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Sleep Disorders

Congestion and sleep apnea

11/13/2008

Question:

Can congestion be the major cause of sleep apnea?

I`m told that I sometimes snore and stop breathing at night when I don`t take a decongestant for my chronic (cause undiagnosed) congestion, but that I don`t do either when I take a decongestant at bedtime.

I`ve been diagnosed with mild sleep apnea (I didn`t take a decongestant before the test). It appears that my insurer (Kaiser-Permanente) greases the skids for the use of a CPAP device because a request to see an ENT was declined

Answer:

I assume by your question that you were diagnosed with obstructive sleep apnea and not central sleep apnea. This would make sense in the context of your question. Obstructive sleep apnea (OSA) is a common condition, affecting roughly 5% of middle aged adults in America.

The major risk factors for OSA include obesity and craniofacial abnormalities. While nasal congestion could be a contributing factor to the development of OSA by causing an anatomic obstruction of the nasal passages, it would be unusual for this to be the sole causative factor in an individual’s OSA. Having said that, it is actually quite common to find OSA in individuals who suffer from chronic nasal congestion. In addition, there is some data that the use of nasal steroids (to relieve the congestion) may improve the underlying OSA in some of these individuals. It’s possible that in your case, the degree of your sleep apnea may wax and wane with the severity of your nasal congestion.

CPAP is the usual treatment of choice for OSA and usually surgery is reserved for those who can not tolerate surgery. CPAP is generally more effective and safer than surgery. In some individuals, oral appliances (mouth pieces) may be of benefit, though these are often tried only after CPAP has failed.

It would probably be a good idea to discuss your case with your Sleep Specialist. Specific factors in your case may influence the management of your sleep apnea.

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Response by:

James   Knepler, MD James Knepler, MD
Formerly, Assistant Professor
College of Medicine
University of Cincinnati