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Enlarged turbinates, and mild positional OSA, advice?
Enlarged turbinates, and mild positional OSA, advice?
This is my first time posting. Last January I had trouble sleeping. I eventually got a sleep study test completed and it came back as me having a mild positional osa (5 ati) while in supine. I barely made the classification.  Since the test, which was taken on April of last year, I have noticed something else happening. The turbinates in my nose become so engorged at night I can’t breathe.  I have not slept through the night in a year now.  I wake up and I can’t get back to sleep because my body has forced me up and is stimulated from feeling like I’m choking. 
I use otrivin saline congestion solution a lot as it is not habit forming and it works most of the time. 
I went to an ENT and the doctor said I had enlarged turbinates and a deviated septum. It wasn’t much of an examination and more of a quick glance. He recommended surgery with microdebridder for turbinate reduction and a deviated septum repair. The surgery won’t be for months, probably April or May of this year. 
I suspect I have UARS (upper airway resistance syndrome).
I am asking for advice and what to do in regards to the turbinates. I have been trying to figure out why they react at night and I know it’s normal for them to grow through the nasal cycle at night, but I wake up almost gasping for air with my nose plugged. I never had this problem before. I am looking into allergies.  I am looking into food sensitivity and intolerances as I read online they may be exasperating things. It’s only one side that plugs but sometimes I need to use a decongestant to clear it up. I’m worried about decongestant use due to rebound affect. I also end up sometimes taking something to help me get back to sleep, like a lorazepam, and don’t want to become addicted to benzos. 
I have raised the head of my bed,  I have a mandibular advancement mouth piece, nasal dilators, breathe right strips, humidifiers, a noodle to stay off my back, a wedge pillow, I have also tried steroids which seem to make me wake up and my heart race, and there is nothing I am doing that seems to have any impact. 
I feel the turbinate issue separate from the sleep apnea issue but is contributing with constricting airflow and then waking me up. 
I am getting not many hours of sleep and it is impacting everything. 
I was recommended a cpap but my insurance won’t cover it and I have just been laid off my job. I am trying to make it work but it is draining my reserves. Also I hear with enlarged turbinates, CPAP isn’t the most successful. 
I lay down and shortly later my nose is plugged.  I wake up with at least one nostril completed plugged. 
It is really impacting the quality of my life and I am pleading with anyone who has some kind of hopeful experience with this. I am doing an elimination diet to try to focus on what could be contributing to the mucus build up in my turbinates. 
I am hoping someone can offer me some advice to help deal with the turbinate issue.Any help would be beyond appreciated. Thanks!
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RE: Enlarged turbinates, and mild positional OSA, advice?
A lot of people successfully use CPAP with nasal pillow masks like the Resmed Airfit P10. This applies air pressure directly to the nares and helps inflate the nasal passages. It makes a huge difference for me. Another way to reduce inflammation and improve nasal air flow is to use something like fluticasone propionate (Flonase) nasal spray. As far as a CPAP machine, if you are able to afford used, a Resmed Airsense 10 Autoset would be ideal. It has exhale pressure relief, so it works like a bilevel machine providing higher pressure during inhale and lower pressure during exhale. The "feel" is very comfortable and helps overcome flow limitation. Canada is a tough nut due to the social health care, it can be hard to get a machine through the provincial health plan. If that is a dead-end, a used or new machine can be purchased online. It is a terrible time to be looking due to a shortage caused by a recall of Philips Respironics machines that has literally doubled the price of new and used equipment.
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RE: Enlarged turbinates, and mild positional OSA, advice?
What you just described is identical to my situation. This is my procedure. I take a hot shower 2 hrs before bed time and concentrate of cleaning out my nasal passages with water real good. Then use fluticasone Propionate 50mcg as soon as I get out of the shower. One spray in each nostril. It works wonders.  I have enlarged turbinates and a deviated septum also, had a allergy test, went to ENT the works.
Dreaded the surgery, then I tried this method with great success.   

If you try this, be patient because it takes 2 or 3 days for full effect of the nasal spray.

