I started using CPAP for OSA in late 2011. Started with full mask over nose and mouth for 1st couple of months. Even though I got used to it, it didn't seem to help so I changed to nasal pillows. 1st 2 nights was a very big difference and was excited. In coming months started having sinus issues which I have never had before. I normally have the humidifier part on machine set to 7 and have increased to 10 (high setting) and had tried nasal rinse. Went to doctor and he had given me antibiotics...tried for while and didn't seem to help.
Then in 2013 had been diagnosed with sinus infection and had sinus surgery. Off CPAP for a while healing. Sinus' seemed better until I went back on CPAP. Finally In early 2018 I had stopped CPAP and tried a different option. Snorex mouthguard which did help with OSA some but not near as much as I expected.
Now new year and need some advise and what I can do next. I want to try full face mask again but even though I have a goatee, couple of people said leaking won't happen if I keep it trimmed short....however I did this when I started in 2011...didn't notice leeks but didn't seem to help with OSA.
Thanks in advance on suggestions. Dave
Hi BrightOliveAlbatross1947
You have been using CPAP for a long time!
What were your numbers at the start and what are they now?
I'm trying to track down sleep study results from 7 years ago but I think I remember diagnosed with moderate/severe OSA (25-30 episodes per minute). Have to verify when I find documents.
As for now, I tried logging on to account online that is connected to my latest CPAP machine and tracked nightly results...Appears to be gone now as a year has elapsed since last CPAP use. What I do remember is that results were much better (episodes, mask leakage etc)
I am not sure there is any reason a nasal pillow mask would cause sinus issues any more than a full face. My son has a full beard but still uses a full face. His leak rate is higher than average though. My thoughts however would be to use a nasal pillow and mouth taping if air leaking out of your mouth becomes an issue.
Are we talking about same nasal pillow as mine...mine is not a mask but a spongy rubbery pillow with 2 openings that fit right into nostrils. Are you talking about a mask that looks somewhat like a full face mask but smaller that just covers the nose area? If so, my nasal pillow appears to be where air is blown directly into nose where mask sits away from nostrils more.
I had been wearing a chin strap specifically made to keep mouth shut so no leaking through mouth.
There are different types of nasal pillow masks. I use the ResMed AirFit P10. It has a couple of double layer cone shaped pieces that fit into your nostrils. My wife uses a F&P Brevida. It also fits into each nostril but also fits around the nose a bit. DreamWear has two types of inserts that can be used with the same frame and headgear. I have not tried them, but others report they are good. One insert kind of fits under the nose and has a single wide oval opening in it. They call that the nasal version. The other is a more conventional nasal pillow prong type with gel cushions.
The P10 is probably the least expensive of the choices and the most popular. The main drawback is that the headgear is flimsy. But, if you use a chin strap and put the mask on first, and the chinstrap second, that keeps it in place. I use the Breathewear Halo chin strap with the P10, but I still get mouth leaks, so I tape my mouth too.
What CPAP machine are you using? The ResMed and DreamStation machines have an optional heated hose. When used at least the ResMed can be set in Auto for humidity. I find that quite comfortable and does not dry my nose out. I suspect the DreamStation does the same, but I am less familiar with it.
We sometimes connect dots that were not meant to be connected.
It's easy to picture lots of humid air causing sinus issues but I had sinus issues for many many years before I got a CPAP machine and probably have less now.
The 'experts' seem to consider that dry air might carry as much or more risk than humid air.
That's my philosophising and stirring done. Now for the radical diversion;
What else can I add to the humidifier other than just boring old water?
Peppermint oil? Eucalyptus leaves? Antiseptic?
Something that smells like roses and turns the water a pretty pink?
Should I add "Don't try this at home" in anticipation?
In my case, I don't think it was the too much humid air but instead not enough. When I dropped humidity level on machine things seemed to get worse. As mentioned, I've been off CPAP for close to a year now. Within that time, one of the things I tried doing for sinus relief (feels like permanent low grade flu) is go to the gym and sit in a steam room there that has eucalyptus in steam....also like the sweat I do after workout. Does some good for sinus relief but only temporary. On dec 22nd 2018 I went back to go in steam room but it was closed for cleaning for a week. So I went into dry sauna....seemed to have some negative effect. I then went on dec 24th back to gym in dry sauna....bad decision. Shortly after when going to xmas with family, sinus' acted up big time. Worse than it ever has in a long time. Eyes watery and puffy feeling around eyes/nose for a couple of days. Went back to sauna steam room when opened back up....felt better.
