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[Symptoms] Extreme Dangerous Dry Mouth - Printable Version

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Extreme Dangerous Dry Mouth - Swindonian - 12-15-2019

Hello Everybody, I live in the U.K. and am new to this very active forum and I need your help. I have been on cpap for O.S.A. some 14 years and thought I had dealt with just about everything to do with sleep apnea until in August I was diagnosed with enlarged prostate (B.P.H.) and prescribed Tamsulosin Hydrochloride which worked on my symptoms but gave me well known side effects of dry mouth and nasal congestion which have continued to escalate and are now serious. The nasal congestion prevents me from using a nasal mask anymore so I have aquired several new full face new style masks (dreamwear, resmed airfit and the hybrid) these are great and I end up mouth breathing. However, constantly mouth breathing whilst using cpap creates a serious medical condition where your lips and tongue stick to your teeth. I am expecting many people out there to have experienced this and would welcome their advice on what worked for them. I am at my wits end and only find some slight relief using synthetic saliva spray. I should add that I saw my GP who prescribed steroid nasal spray which might provide some answers but will take up to 6 weeks to click in. There is also a chance that the nose blockage is due to polyps although the GP did not diagnose this. I have to find the answer to this as I am sitting up most nights because being verticle helps but of course it is without the cpap which most definitely worsens the dry mouth. Interestingly, my throat is not dry and my nose is completely blocked but clear of mucus. Thanks for reading.


RE: Extreme Dangerous Dry Mouth - ApneaQuestions - 12-16-2019

I use a full face mask because I simply cannot get air up my nose efficiently.

I have the same symptoms as you.

In my case, I had a couple of undiagnosed conditions
1) deviated septum
2) enlarged turbinates
I got them both "fixed" last year but the results were not impressive.
I thought about getting a more aggressive turbinate reduction but didn't want to risk going near "empty nose syndrome". That irreversible condition sounds awful.

When I used to lie down my nose would vary from "very congested" to "totally blocked". Getting vertical was the only solution for me too.
Raising your head with higher pillows and/or using a wedge to raise your whole body at angle can help.

After surgery (for me) my nose still gets "very congested" but there's less tendency to be "totally blocked". Yes polyps are another possibility.

I would ask your doctor to refer you to ENT for a proper diagnosis.  Those 7 minute appointments in the UK with a GP aren't the best way to get proper diagnosis.
A nasal probe will rapidly give you a diagnosis if there's anything to be seen.

I tried the various nasal sprays but they didn't seem to have any effect for me. Hopefully your mileage may differ. 

If you want to know how a "normal" person might feel...There's an experiment you could try for ONE NIGHT ONLY by using Afrin (oxymetazoline ). 
Is that OTC in the UK?  It's been a while since I was there.

It works by constricting blood vessels.  This will cause the turbinates to shrink and presumably polyps too.
However, as a consequence, it will increase blood pressure because that's what happens when blood vessels contract. So if that's a severe uncontrolled issue for you be aware.

The worst thing about Afrin is that it has a rebound effect and things get temporarily worse when you stop it.
People who don't know better just keep using it more and more to keep treating the rebound and essentially become "hooked" on the stuff. 
That's why I said ONE NIGHT ONLY.   Even the bottle tells you three days max for the same reasons. 

The reason I did the experiment was to get a subjective baseline of how good a clear nasal passage could actually feel.
Because I've been blocked all my life... I never experienced it to know just how bad my blockages were.  It's just a thought.

Antihistamines can give some relief for some people. Watch out for urinary retention if BPH is in your list of issues.

Another thing to consider (if the symptoms change depending on time of year or environment) is to ask for a referral for an allergy profile. 
I got one done but came up negative on all the usual suspects... dogs,cats,tree,grass pollen.  Not sure if they tested for dust mites or not.

So I too am a mouth breather.  Very dry without PAP. Totally dry using PAP.  I hate to think what it's doing to my gums. I've only been at it for a few weeks.
I haven't figured out yet how to have a sip of water in the middle of the night without risking becoming totally awake by messing with the mask and the machine.

I tried the various solutions and gels to try to get moisture to hang around but (in my case) in no time at all things dry up again.
Lots of people swear by "Biotene" but my results weren't great.  You may have more success. It's worth a try. The gel version is longer-lasting.

Of course, some drugs have a tendency to make the turbinates swell by dilating the blood vessels. An obvious candidate there would be [[[please REPORT me, I am a SPAMMER]]] /C-ialis.
That's a pity because it can have some benefits for BPH.
Other drugs have a tendency to dry your mouth and nose. An obvious candidate there would be HCTZ used routinely to treat blood pressure as a diuretic.

That's about everything I know about nasal blockage and dry mouth.
Hopefully your results may be better than mine. Good luck.


RE: Extreme Dangerous Dry Mouth - ApneaQuestions - 12-16-2019

Another reply because too many edits.

I don't know how bad your BPH and urinary symptoms are but there are surgical procedures that can help without all the sexual side effects of TURP.
Check out "Rezum" and "Prostate Artery Embolization". These can offer good subjective benefits without the side-effects. There are some doubts about how long the effects last but studies of 5 years or more are starting to roll in and look promising for PAE. I believe the NHS offers these. Maybe I'm getting way ahead of your current situation if you are just starting on the BPH path.


RE: Extreme Dangerous Dry Mouth - Swindonian - 12-16-2019

Thank you for both of your responses. The first was much more explicit and addressed my symptoms better than any doctor I have seen and I will be selectively following up on your suggestions. I will let you know how I get on. I have belonged to several U.K. Apnea Forums in recent years but the activity has reduced dramatically lately so I was very pleased to find this one which is alive and kicking. With regard to the BPH I have already had 3 TURP ops, all of which were successful for a time but my benign prostate just keeps growing, so I opted for this less invasive course of Tamsulosin. I am aslo on Finasteride which is claimed to reduce the size of the prostate by up to 20% over a six month period, of course there are know down sides on both so it is a trade off. Thanks again for sharing your history, reading it was like a consultation and I now have a plan.