You can buy it own Amazon in a 3 pack.  I put off the surgery since I started doing this, it really helps.
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RE: Enlarged turbinates, and mild positional OSA, advice?
I will check it out. My doctor recommended Avamys spray and I have been trying that. 
I am nervous of the surgery as it appears most people have to get it again later on and then the concern over ENS that makes it even less appealing. I’ve read online of people saying their turbinates shrunk on their own due to diet restrictions. I am praying this is true. It’s been torture. I feel like a ghost some days from lack of sleep. I really appreciate your advice. Thanks

Thanks for the advice. I will look into that machine. I appreciate rhe help.
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RE: Enlarged turbinates, and mild positional OSA, advice?
I was in a similar boat. Nasal rinses and every kind of nasal spray you can buy. The best nasal spray that doesn't cause rebound issues is dymista. If you can't get relief from an antihistamine or steroid on its own ask to try dymista.

My congestion improved significantly with the removal of dairy from my diet and it allowed me to come off sprays. I did end up getting surgery after that which also helped a bit. I still get the odd congestion but nowhere like I used to and it has probably been at least 1.5 years since I have used a nasal spray other than when recovering from surgery. I think the gut plays a huge role in nasal congestion and one thing I have noticed on here is how many people have the same issues, apnea, IBS, reflux, congestion...

CPAP helps my congestion, I think it is the extra air flow and humidity. I have actually been told I don't have apnea anymore but CPAP does help me sleep better and I believe a big part is how it helps my nose. Before CPAP I used to have a dry crusty nearly bloody nose all the time and I haven't had that since starting CPAP.
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RE: Enlarged turbinates, and mild positional OSA, advice?
I agree with Geer1, the cpap with humidifier helps. Even if I’m a little clogged up, within 5 min the pressure and moisture open up my passages and I’m good to go.
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Somewhat of a solution
So I have figured out something to make due int he meantime and may help anyone who is struggling with enlarged turbinates and not having access to cpap or saline rinse.

I jimmied this contraption, a string with some tape that mimics the Collette maneuver.  I now have been sleeping with a single string with a knot on each end and tape placed after the knot on my cheeks, so that it spreads my nasal cavity open.  It works well.  I mean the head of my bed is still elevated, but I haven't had to use any nasal sprays or anything.  It works really well.  I can't find any working models on the internet that spread the nasal cavity open laterally from the cheek bones.

Anyway, it is a cheap, albeit an unattractive way to help get your sleep back.  I thought I would share.
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RE: Enlarged turbinates, and mild positional OSA, advice?
I assume you have also tried the nasal strips?
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RE: Enlarged turbinates, and mild positional OSA, advice?
I have tried the following:
Otrivin saline for congestion which honestly worked the best out of any saline spray and no rebound effect
Nasal dilators - mute as well as the cones of various sizes - always still woke up with enlarged turbinates
A noodle to keep me off my back - no success with turbinates
Otrivin medicated - this worked well but was worried with rebound and use it sparingly 
Breathe right strips - did not have it 
Elevated head of bed - this worked well but not all the time 
Neti pot - got my sinus’ clean but did not impact turbinates later in night 
Steamed water breathing in - this cleared my congestion but wasn’t realistic early in the night 
Antihistamines - Clairtin 20mg it worked mildly but did not control the problem. I still woke up but symptoms weren’t as bad 
Mandibular device - a retainer that pulled my bottom jaw forward but did not change anything. 

It was so weird because it was all of a sudden an issue waking up being unable to breathe. I don’t know what changed or turned but it just starting happening. 

The only thing that keeps me from waking up for the most part is the contraption with the string and tape based on the Cottle method. I think because it expands my nasal cavity and seems to aid in allowing the turbinates to drain efficiently. I don’t know why it is working but I’ve been getting 8 hours sleep a night since doing it, albeit I look ridiculous.
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RE: Enlarged turbinates, and mild positional OSA, advice?
Hi Cblink19,

Thanks for the info. I might be facing the same issue. Would you happen to have a picture of the Cottle string contraption you made?

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