So with that, dry air bad...humid air good, but not to the point I would hope.
In addition to my individual replies above...……..Most dr's outside of my family physician think that sinus issues starting shortly after start of CPAP was purely coincidental. While couple others that I talked to knew somebody had sinus issues while on CPAP...also read similar situations to mine online. So the coincidental aspect is very hard for me to accept. For 45 years, no sinus issues then start CPAP and issues start.
Now I didn't mention something yet that I'm going to be reamed on....I'm a smoker. So thinking at least a little bit, coincidence may not be the issue. I've smoked for years but no sinus issues. But could it be smoking & CPAP together is causing issues? At first I thought well I know 2 people personally that are on CPAP and smoke (more and longer than I) that don't have same issue. Common denominator, they use full face mask and I use nasal pillows. So I thought last couple of days hard on what I need to do.
1) Quit smoking. For those that don't smoke, believe me and others that have tried, it's extremely hard. But I need try again and wife and I are discussing both quitting.
2)Have had periodic appointments with pulmonary drs in last 7 years. On only 1 of those did I have the same dr. Wondering if trying to see if I can start seeing same dr consistently would help.
3)Try finding and alternative to CPAP...tried the mouthguard and that isn't working that good. I wonder if there's different masks that would be more helpful....other than nasal pillows and full face mask I started with.
So most might say that #1 above will help significantly and everything will fall into place. I would tend to agree but need to address even the small items for success
It's a very challenging list Dave but well worth it.
I've no personal experience with smoking issues but I have loved ones who struggled with it trying, failing, trying again, failing again but eventually succeeding so I know it's not an easy task you have set yourself. I wish you the very best and know that you can do this if you want it badly enough and don't give up on yourself.
Because I have memory and fatigue issues I put together a very brief medical history (single page) well in advance of significant appointments and give it to the doctor. It helps them connect the dots and it saves time and misunderstandings. It also gives them confidence in their own analysis and suggestions.
Finding an alternative to CPAP is a goal that needs to be pursued more often and with more determination by all of us so hang in there and I'm sure there will be more discussion of that particular aspect of your goals as well as the pros and cons of various masks in the days to come.
I am a dentist working in dental sleep medicine. The snorex mouthguard is intended for snoring only and is not intended to treat obstructive sleep apnea. If you tried a high quality sleep apnea appliance, like the DreamTap, custom made by an experienced sleep dentist, chances are that the results would be sufficient. Of course, you are paying a lot more money, but, in this case, you get what you pay for and the sinus issues go away. Arthur B. Luisi, Jr., D.M.D.
So even if snorex helps with snoring, doesn't necessarily mean it helps with OSA? My main drawbacks is trying to get used to and wake up with sore bottom front teeth, although temporary.
DreamTap appears to be same type of technology (moving mouth bottom forward) and higher quality. Sounds like mouth piece impressions are done by qualified sleep dentist where snorex is done at home by me (not qualified). Snorex box does say not to use if I have crowns and peridontal issues etc. I have both but periodontal issues getting better. I have appointment with dentist in early Feb and will ask him about this.
Also, will this help if I had been diagnosed with moderate/severe OSA 7 years ago?
My understanding is that success with an oral device is most likely with mild apnea, and sometimes is achieved with moderate apnea. With severe apnea you may get a reduction, but not likely full relief from apnea. Just my thoughts as an observer, not a professional. Here is a link that you may find helpful. It includes a pdf document which compares the various oral devices.
Most oral appliances work by protruding the mandible to open the airway. The OTC anti-snoring appliances have a lesser level of protrusion because they are dealing only with snoring and must appeal to a diverse audience of patients. Typically, you must obtain a much greater level of mandibular protrusion to treat moderate to severe sleep apnea. This is why you need a quality custom appliance carefully adjusted by a professional sleep dentist to exactly the right level of protrusion for each patient. American Academy of Sleep Medicine recommends oral appliances for both mild and moderate OSA and a high quality appliance works pretty reliably for both levels. For severe OSA, an appliance will give full resolution about 30% of the time and, in other cases, partial resolution, which may or may not be of practical use to the patient. Patients must understand. however, that there will be a significant number of clinical failures at any level, so success is not a certainty, any more than it is for CPAP. Arthur B. Luisi, Jr., D.M.D.
