CPAP Therapy: Reducing Nasal Congestion

A new study from Ireland evaluated methods to improve nasal symptoms in people using CPAP therapy for obstructive sleep apnea. The results were published yesterday in the Journal of Clinical Sleep Medicine.

The study involved 112 people; most of the participants were men. On average they were obese and had severe sleep apnea.

They were randomly assigned to one of three CPAP therapy groups: dry CPAP, CPAP with a humidifier or CPAP with a nasal steroid spray.

After one month of treatment, quality of life was improved in all three groups. Fatigue and daytime sleepiness also decreased. All groups used CPAP for an average of more than five hours per night.

People who used “dry” CPAP were least likely to have itchy or watery eyes. But they were most likely to have nasal congestion. At the end of the study 70 percent of this group continued with dry CPAP; the others added a heated humidifier or a nasal steroid spray.

People who used CPAP with a heated humidifier were least likely to have nasal congestion. But eight of these people were unable to tolerate the humidifier; they all switched to dry CPAP. At the end of the study 46 percent of this group continued with a humidifier; the others switched to dry CPAP or added a nasal steroid spray.

The other group used CPAP and a nasal spray with fluticasone, a steroid; they used the spray two times a day. They were most likely to have problems with sneezing and runny nose; but the sneezing stopped within a few minutes of application. At the end of the study only 35 percent of this group continued with the nasal spray; the others switched to dry CPAP or added a humidifier.

The authors conclude that people who use CPAP should be evaluated on an indi­vidual basis; some may benefit from the addition of a heated humidifier or topical steroid spray.

Talk to your CPAP supplier if you have questions or concerns about the treatment. Call your sleep center if you have ongoing problems with CPAP therapy.

Get tips for solving CPAP problems on SleepEducation.com. Contact an AASM-accredited sleep center near you for help with sleep apnea.