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Sleep Disorders

Sleep Apnea and Nasal Congestion

02/10/2005

Question:

I have sleep apnea and use a cpap machine everynight. I am having a problem because I am very congested from a cold. Is there anything suggested to help open my airways? I have had to sleep without my machine two nights this past week and am feeling the lack of sleep.

Answer:

Chronic nasal congestion is commonly associated with sleep apnea and may be part of the symptom complex of sleep apnea or a direct result of the treatment. When acute nasal congestion arises in an individual already on CPAP therapy for sleep apnea, it can become a major problem and limit use of the CPAP device. Acute congestion most commonly accompanies an upper respiratory tract infection, as you are describing, or allergies.

Treatment to minimize nasal congestion will depend on the specific underlying cause. For acute nasal congestion related to an upper respiratory tract infection, symptomatic relief is usually best obtained with a decongestant. These come in a variety of forms, ranging from nasal sprays and nasal drops to pills and liquids. Most of these treatments can be obtained over the counter and work by constricting the blood vessels to relieve congestion. Common generic names include pseudoephedrine, ephedrine, naphazoline and oxymetazoline. These agents need to be used with caution in anyone who has a diagnosis of hypertension or heart disease and, in these cases, should not be used without consulting a physician first. They also may produce a mild stimulating effect that can lead to insomnia in some individuals. These medications should only be used for a short period of time (i.e. for no longer than 2-3 days) as they can be difficult to stop if used for a longer periods of time. If you are unable to utilize one of these agents, then menthol may help. This usually comes as a topical ointment or inhalation medicine and can help relieve congestion in some individuals.

If acute congestion is related to allergies, then antihistamines and topical nasal steroids are likely to be the best treatments. For more chronic congestion, heated humidification with CPAP is often beneficial (this may also help in acute congestion). In some cases, switching to an alternative CPAP interface (either a full face mask or oral interface) or an alternative treatment (such as surgery or the use of an oral appliance) is required.

You should discuss the above options with your Sleep Physician to determine which will be best suited for you. Getting you back on your CPAP should be a priority and can usually be managed with one or more of the above measures.

To learn more about sleep apnea or other sleep disorders, please visit the American Academy of Sleep Medicine's website at www.aasmnet.org. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you.

Good luck and here's to good sleep!

 

 

 

 

 

 

 

 

 

 

 

 

 

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University