Sinusitis and Cpap Use

[jimk4490]

Hello, I often get a long lasting sinus infection (> 6 weeks) after each cold or flu. Should I stop using my cpap until the sinus infection clears up? Or should I turn off the humidifier? I do nasal flushes (neti), sinus massages and take good care of my health and diet, all to no avail. It seems I have a weakness that each cold ends up as a sinus infection lasting about 8 weeks or so.

[Homerec130]

The BEST route is to talk to your medical person about this and whether or not you should use your CPAP. A lot depends on the severity of the sinus infection and the severity of your sleep apnea. You should inform them about your CPAP use and concerns. I am not sure if you are seeing a GP or not. If you do not have one, I would recommend finding a good ENT (Ears, nose, and throat) doc who can advise you better. I am lucky as my ENT is also my sleep doc. They may be able to determine why you have so many sinus infections and may be able to find a treatment that would knock them out completely. Choice of meds may help. For example, Z-pac antibiotics don't work for me, so my docs prescribe the traditional antibiotics. Make sure you take the meds as directed and not stop early.

From a personal standpoint, I have always been prone to sinus infections and still continue to use my CPAP device while fighting them. You have to be sure to clean your mask and other equipment more often. I do not make any changes in my humidifier and essential soldier through it. However, when the infection clears up, I do swap out the mask for a new one. (I have plenty of spares).

[jimk4490]

Thank you Homer. I do not have an ENT and my regular doc does not seem to know quite what to do. He told me a cold virus dies after 10 days, but then another virus can spring out of that, that can last months in your sinuses. Wow, that is not good.  I did the traditional antibiotics after 9 days of the cold. I don't want to do any more antibiotics or even nasal spray. I figure somehow my body needs to know how to defeat these viruses that linger in my sinuses.

[Melman]

If your infections are viral antibiotics will not help and are a waste of money. If your doctor believes your infections are viral and prescribes antibiotics you should find a doctor with some understanding of microbiology and infectious diseases. Sorry if I'm lecturing but as a microbiologist I know that unecessary use of antibiotics is a major contributor to development of antibiotic resistance in bacteria which is a major problem.

[jimk4490]

The doctor explained to me that most of these are viral, and hence the ABs won't do any good. But we tried it anyhow. I don't think the doctor can tell if they are viral or bacterial.

[Brazen]

If your doc can't/won't differentiate the most likely cause of infection, and gives antibiotics while suspecting viral infection, you need a new doctor.

It's actually quite common for a viral common cold to create the perfect snotty environment in sinuses for bacterial overgrowth.
The body fights off the virus, usually within a few weeks but viruses don't have to follow that time-line, and then the body gets to try to fight the bacteria that took advantage of perfect conditions to grow amuck.

You have to do everything you can during a viral cold to make the environment less friendly for bacteria. Reduce the snot. More neti rinses, decongestants, drink more water.

Talk to your sleep doc about whether you should use the cpap while fighting infection. 
I suspect the answer is to still use it, clean the cpap equipment more often.

[jimk4490]

How can one tell if it is viral or bacterial?

Thanks, Jim

[Brazen]

The best way to tell the difference between viral and bacterial (or fungal) infection is experience, a medical degree, physical exam, and/or lab tests. 

Sometimes it's clear-cut (eg: bacterial UTI) but respiratory congestion can easily be either. Tests can rule out some things, like covid, flu, RSV, strep, and time-line of illness also gives clues.

Bacteria sinus infection often occurs after the symptoms of a cold have started improving and the person is left with weeks of sinus pain.
Lingering green phlegm also hints toward bacterial.

[jimk4490]

Thank you. It's a real conundrum then, isn't it? Say you had a cold 6 weeks ago, and 4 weeks ago went thru a course of amoxicilin, and have a lingering sinus drip.  I have had many doctors tell me it's difficult to tell if it is bacterial or viral at this point. So if one wants his/her immune system to beat it on its own, then one would want to not take any more ABs (antibiotics). But if it is bacterial, then ABs would be just the thing to take. Thank you so much for your kind reply. ..--Jim

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Oh, and PS, one more thing. Last night I tried not using my CPAP, as I feel it pushes on my sinuses and may be hindering the healing process. I'll try this a few more nights and see what happens.

[Homerec130]

Just to muddy the waters even further... Are we sure these are infections, viral or bacterial, or are they allergic responses? Have you been tested for any environmental allergies or have you charted out when you have your infections? By this I mean, is there anything in your life style or environment that coincides with your sinus issues? My ENT had me do this leading up to my allergy tests. It essentially helps if the issues are somewhat seasonal and helps determine what you need to be tested for.

As I have chronic draining sinuses, I use either a basic saline spray to keep the sinuses moist and when it gets bad I use a flonase type spray. Bear in mind, it takes a bit for flonase to be effective.