Sleep Apnea and Sinus Issues

Hello Everyone!

I am just beginning my journey with suspected sleep apnea. I just had my second sleep study done and haven't had the follow up with the Doctor yet, but I'm anticipating a diagnosis of sleep apnea in some form or another. I'm not overweight but I do have a very retronagthic (small jaw, no chin) face.

My question for research is how do chronic sinus issues play into sleep apnea? I live in an area notorious for sinus and upper respiratory issues such as allergies, asthma, COPD, etc. I started having a chronically runny nose in my 20's (I'm 36 now). Eventually it got bad enough I went to an allergist. Between two different allergists (I moved in there), I was being treated for over 4 years for allergies (shots, nasal sprays and antihistamines) with very little results.

I'm wondering if chronically inflamed/irritated sinuses could contribute to making sleep apnea worse?

Welcome SleepyKitty! What a good topic. Of course your doctor who has looked at your entire airway can answer those questions best. There are many research studies trying to find ways to figure out just where the obstruction in obstructive sleep apnea (OSA) is, which of the places where there is obstruction should be fixed first, what causes the obstructions and what the best ways to fix the various types of obstructions. The answers are very individual. Each person comes with a unique mix of apnea causes and their own apnea pattern.

It will be interesting to hear other people's stories and see what would be most important for all of you to be studied and answered. Awaiting the next chapter in your journey!

Dear SleepyKitty, I am a dentist working in dental sleep medicine. The answer to your question is unequivocally, yes. Remember that the fundamental cause of OSA is that airway resistance in your nasopharynx that has been abnormally increased until your throat closes fully or partially during sleep. Anything that causes an abnormal increase in airway resistance can be contributory and sinus problems are certainly one of them. a.b.luisi,d.m.d.

I have complex ( mixed) sleep apnea which is mostly central but some obstructive. I've had allergies and sinus problems for years and I believe that does contribute to the sleep apnea.

Hello SleepyKitty, chronic sinus issues indeed could worsen snoring and sleep apnea. However, the improvement in sleep apnea just with the treatment of nose issues is usually not that significant. The treatment, however, may help decrease the CPAP pressure required to treat the sleep apnea, and also make it easier to use the device.

Rohit

CPAP4LIFE

Has anyone seen an improvement in sinus issues after they have initiated CPAP with humidity? I have felt for years that if the snoring, coughing, gasping from OSA could be eliminated the irritation caused to the upper airway would alleviated some of these sinus issues.

If you have sinus issues that result in congestion, you might want to consider a full face mask vs one with just nasal pillows.

Thank you everyone!

I was wondering about the allergy aspect. CPAPs use ambient air right? So if I have allergies to dust mites and pollen (no air conditioning here so windows open when it's warm) then will having the ambient air blasted into my sinuses make allergies worse? Can you get allergen filters for them? Maybe filtering the air I breathe directly will help the allergies - that would be nice!

So far I'm waiting for my follow up appointment with the Doctor, so nothing new to report yet.

I have sinus issues and OSA. As annoying as my sinus problem can be, it has not been affected one way or the other with my OSA treatment. I used to snore like an Apache helicopter attack, and was diagnosed with severe sleep apnea. The dentist knows of my sinus problems, but prescribed a proprietary hybrid oral appliance. At night when all my muscles relax, my tongue would also relax and physically block my airway. The oral appliance has an arch across the back (the open end) which my tongue rested against at night and stayed out of my throat. Simple. Snoring stopped immediately and a post sleep study proved my OSA is being successfully treated. In the seven years wearing this device (at night, haha) I do not know of anybody who has not been successfuylly treated with this appliance. Keep the tongue out of your throat and it solved my problem.

I am a dentist working in dental sleep medicine. The previous poster made a very important point. It is a known phenomenon that the pressurized air blown through the nasopharynx by PAP machines will, in some cases, make sinus problems worse. Remember, I said in SOME cases. In many patients the air does not bother their sinuses and in some cases the air actually improves their sinuses. It is highly individual. However, in those cases where the air is bothering the sinuses, switching to an oral sleep apnea appliance will in many instances take care of the problem(if the appliance turns out to be effective for the patient). OAs allow the patient to breathe normal unpressurised air. No more air pressure equals no more problem. a.b.luisi,d.m.d.

Just some information about filters for the CPAP machines. There is a reusable large particle filter that is washable usually located in the back of the CPAP machine. There is also an optional hypoallergenic filter (usually white) that is disposable for those needing more filtering. Besides those with allergies I think smokers might benefit from that option. It would be interesting to do a study measuring the effectiveness of these filters.

