to use the machine for more than 5-6 hours, i feel really fresh and energetic from the morning. Also the AHI comes in the range of 2-3.
But if i am not able to use the machine for various reasons explained below, then I wake up with a headache and feel too sluggish and sleepy throughout the day. This happens with me around 2 to 3 times every week.

Reasons for not being able to use the mask:
1) I remove the mask as i feel uncomfortable (maybe i feel asthmatic / claustrophobic )
2) Due to air in my nostrils, i feel irritated and start sneezing with runny nose and watery eyes.
3) I remove the mask involuntarily.

Additional Information:
Currently I have lot of work and stress at work.
Also i feel more hungry and end up eating more especially carbs on days when i am not able to get a sound sleep. Is this normal ?

It would be great if somebody who had similar experience or any guidance can help. Thanks a ton !!

Hoping to actually getting my life back !!


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#2
G'day getmylifeback, welcome to Apnea Board.

It's obviously harder to adjust when there are multiple issues happening. I don't know too much about asthma combined with apnea, so I'll defer that part of the question.

However I can tell you that it's extremely common to remove the mask during your sleep. We all do it at first, but usually the incidence decreases with time. Having said that, I still find myself removing my mask occasionally even after three years as a hosehead. I think the causes are three-fold:

1. Nasal congestion causing mouth-breathing which leads to uncomfortable dry mouth
2. Leaks causing air to blow into my eyes or "face farts" which disturb my sleep
3. Adjusting the straps too tight in order to counter the leaks, leading to discomfort.

There's no easy answer to this. It's a matter of finding a mask you're comfortable with, then adjusting it to minimise leakage and maximise comfort. Mask liners (pad-a-cheek or remzz) might help. I've found F&P Simplus and Resmed Quattro Air masks are best for me. I use the Simplus without a liner, and a pad-a-cheek liner on the Quattro. Other things which can help are to wash the mask frequently to prevent build-up of oil from your skin, and thoroughly cleanse your face before bed. I also run a razor over my face last thing at night.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#3
Hi getmylifeback,
WELCOME! to the forum.!
Good luck to you as you continue your CPAP therapy.
trish6hundred
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#4
Thanks DeepBreathing and trish6hundred !
Hoping to solve this peculiar problem of combined issues of apnea, asthma and nasal allergy soon.
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#5
(09-20-2016, 12:30 PM)getmylifeback Wrote: Thanks DeepBreathing and trish6hundred !
Hoping to solve this peculiar problem of combined issues of apnea, asthma and nasal allergy soon.

What have the doctors suggested regarding your asthma and nasal allergies since they seem to be interfering with your pap therapy?

Thanks!

49er

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#6
Hi 49er,

Doctors have suggested inhalers (Foracort 200) for asthama and 'Allegra 120' for nasal allergy.

I tried doing breathing exercise but they seem to backfire as they increase irritation in my nose leading to incessant sneezes.

Last night I had an AHI of 9.00 after using CPAP for around 3 hrs. As a result I Feel like hell. Too sleepy, unable to concentrate and do anything.

Does eating has anything to do with increased apnea. Sometimes late dinner seem to aggravate the apnea. Is there a correlation between that ?

Thanks a ton for your advice !!
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#7
Getmylifeback, you have a very good machine to help you out. I'm going to ask a few specific questions to see if we can get a handle on your difficulties:

What is your average and 90-95% pressure currently?
Are leaks fairly well controlled?
Of your AHI of 9.0, what portion is CA, OA and H?
What EPR setting are you using?
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#8
As for eating, yeah, it could. Anything that can interfere with sleep can interfere with sleep apnea. Stomach acid, too full, too hungry, etc.

I have nasal allergies and asthma. I switch between a full face mask (Simplus) and a nasal pillows (Nuance). I also maintain a good humidity during allergy seasons. This really helps. I have found the nasal pillows does a better job of keeping my nasal passages clear during the night than the full face mask.

Also consider saline nasal rinses before bed and after getting up. During allergy season that is what I do to help keep things cleared out as much as possible. The first time or two is hard to do but once I got over the "ew" factor, I love it!

If you have allergies year round, time to see the allergist. Don't use a nasal spray for too long as your nasal passages will get too used to it (it is a kind of addiction). You can find saline nasal sprays to use during the day. If the allergies are just seasonal, then it is "just" a matter of adjusting during that time of year.
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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#9
getmylifeback,

Google "Eating late leads so apnea" and click on the 2nd result which will lead you to the website of Dr. Steven Park. He provides an excellent explanation as to how eating late can lead to more apneas.

Agree with Paula's advice about trying nasal rinsing to alleviate your allergies. If you find that isn't enough, please see your doctor about getting better meds as I am inferring from from your posts that what you are on right now isn't working. Please correct me if I am wrong.

49er
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#10
Dear sleeprider, PaulaO2 and 49er. Thanks a ton for your responses.

From June to August, the situation was not that bad. Starting Sep it seems to be deteriorating fast.

(09-28-2016, 11:52 AM)Sleeprider Wrote: What is your average and 90-95% pressure currently?
Are leaks fairly well controlled?
Of your AHI of 9.0, what portion is CA, OA and H?
What EPR setting are you using?

Avg 95% pressure : 8.8
Leaks data - 95% : 1.2 | Max : 45.6 | Median 0.0
AHI : Maximum apneas occur towards the start. After using the machine for arnd 45 minutes to an hour, AI is > 7. This avergaes out over the night
Average AHI data for last 14 days is AI : 3.3 | Obstructive : 1.0 | Central : 0.5 | Unknown : 1.7
Avg daily use : 3:56 Hrs
EPR setting is at 3


(09-28-2016, 03:49 PM)PaulaO2 Wrote: As for eating, yeah, it could. Anything that can interfere with sleep can interfere with sleep apnea. Stomach acid, too full, too hungry, etc.

I have nasal allergies and asthma. I switch between a full face mask (Simplus) and a nasal pillows (Nuance). I also maintain a good humidity during allergy seasons. This really helps. I have found the nasal pillows does a better job of keeping my nasal passages clear during the night than the full face mask.

Also consider saline nasal rinses before bed and after getting up. During allergy season that is what I do to help keep things cleared out as much as possible. The first time or two is hard to do but once I got over the "ew" factor, I love it!

I tried multiple nasal masks but none of them suited. Most of them cause irritation in my nose. Have been using nasal pillow for last few months.
As for nasal rinses, pardon my naivety, but are there any specific solutions for this ?

(09-29-2016, 02:33 AM)49er Wrote: getmylifeback,

Google "Eating late leads so apnea" and click on the 2nd result which will lead you to the website of Dr. Steven Park. He provides an excellent explanation as to how eating late can lead to more apneas.

Agree with Paula's advice about trying nasal rinsing to alleviate your allergies. If you find that isn't enough, please see your doctor about getting better meds as I am inferring from from your posts that what you are on right now isn't working. Please correct me if I am wrong.

49er

Thanks for the suggesting site by doctor Steven Park. This seems to be an amazing source for apena related info.
And you are right about the medications not having the required effect.
I am seeing my doctor again tomorrow.

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