RE: Extreme Dangerous Dry Mouth - Plmnb - 12-16-2019

Good morning.  Newer member chiming in...

You more than likely have already thought of this but just in case...

When I first started with CPAP therapy over 7 years ago (and stopped after about a year or so), I would get the WORST dry mouth.  I had never experienced anything like it before.  This discomfort is just one reason I discontinued therapy.  (I had around that time had my Uvulectomy, turbinates, septum & polyps taken care of as well.) I was even given numerous masks to try.  It was all for naught.

Now, I am trying therapy again.  My new machine has a built in humidifier.  Last week when I first started using my machine, the setting for the humidifier was around a 4 I think.  I was getting awful dry mouth.  My gums were killing me.  (I don't have great gums btw anyway).  After a little research I increased the setting on my humidifier.  I kept going up until I got too much condensation in the tube and mask.  So then, I went down a number.  I have found that at a setting of 7 I no longer suffer from dry mouth.

The humidifier may be an obvious thing to everyone else to adjust, but I had no clue about how it MIGHT help.  Thankfully for me, it did.

Regards,
Plmnb


RE: Extreme Dangerous Dry Mouth - ApneaQuestions - 12-16-2019

(12-16-2019, 05:39 AM)Swindonian Wrote: Thank you for both of your responses...
You're welcome.  I was just sharing what I figured out from my journey looking for answers. It takes a lot of reading and digging so I hope I saved you some time.

One thing I didn't mention is the "Saline Sinus Rinse".  It's basically a squirt bottle where you mix some salts with distilled water and squirt up one nostril and down the other. Then switch to the other nostril. Alternate and repeat until the bottle is empty.  Although you can make your own mixture with purified table salt and bicarbonate of soda, the premixed sachets are inexpensive and have a known ratio to ensure a good PH balance that prevents any discomfort.  At the very least, this gets fluid into your nose. It will also clear out any debris and has the added benefit of rinsing out pollens if you have an allergy issue.  Google "Neilmed" from Boots.

The first step (for me) would be to get an ENT nasal probe to see exactly what (if anything) is your primary root cause of blockage.


RE: Extreme Dangerous Dry Mouth - ApneaQuestions - 12-16-2019

(12-16-2019, 05:39 AM)Swindonian Wrote: ... my benign prostate just keeps growing ... 
This is one of the reasons why PAE (Prostate Artery Embolization) can be effective... especially if your prostate is larger and therefore highly vascular.  In simple terms, the procedure blocks the artery to each side of your prostate and the lack of blood causes the tissue to die off and the prostate reduces in size.  The bigger the prostate, the better the outcomes (typically).
The improvement from TURP is usually more significant in the short term (first few months), however, in the one year time frame, the benefits of PAE catch up and become very similar to the symptomatic benefits of TURP without all the side effects.   Recent papers are now showing fairly good results persisting into the 5 year follow up period.

The PAE procedure is not done by a urologist, it's done by an interventional radiologist. For that reason, some urologists subconsciously feel that they are in "competition" with the upstart interventional radiologists... hopefully that won't be the case in the UK because of the State-funded NHS system which (hopefully) avoids these competitive mindsets.  If you feel any push-back from the urologist.. bear this in mind and do your own research.

BTW I am not medically trained.. I just read a lot trying to figure out what's going on.  I used to believe that "Doctor knows best"... as I got older I began to realize that the time-constraints that doctors are under tends to result in hurried office visits that are too short to cover all the possible interventions that are available. Do your own research and be your own best-advocate.

Sorry I forgot to mention the humidifer thing. A heated tube can help if you start to get condensation in the tube and squirts of water into your face. The UK has a damp climate so the humidifer may be less effective for you.... but it can really help a lot for people in drier climates.


RE: Extreme Dangerous Dry Mouth - Osiris357 - 12-16-2019

I have the same issue with full face. My work around for that is using a heated hose in manual mode. I turned up the humidity and hose temp to just below rainout conditions. I have my resmed on 6 out of 8 for humidity and I have the hose temp on 86. That’s kinda warm for some but it perfect for me now since it’s cold outside. Summer may be a different story. I see you have an older PR but I think I remember seeing a heated hose compatible with that. 

Or an alternative would be to go to a fabric store and buy flannel and wrap the hose enough to stop rainout so you can turn up the humidifier. I have never tried it but I almost did before buying my current heated hose


RE: Extreme Dangerous Dry Mouth - sonicboom - 12-16-2019

If you do try turning up the humidity manually (instead of using the Auto setting which would for most eliminate rainout) there are many hose cover alternatives available online that will help the risk of rainout. I use a fleece hose cover and it works fabulously.


RE: Extreme Dangerous Dry Mouth - ApneaQuestions - 12-17-2019

I just thought of some other options I forgot to mention earlier on trying to help air flow through your nose.

You can try "nasal strips".  These are semi-rigid self-adhesive strips that hold your nostrils open slightly.

https://www.breatheright.com/how-to-breathe-better/how-breathe-right-nasal-strips-work.html
( ... other brands are available)

These helped a little for me but I stopped messing with them after my septum/turbinate fix.

There is a similar, but different, gadget I tried that helped a little but not enough to keep me interested
I tried the "mute" brand but there are other brands too.
google for "nasal dilator"
Here is the mute brand
https://www.google.com/search?q=nasal+dilator+mute