It's like sleep apnea, but through my nose. What's going on?
January 3, 2014 11:19 PM   Subscribe

It's like sleep apnea, but through my nose. What's going on?

About a week and a half ago I caught a cold and since then I've been having terrible difficulty falling asleep. In the past I have been diagnosed with sleep apnea, but this is different because it occurs *before* I fall asleep; as I'm drifting off my nasal passages get blocked off, I snore *extremely* violently and jolt awake. Over and over and over again.

I have been to a doctor and was prescription-strength antihistamines, which don't seem to be doing the trick. I have tried neti pots and nasal strips, I sleep on my side or on my stomach...nothing works. It's driving me nuts and I've already missed two days of work due to completely sleepless nights (and I'm posting this at 2:00 in the morning). I will go back to the doctor, but in the meantime...has anybody had experience with this sort of thing, and was there any way you obtained relief (aside from recovering from the cold)?
posted by The Card Cheat to Health & Fitness (14 answers total) 3 users marked this as a favorite
Response by poster: I should add that I have no known allergies.
posted by The Card Cheat at 11:21 PM on January 3, 2014

Have you tried oxymetazoline, aka Afrin? It isn't something you want to make a habit of, but it unstuffs a nose like nothing else. It should help you get to sleep, but it only lasts a few hours.
posted by qxntpqbbbqxl at 11:48 PM on January 3, 2014 [1 favorite]

Best answer: I've been giving this advice a lot lately wrt sinus stuff, but: try 800mg ibuprofen. It can shrink swelling ANYWHERE. (Prolonged use of this dosage of ibuprofen is probably a bad idea; it is not great for your kidneys. But once in a while is fine, as far as I know. I am not a doctor.) Also try asking your doctor for Flonase or a budesonide spray, they are steroids that will shrink sinus tissues like nobody's business. I myself was, if not cured, at least greatly released from suffering from a case of chronic sinusitis by a creative doctor who gave me antibiotics and steroids to put in my neti pot, which got a lot more penetration of the medication than just the sniffer spray bottle.

but before you go down all those dark and mysterious roads, try the ibuprofen.
posted by KathrynT at 12:59 AM on January 4, 2014 [4 favorites]

Use pillows to raise your head in bed. That and Breathe Right strips something like Nyquil should help.
posted by Cranberry at 1:01 AM on January 4, 2014

Be sure you've got adequate hydration if you go the afrin route, or the psuedoephedrine one. Both will make you drydrydry and that keeps me up too.

In the winter I sometimes need a humidifier to have a chance of sleeping. Right now I have a warm washcloth draped over nose and mouth.
posted by nat at 2:54 AM on January 4, 2014

Do you have a humidifier on your room? I am suffering the same symptoms and haven't had a cold yet this year, the humidifier crammed up high and some eucalyptus oil had helped immeasurably.
posted by wwax at 3:00 AM on January 4, 2014 [1 favorite]

I can't believe I'm saying this, but have you considered nightly saline irrigation? I know you said "neti pot" but how regularly, and did you actually manage to clear your passages? My ENT made me start doing it twice a day, and it helps a surprising amount with congestion and snoring (which I assume is what your jerk-awake would be if you could actually move air), especially in combination with ibuprofen, nasal steroids, and antihistamines. (Even 400 mg of ibuprofen twice a day helps me.)
posted by gingerest at 3:16 AM on January 4, 2014

Have you tried real Sudafed (the stuff they keep behind the pharmacy counter)? Pseudoephedrine is different than an antihistamine. They work differently and the combination can clear you up quickly.
posted by cecic at 7:41 AM on January 4, 2014

Response by poster: Hi, everyone, thanks for the advice...I tried 800 mg of ibuprofen last night and that seemed to help. I do use a humidifier in my bedroom. On Monday I'll ask my doctor about some of your other suggestions.
posted by The Card Cheat at 8:07 AM on January 4, 2014

Nthing increasing the frequency of your neti pot use.