I have used "PAP" machines for 20+ years... but a BiPAP Auto with Humidifier for only 3 years. IMHO blowing air down your nose can cause drying, irritation, and inflamed sinuses and this complicates your OSA.

I have used a humidifier only for the past 3 years and "rain-out" can be a problem. A machine with heated tube would probably help me a lot... but definitely you want added humidification with your "PAP" machine.

I have both deviated and perforated septum (the wall between your nasal passages) and recently discovered a device called "NasiVent" which are a pair of "tubes" that insert into your nasal passages. I think the outer walls of my nose easily collapse due to the PAP's air pressure and these tubes help keep my nostrils open! This helps a LOT !

Also in addition to my nasal problems, I am a chronic "mouth-breather" and the best aids I have found to deal with this have been: (a) a full-face mask with my PAP machine... but then I found it leaked too much and this caused my BiPAP Auto's algorithm(s) to fail... so could not use the full-face mask! (b) I now use a combination of chin-strap and mouth-piece and this works for me. Regards, Sam

This is my 1st time in the forum area. I too have diagnosed med OSA with no luck so far trying different strategies to improve my sleep quality the last 15 yrs. I've had 2 dev septum surgeries + turbinate reductions 20 yr ago and 1 yr ago. 1 yr ago an ENT also implanted little wings made from straightened septum tissue to hold open my collapsing nasal passages. I do bring breathe a little better since the wing/bridge inserts, yet I'm still a mouth breather and yes still a big time snorer !!! I tried UPPP 7 yrs ago with little effect.. did snore less for a while but now Im loud as ever says my wife,kids. I also tried RF tongue reduction about 5 yrs ago...no improvement. My ENT at the time said I have a large tongue. During my 2 sleep studies, 12 yrs ago and about 5 yrs ago I only lasted 3-4 hrs before going home. After all those 40 + sticker and wires are attached to you, I struggled to sleep in a strange bed. They got enough to confirm OSA both times and I seem to have restless legs. I tried a top of the line CPAP machine 2 summers ago for 2-3 weeks, even leaving on the mask during the day when I could ( not very long). Never once got to sleep with it on at night. Called the Doc's asst assigned to me and she had the Doc prescribe me a sleep pill/Ambien. Still...never got to sleep with the mask/machine on. FRUSTRATING !!! Gave this NEWEST/BEST CPAP machine back to the company. Received a call from the doc a week later to tell me Im going to die soon and I didnt try hard enough to adjust to CPAP.. My response to him was I would love to have a good nights sleep with a CPAP...didnt happen for me !!!!

I've bought an inexpensive custom dental appliance $200 to hold my lower jaw forward at night, but I cant seem to keep it in at night. Its on the floor every morning. Wish I could find a solution to a better nights sleep. Getting older isnt help muscle tone. Im still very active and working despite poor sleep. I fall asleep on the couch early many nights and feel sleepy during the daytime sometime. Ill even fall asleep at the movie theatre. However, even on nights when I have no early nap sleep is just OK...snoring loud also. Dry mouth at night during the winter wakes me up also. Not sure what else to try. I'm on no meds of any kind 61yrs old/182lbs, but my BP has been rising the last 2-3 yrs and at 145/105 recently. Think my reg doc is going to put me on meds to control my BP better. Im also struggling with Sciatica for the last 8 months which wakes me up at night sometime to worsen sleep continuity. I think my poor sleep is at the root of some of my problems.

Angie I was diagnosed with OSA in my late 40's, and was diagnosed at 50 with Primary Biliary Cirrhosis. During this same time, my hearing became poor, and I began using hearing devices. At 60, my liver failed, and I underwent a transplant. I began experiencing heavy fatigue shortly after the liver disease diagnosis, and I was prescribed Modafinil. This drug has been of huge benefit to me, and even now, I am unable to wake up fully without taking it. Over the years, my mask has begun to cause problems with air leaks. This wakes my spouse, and I'm then unable to wake up fully enough to readjust the mask. I have always used the nasal pillow type of mask, but am now considering the idea of a full face mask. My blood pressure runs slightly high, perhaps because of the OSA. When I retired from work and went on Medicare, the cost of Modafinil became too high for me to afford, and I had to go without it for about six months, which was very traumatic. I then went to a sleep neurologist, who was able to submit a prior authorization to lower the high cost of Modafinil.

