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Sleep apnea,severe congestion in night with breathing problem using CPAP machine. Ideal setting for CPAP?

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I am a 42 year old man with sleep Apnea. I have been using a CPAP for three weeks now, and I noticed an unusual problem recently. I have been experimenting with the humidifier attached to my machine. I started with a setting of 'zero,' which I assume is a simple passover humidifier. A couple of nights ago, I found that moving the heat on the unit to a higher setting (2 out of 5) was much more comfortable, at least at the start of the evening. However, by the morning my nose was very congested. The next night, Last night, the congestion got so bad that I woke up having trouble breathing even with the CPAP still on. Today I am experiencing sinus pain. My question is, could increasing the heat on the humidifier actually make my congestion worse? (Everything I have read says just the opposite, that the heat+ moisture helps, not hurts) Also, as far as tonight goes, should I decrease the temp back to 1 or zero, should I leave it at its current setting, or should I increase it?
Posted Sat, 14 Apr 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Naveen Kumar 3 hours later
Hi

Thanks for the query.

The settings of the CPAP(continuous positive airway pressure) machine is adjusted based on report obtained during the sleep study and titrated accordingly. A sleep study is used to diagnose and determine the severity of your sleep apnea. The titration of the CPAP pressure and humidification is carried out depending upon the severity of your sleep apnoea.

In your case, you have changed the settings which could affect your health. Sinusitis, headache, emphysema, etc. are a few common problems encountered when the settings are changed.

Q: Could increasing the heat on the humidifier actually make my congestion worse?

A: Yes, if the heat of the humidifier is increased above the optimal level required for an individual at the room temperature, it can cause dryness of the nasal mucosa, leading to blockage of the sinus opening and stasis of the sinus secretions giving rise to headache. Warm humidified air is definitely good for health but if the same is increased and continued for long, then it can affect the general health.

Q: Should I decrease the temp back to 1 or zero, should I leave it at its current setting, or should I increase it?

A: It would be better to adjust the heat settings to the level which was first recommended to you by your physician. The temperature settings are usually maintained according to the room temperature and the tolerance level by an individual, you can try with zero initially and later on increase to 1 depending on the comfort level.

Hope I answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Sleep apnea,severe congestion in night with breathing problem using CPAP machine. Ideal setting for CPAP? 2 hours later
The sleep study was done by giving me a cpap machine to take home for one week. The machine they gave me did not have a humidifier, nor was any humidification level 'suggested' by anyone before, during or after that test. I complained that the machine "dried me out' and it was then, and only then, that I was given a unit with a humidifier. Therefore, I cannot set my unit "to that which was recommended," but I will start back at a lower setting and go from there.
 
 
Answered by Dr. Naveen Kumar 11 hours later
Hi

Welcome back

It is sad to know that you had been prescribed a CPAP machine without a humidifier. There are various brands of CPAP machines available in the market with lots of options and the settings vary depending upon the brand.

It would be wise to start with the lower settings initially and then gradually increase to the most comfort level. Also you need to drink plenty of warm water every day to keep the mucosa of the nose and mouth moist.

Apart from this, I would suggest you to get a thorough check up from a good ENT specialist and a Pulmonologist regarding the level of obstruction in the respiratory passage leading to sleep apnoea. Once the level of obstruction is found out then there are various surgeries performed which will give you good relief and get rid of CPAP machine once for all.

Hope this information was beneficial; Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
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