I irrigate my sinuses three times a day, four if the air's really bad. I had a couple sinus surgeries last year and I've always had trouble getting a decent night's sleep. Since I started using the neti pot multiple times a day, it's made a huge difference.
posted by carolinecrane at 10:17 AM on January 4, 2014

Just wanted to say, I find Neti pots good for maintenance, but when I had a terrible, stubborn allergic reaction to some mouldy leaves I had raked, one of those pressured saline washes (you shoot it in your nose like whipped cream!) was like magic--better than any drug or mechanical method I'd tried. They're incredibly expensive so I don't think of them for daily use, but it's worth a try. Found at a drugstore near you.
posted by blue suede stockings at 11:04 AM on January 4, 2014

Best answer: Afrin (or store-brand oxymetazoline equivalent). It comes down like a sledgehammer on nasal congestion. You can't use it all the time (though it's tempting, because you'll find yourself suddenly breathing better than you can ever remember) because you'll get rebound congestion where you'll have to use it all the time or else suffer terrible, vice-like sinus clamping and eventually, with continued (year or more) use, glandular swelling in your nose that might require surgical intervention.

However, as an occasional get-out-of-jail-free card for really awful nasal congestion it works like nothing else and doesn't have any side effects to speak of. If you only use it at night and never during the day I would say (personal experience, IANAD, YMMV) that you could probably get away with using it about one night in three without much risk of dependency.

For regular use, the other options mentioned above are good ideas. Taking a big dose of ibuprofen (again, not something you want to do every day or you could mess up your stomach) will reduce the swelling. Pseudoephedrine (yes, the real stuff from behind the pharmacy counter) works very well but is also a stimulant in some people so you might have trouble sleeping on it – but if it works for you then it might just be your magic bullet. A humidifier would probably also help if your congestion is due to excess mucous production or inflammation of nasal passages that are irritated by dry winter air. A mentholated ointment like Vick's, applied under your nose before you go to sleep, might also help. And you can keep using the antihistamine, nasal strips, and neti pot for whatever ancillary benefit they might provide. I would also try drinking some peppermint tea before bed – I find that the peppermint-infused steam coming off the mug helps open up my sinuses, and it's also a very relaxing before-bed drink.

You can also get mentholated nebulizers and sprays which might help you. I've never tried them myself, do your research.

You could also talk to your doctor about a prescription for fluticasone propionate, aka Flonase. It's a steroid spray that you use daily, and after a few days of use you should find that your nose clears up considerably. According to my doctor it's usually well-tolerated and quite safe, and you can pretty much use it forever as long as you aren't noticing any unpleasant side-effects. It's also very cheap.

Another thing you might look into with your doctor is having your nasal passages inspected for any diversions, obstructions, or impactions that might be interfering with airflow. Such things are quite common and usually go undiagnosed because people (and doctors) tend to assume that the problem comes instead from even more common allergies and irritation. The situation is further confused by the fact that treating for allergies and irritation usually also works for obstructions – but only up to a point. If you've been dealing with this problem for a while and the usual treatments aren't effective, you might actually have an obstruction of some kind. If you do, it's a simple outpatient surgical procedure to go in and clear it out. (You can watch it done via laproscope camera on Youtube, if you're not squeamish. It looks worse than it is.) If you have a significant obstruction, surgical intervention is probably the only thing that will give you serious, long-term relief and the procedure is generally very successful. If I had an obstruction, I wouldn't hesitate.
posted by Scientist at 12:20 PM on January 4, 2014 [2 favorites]

In the meantime while waiting to follow up with the doc on a prescription spray and such, you could try elevating or inclining your head slightly with a second pillow while sleeping to help with drainage.
posted by NikitaNikita at 10:01 PM on January 4, 2014

It would help to get a sleep study, if you have insurance that covers it. Sleep apnea by definition happens when you're asleep, so you can't know if you have it.

The test apparatus gets lighter and better every year, and the modern machines are also quieter and less bothersome. I've used a CPAP and its successors for 30 years, and it's saved my life.
posted by KRS at 7:58 AM on January 5, 2014

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