BLUF: Is there a connection with Rhinitus, Sinusitis and Sleep Apnea?
Background:
I'm an Iraq War Veteran who spent time around burn pits, and the not so fun stuff found in the sand over there. I immediately had breathing issues upon returning in Dec 2008. Didn't think much of it, as many people said it was just from breathing the crud in the sand and would pass. A year later it didn't pass. Went to the VA doctors starting later 2009, and began the painful process of trying to figure out what's going on.
From 2009-2015, I only had issues while laying down. If I was standing up, I was fine. If I laid down, my head was always stuffed up like I had a head cold. I had multiple allergy tests that came back negative. This would happen every night, no matter where I was and symptoms would clear shortly after getting up. I had two in hospital sleep studies done, which came back negative for sleep apnea. I question these as being hooked up with all the wires, and trying to sleep in an unfamiliar place was not working. I barely even fell asleep, and even the technicians conducting the tests said the same. The doctors responses were "you didn't snore, so you don't have sleep apnea".
For years, I kept getting the "we don't know what's wrong with you" from the VA till about early 2015. I had been diagnosed before with non-allergic rhinitis, and allergic rhinitis which they always discussed. I tried many nasal sprays, but they had minor effects. Reviewing my records it shows I have had chronic sinusitis for years, and it was noted as being present in multiple MRIs (Ethmoid, and Maxillary). The VA ENT doctos never said a single thing about it, and after 7 years they still have never checked me while laying down when I said the symptoms are primarily present.
I had turbinate reduction surgery in August 2015. While air flows through my nose better, the head stuffiness while laying down became much worse. I get a runny nose constantly, and usually wake up with crust in my nose (sometimes bloody). By Jan 2016, it became to where I started getting the symptoms while standing up. I can't go running anymore, because I get instant headaches, and feel pressure between my eyes. I told this multiple times to the ENT doctors, and the answer I received was "we cleared your nose out, we don't know what it is". Doing my own research, looking at the symptoms and area I highly suspect it's the ethmoid sinusitis. Everything seems to match up as far as the pressure.
I had another sleep study in May 2016 (take home study), and was diagnosed with mild OSA. The VA gave me a CPAP machine. Now, the whole reason I had the sleep study done was of because of how the Rhinitis (and Sinusitis) affected my sleeping, not a concern for snoring. The CPAP actually helps my symptoms. While using it, it keeps my head from becoming stuffed up. I've tested it, some nights with others without, and some nights where I use it on and off. Every result is exactly the same. Using the CPAP, no symptoms and stuffed head without it.
I tried talking to the VA ENT doctors, and one outside DR (who I found out was trained by the same VA DRs). I asked them if my rhinitis and sinusitis is possibly causing my sleep apnea. They say it's completely impossible, and there is absolutely no way they can be connected. To be clear, this wasn't specific to my case. This was in general, that it's impossible for anyone to have rhinitis or sinusitis linked to sleep apnea.
Can Sleep Apnea be secondary to Sinusitis/Rhinitis?
Weather is be from swelling of the nasal area causing sleep apnea to be worse than it would normally be? Mucosal inflammation, or just mucus from sinuses draining to throat?
It's just hard because the actual doctors I see say no, along with "we don't know what's wrong" after 7 years. Yet, others say yes.
Sources:
- https://sleepfoundation.org/sleep-topics/sleep-related-problems/allergic-rhinitis-and-sleep
- https://www.ncbi.nlm.nih.gov/pubmed/19663122
- http://sleepne.com/from-the-desk-of-dr-lynch-allergy-newsletter/
- https://www.wakeuptosleep.com/blog/2014/03/allergies-and-sleep-apnea.html?support=false
- https://www.ocf.berkeley.edu/~dshuster/OSA/Staevska_2004.pdf
- http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.490.5496&rep=rep1&type=pdf