I had surgery for a deviated septum when I was 19 years old, and had many nasal congestion problems during those years. I went to an ENT for my nasal congestion many years ago, which has improved dramatically since then, and I have no allergies of which I'm aware. This same ENT performed a Pillar Procedure, which made no difference in my OSA, and one year later, one of the implants deteriorated and caused in irritation in the roof of my mouth. The ENT had difficulty removing the implant as it had separated into several pieces. I don't have a high regard for this procedure, and even though the procedure is not widely known, I've never heard of anybody else having this problem. My last MRI revealed that my right sinus is completely opaque, which causes me to wonder if there's a connection there. My next step is to try contacting Apria to make yet another appointment to be evaluated for a different mask. I do not have a weight problem, nor do I smoke or drink alcohol.

My sinuses have protested stronger and stronger since I started in 2007. After a terrible summer of mental fog, balance issues, constant need of decongestants to stop from constantly coughing....I finally decided to pull out the oral mask I had tried once before...aka the Oracle, by Fischer Paykel...is the only mask for me. I have a new auto BIPAP that works beautifully. I used the heated hose and humidity all the way up.

My sinuses are slowly retreating in their assault on my head. I did use the medrol dose pack of prednisone to help them quiet down. I can actually think once more. Balance is better also.

I been on CPAP for almost 10 years and a sleep tech. I hear these stories all the time. Your humidity is to personal preference. Not dry and you sneeze and not too wet that you have rain out. Congestion is usually from a leak. Yes there are hypo filters that will remove allergens and dust. The thing that is most important is a mask that not only fits you, but your style of sleep and need. If you can't contain the leak you need a different mask or mask style. There are at least 100 different masks to choose from, so don't hesitate to ask for a better fit. The fit should be snug but not to tight. There is relief from sinus conditions and other health problems, but it takes time. Don't think of this as a way for better sleep that's a side affect and shows you have adjusted well to CPAP. Sleep Apnea can lead to stoke, hypertension, and diabetes are the biggies. Each apnic event sends adrenaline to the body that is toxic to your health. Did give up on the therapy. It took me over a month to be able to wear the mask one full night, but 3 years later I was able to discontinue all my asthma medications and inhailer. No more headaches, no more naps. I wake up ready for my full day. You have to be patient ask questions there are ways to help make this work for you just stay in the game. You didn't get to were you are over night so don't expect instant results. This is a fiscal issue of airway collapse and XPAP is the best way to control the apnic events.

I m dating someone with sleep apnea. I ve heard it occures in familes. Will i catch it. I suspect it can be caused by some bakteria that weakens nervous system that is responsoble for muscle control. When i kissed my boyfriend his salvia is ticker. What if i catch it. I think i woke up myself few days ago with sound of my lips flopping with snore. Never happend before i met him. Im worried

This is a great post. I have had chronic sinus infections (at least 5-6 a year) since I was a kid and have therefore suffered from chronic fatigue. Currently, at age 35, I finally had sinus surgery a few months ago, that ended in a raging post-op MRSA infection. Defeated, my new primary care recommended a sleep study to address my chronic fatigue, and a possible cause of lack of sleep, depleted immune system and therefore chronic infections. Lo and behold, I have been diagnosed with OSA - and from what my doctor told me, not someone who he initially would have suspected to have it prior to my sleep study. I have just received my CPAP with nasal pillows and am still trying to get used to it, but I am very interested to see how it will effect not only the quality of sleep but my immune system and chronic sinus infections. My issue is that I'm feeling suffocated by the hot air coming through the CPAP. I'm afraid to tinker with the humidity because of fear of drying out my sinuses, but the hot air coming in through the CPAP causes the feeling of panic. I have the coil heat turned completely off and the humidity set at 3 on my ResMed AirSense 10 machine. I'm using the AirFit P10 for Her nasal pillows. Any recommendations on how to overcome the heat/suffocation issue without it drying out the sinuses would be helpful!

Hi @Not2bSleepy. The sensations you describe are common for new CPAP users. You can attempt lowering your humidity setting to 2, and you should know pretty quickly whether you feel like you are getting dry. If so, just bump it back up to 3. You did not describe the feeling of not getting enough air, even though you use the work 'suffocated' in your description. If you feel the problem may be that you are not getting enough air, you might consider talking to your equipment provider. When I started CPAP, I definitely felt like I was suffocating. My starting pressure was bumped up by only 1 cm, but it made all the difference. I would also recommend you practice wearing your treatment before you actually go to bed. Sometimes wearing it while watching television or reading a book in the evening helps people adjust to the feeling of treatment, and then there is less anxiety at bedtime. Hope this helps, and please keep us posted!

I am new to using CPAP, less than a week. My problem isn't sinus but a cough I have been experiencing during the day since starting the treatment. Has anyone experienced this?