CorruptAlligator - CPAP Problems

[John70]

Hello CA,

I can vouch for cooler sleeping room. I typically turn the AC on at least a hour before bed. 

I have a humidifier attached to my furnace and my CPAP machine. I use the manual setting on CPAP at 6 or 8 if humidity gets too low. We live in a desert, so it is important to maintain humidity level of at least 40%.

Lastly, I use Xlear nasal spray mostly every night. Also, I do breathing exercises that you can find on youtube. 

I hope that helps,

John

[SarcasticDave94]

If you need a nasal spray, do some checking into getting Flonase.

[CorruptAlligator]

Thanks John and Dave. I was prescribed Flonase, but wasn't sure if it's bad for me to use it on a regular basis. I have GERD and I'm sure contributes to the sinus issue when lying down.

[SarcasticDave94]

I've got GERD and have used scripted Flonase in the past. I quit Flonase as it wasn't helping with COPD symptoms. I'd consider trying it despite GERD.

There should be over the counter and scripted strengths.

[CorruptAlligator]

Quick internet search tell me that fluticasone is a steroid which is known to lower immunne response:

corticosteroids lower your immune response and may make you more susceptible to respiratory infections

[Sleeprider]

During allergy season I use Flonase and have recommended it to others. The side effects are nothing I have ever noticed, and I find I can move in or out of Flonase as a therapeutic without any impacts. I don't know if it actually lowers immune response to anything, but it's not anything I have noticed. It clears sinuses during allergy events, and does not have a rebound effect. Pretty mild stuff.

[SarcasticDave94]

I had tried Flonase in 2016-17. I myself was told there's supposed to be very little side effects, none of which impacted my immune system. It just didn't help my COPD breathing symptoms, which is why it was prescribed for me. So doc and I decided we'd go to COPD inhalers instead.

[Geer1]

Nasal steroids aren't much of a concern and are used long term by many people. I used dymista (steroid/antihistamine spray) for a while and it helped a bit but what actually improved my congestion and LPR (similar but different to GERD) was diet modifications. I found out that dairy was causing/worsening both congestion and LPR significantly. I think SIBO might have had some effect on this as well. If you are having other digestion issues I would recommend trying elimination diets and maybe SIBO testing if you think it might apply.

I also feel that the main improvement I get from PAP is also reduced nasal congestion due to increased humidity. I have non allergic rhinitis that definitely acts up more when not using PAP. I recently had nasal surgery and have noticed that the nasal steroid rinses definitely help with this as well (more so than dymista did back in the day) but I don't know that my current steroid use is recommended long term.

[CorruptAlligator]

I guess cause of GERD is personal like allergies? I don't know if it can be called GERD if the trigger is different for everybody. That would technically be allergies?

There's probably a trigger for my GERD as well, and I need to figure it out. What is causing the sinus issue when I lay down at bedtime. Humidity from the CPAP helps alleviate it however.

[Ratchick]

GERD can absolutely have different triggers without being an allergy. Many disorders have different triggers or causes. Allergies are a very specific immune response and a lot of things that people THINK are allergies (like getting diarrhoea from antibiotics, or yeast infections) are not actually allergies, they're just side effects. Ditto lactose intolerance isn't a food allergy, it's just that you lack the enzyme to break down the sugar in milk. Dairy allergy is where you make antibodies to the proteins in milk. And while lactose intolerance is uncomfortable as heck, milk allergy can be deadly.

Re: corticosteroids in nasal sprays and inhalers - the general consensus is that they don't cause the same problems with immunosuppression as taking oral, systemic steroids because the low doses only act on the immediate area of effect (so, the surface of the airways or nose lining) to reduce inflammation. There's no real evidence that using them compromises your immune system though, which is why they can be purchased over the counter (at least the nasal sprays can in the UK).