Nasal Congestion and problems with CPAP

It's coming up pretty frequently now in cpaptalk.com: Posters with problems with sinus pain or nasal congestion that are either aggravated by the CPAP or that are making it more difficult to use the CPAP machine at night comfortably.
I've been dealing with my own bugaboo on this issue since the trees started pollinating in Buffalo back in March. Pre-CPAP, I'd have the sniffles and sneezles from the time trees started pollinating through the first good killer frost in the fall that would finally kill off the ragweed. My allergies are NOT major: Prior to CPAP, I'd be able to take OTC antihistamines on the worst days and simply ignore the minor congestion and minor sinus pain that would be around most days during growing season.

But with CPAP, I've found that I have to have a zero tolerance policy towards the nasal congestion triggered by my rather mild-to-moderate hayfever. When I'm congested, I find that the BiPAP's Auto algorithm frequently increases the pressures up to my max level of 8/6, which triggers more problems with aerophagia. And even more distrubing, increased nasal congestion seems to be correlated with increased AHI's---as in I'm more likely to have AHI's in the 3--4 range instead of the 1--2 range where I seem to feel better. I also think the increased nasal congestion seems to indicate that I've got some system-wide inflammation issues since the hand/foot pain seems to return whenever I have two or three days in a row with AHI's that are above 2.5. Hence the need for the zero tolerance policy towards the congestion.

What works for me is a three pronged approach and the timing of the parts of nasal hygiene are as important as the parts themselves:

1. Early AM:  I need to take half of a standard OTC Zytex  every morning.  The full Zyrtex was triggering too many problems with dry mouth and Allegra and Claritin just don't seem to get the job done.
2. Late Afternoon or Early Evening: I try to do a saline nasal/sinus rinse (with a NeilMed Sinus Rinse bottle).  On days with low pollen counts, it's not so critical.  But if I've been outside working in the yard or if I've had a bike ride, it helps a lot.  And on high pollen count days, it seems to be critical.  But I also have to get this done several HOURS before bedtime since the sinus rinse seems to temporarily swell my nasal membraines slightly.  It also allows plenty of time for drainage before bedtime.
3. Bedtime: Two squirts of Flonase in each nostril.  The new sleep doc prescribed this, and it's become a powerful ally in my battle to get my insomnia monster fully under contol so that the BiPAP can do its job every night.

Two good links for learning more about the importance of dealing with the congestion when you are on CPAP include:

• Nasal Breathing Video Series is from Dr. Barry Krakow's web pages
• Unstuff Your Stuffy Nose is from Dr. Steven Y. Park's web pages. Dr. Park is a forum member overat cpaptalk.com who posts under the name sypark

A bit about myself and the blog

I've been posting about my misadventures as a hosehead over at cpaptalk ever since they started back in September 2010.

Shortly after starting CPAP I developed major insomnia triggered by the sensory overload of sleeping with a hose on my nose. Since I've dealt with insomnia off and on my entire adult life I was not surprised that starting CPAP led to as many sleep problems as it was designed to fix. But the depth of my crash and burn in Fall 2010 was spectacular and I quickly became "the regular" at CPAP who was dealing with severe insomnia. As a way of helping myself cope, I also started writing long posts to other new hoseheads who were clearly in danger of having the same kind of problems with insomnia that I was dealing with. Eventually a poster over there by the name of Janknitz suggested that I consider writing a blog entry with stuff that was appearing in post after post to my fellow members of the CPAP&Insomnia Club. That material now appears in the Taming the CPAP Induced Insomnia monster tab on this blog.

For now, that's my main purspose in the blog: To give me a web-link that I can type instead of copying and pasting the whole essay every time I see a person who needs some help with ideas on how to deal with their little baby insomnia monster. Or occasionally those whose insomnia monster is as big as mine had gotten by December 2010.

I hope eventually to also add links to the more important chapters of my own story somewhere on this blog page. Probably as part of the About Me tab since that makes sense tome.

At any rate: To any who stumble on my humble blog, I bid you welcome. And if you've stumbled across this blog because you, too, are fighting CPAP Induced Insomnia, I bid you a sad welcome to the CPAP&Insomnia Club.

First post

This is just to get the blog started