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Great Insight - Jeremy H - 04-29-2021
After all these years, years, last night I made an amazing revelation. Your going to think to yourself "dduuuuhhhh???"
My problem is during exhale, my uvula acts like a stopper and stops me from breathing out. I've also noticed that during the night, most of the time, not both nasal passages are open, when one closes, the other opens. I use a nasal mask. I've made these round openers, out of plastic tubing. They help open up my nose overall during the night. Without these, my cpap becomes mostly ineffective. I mean, if your nose is blocked up, how can you breath? Increase pressure? So it hit me, without open nasal passages, cpap therapy becomes ineffective.
What can be done about this? Breath right strips are useless. Can you recommend a brand nose passage opener WITHOUT essential oils? Why do they put that crap into them anyway. Or maybe a nasal passage cleaner?
RE: Great Insight - Sleeprider - 04-29-2021
I use Flonase at this time of year. I can be used long-term but takes some time to reach an effective level.
Regarding your uvula, do a search for "palatal prolapse". This is a condition where the soft tissues of the palate actually prolapse and block nasal exhalation. It has a characteristic appearance in you Oscar flow rate chart of a normal inspiration wave followed by a spike of exhale that is followed by zero flow as air is shunted to oral exhale.
RE: Great Insight - Jeremy H - 04-29-2021
I'm sure that's what it is technically. Point beings, how can I improve the opening of my nasal passages so the pressure can get to and open my airway. When my nasal passages are open more often, I sleep way better.
Cpap can't do anything if it's blowing up against a closed nasal passage. Might as well shove cotton balls up my nose and wonder why the cpap is not working.
I don't believe in prescription drugs. Natural way is the only way to go. Side effects are not worth it. Ever read the potential side effects of flow nase?
RE: Great Insight - Sleeprider - 04-29-2021
With palatal prolapse the problem is in expiration, not inspiration. I don't know a good answer if that is what it is. Can you perhaps post an Oscar chart for a full night, then isolate where you think the problem occurs?
RE: Great Insight - SevereApnea - 04-30-2021
Hi Jeremy,
All good points.
Your profile says "nasal mask" and pressures "unsure". Are these still current?
I assume you have tried the nasal pillows like the P30i? these have their own built in "plastic tubes" you mentioned.
I, and others on this forum, have found that the P30i or similar blow the nasal passage open (and yuck factor warning: can also help clear the mucus)
I too have stopped using Nasonex (similar to flonase/whatsit) on a daily basis, for reasons different to those you mention.
But I do find using normal saline (NaCl) spray into the nostrils in the hour or two before bedtime helps loosen things. Can't get more natural than that: normal saline!
By the way, it is normal physiology for one's nasal passages to vary in the degree of turbinate congestion during the night, some say in 90 - 120 minutes cycles, so that is normal. Internet search for something like cyclical nasal congestion.
I think SR is dying to have a peek at some of your charts! I have no idea, but if it is Palatal Prolapse, perhaps some adjustment of your pressures might help your particular problem?
RE: Great Insight - Jeremy H - 04-30-2021
I don't have machine that is supported by Oscar. Pressure now is set to 5.5. What I meant to get across is when my nose is clear, open, I don't have trouble exhaling as much or at all. By the time the pressure gets past my nasal cavity into my airway, the pressure is reduced because I can only breath through 1 nostril, or partially through both. See my point? The therapy is not getting into my airway at the pressure set on the machine. And it's different every night. I'll try the saline spray, good idea. Looking into a pillow.
RE: Great Insight - SevereApnea - 04-30-2021
I see, I didn't realize that about your machine.
Pressure of 5.5 is quite low for most people. I generally find 4 - 5 too low for me, for a long time I thought lower pressure was better, but I am now trialing 6 -10 and finding that better.
Without charts / data it is going to be hard to make a suggestion. I do understand your explanation of not enough pressure getting past your nasal passages to keep your soft palate from blocking on exhalation. I have no idea how much pressure exhalation can generate, but yes if it is higher than that coming in via your nose it might cause the soft palate to bounce/ move up. You mentioned a pillow: yes, I find a flatter pillow is better, but can be hard to get used to.
Nasal congestion: Just another thought: mine is made worse by certain foods late afternoon/evening: dairy, cream, chocolate etc, all the good things in life. Oh well, Ok then, I will have just mine in the morning: I prefer a good sleep to .
Would a full face mask (FFM) bypass the whole nasal passage saga? Don't know, I do use a FFM and really like it. Trouble is at different time of night I might breathe nose/nose, nose/mouth, mouth/mouth, mouth/nose: no control over that while sleeping, but may be worth trying for when your nose is feeling congested?
All the best.
RE: Great Insight - Sleeprider - 04-30-2021
The solution is to blast that nasal airway resistance with direct pressure from the nares (nostrils) using a nasal pillows mask like the Resmed Airfit P10. Even when I have severe congestion, my P10 expands the nasal passages and sinuses and helps with drainage and full ventilation follows. A nasal mask applies CPAP pressure both inside and outside the nose, so it can't expand the airway in the same manner. Nasal masks also apply pressure along the sides of your nose where your sinuses get pressured and obstructed. Try a nasal pillow mask and use the Flonase as needed to keep open during allergy season, and you will have a very different experience.
RE: Great Insight - multicast - 05-01-2021
For that nasal thing see https://en.wikipedia.org/wiki/Nasal_cycle
RE: Great Insight - Jeremy H - 05-01-2021
You guy's are great man! Maybe your dreaming of Willie Wonka's factory, swimming in a sea of dark chocolate and nuts. That would keep me awake dude. My supplier might allow me to 'try' a nasal pillow, and return if it's not working. You say it takes getting use to, is it uncomfortable? More so than a nasal mask? I'm going to up the pressures to 6 tonight.