Nose plugs up as I prepare to put on face mask or after I lay down

I have used a CPAP since Dec. 2017. I begin to feel better right away. No problems adapting to the full face mask. About 6 weeks ago my nose began to plug as I put on the mask or after I lay down. I sit up till I feel my nose is clear and then lay down. Sometimes soon as I lay down it begins to plug up. Very annoying and reduces the amount of sleep. Any suggestions or ideas? Thanks


What is usually happening in this situation is that there is a lot of post nasal drainage. This mucous drainage is less noticeable when you are awake and upright because gravity pulls it down your throat and you swallow it. When you lay down, gravity is no longer helping you and it pools in the back of your throat. The trick is to decrease nasal congestion. Here’s a link to a free ebook by a truly wonderful sleep specialist:

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I know exactly what you’re going through because I have dealt, & am occasionally still dealing with, post-nasal drip & waking up gagging in my sleep because of it. There are options out there that I have tried & they have lead to solutions that have greatly improved the situation. So, here goes …

I consulted an ENT (Ear, Nose & Throat Doctor, also called Otolaryngologist) to see if I had any structural problems going on. You can guess that I did in fact have structural problems - a deviated septum & crushed conchae from breaking my nose against a steering wheel years ago before shoulder harness type seat belts when I was in a major car accident. It necessitated that my ENT straighten out the deviated septum & perform what’s called a Turbinoplasty (basically roterrootering out a turbinate (a nasal passage) to clear the blockage of smashed conchae (bits of bone in a honeycomb type structure that’s how your nasal passages are).

I also consulted an Allergist because I was aware of reacting strongly to some airborne allergens (mostly trees/bushes/plants & molds). Before seeing the Allergist I had to stop taking all over the counter (OTC) antihistamines & stop using nasal sprays for 10 days before the appointment. At that time I was using an OTC Saline Nasal Spray to keep my sinuses moist (this helps to keep the allergens from being able to irritate your sinus passages & helps keep them moist & prevent them from becoming dried out due to air conditioning & blowing my nose). Before bed I used a Neti Pot to flush out any allergens hiding in my nose before using the saline spray (which, by the way is also helpful especially when using nasal pillow CPAP treatment).

Chances that your post-nasal drip being caused by allergens are pretty high these days with all the air pollution & breathing conditioned air (BTW, make sure your air filters for your heating & cooling system are HEPA filters - I personally like the 3M Filtrete brand). &/Or If there’s something structural going on, you might need a minor surgical procedure (day surgery) to fix the problem. If no structural blockages are found, you might just be suffering from allergies alone. An Allergist will want to do skin prick allergy testing to pinpoint your particular allergen triggers. My Allergist tested for something like 60 allergens when I was tested. He used a grid that was put on my upper back & down the inner sides of both arms & the allergens were applied subcutaneously with a very fine needle prick & I don’t remember feeling a thing (I’m not sure if I was given a couple of Lidocaine shots first at the skin prick sites to numb the areas first, but it’s possible. I just remember not feeling a thing). The Allergist checked the sites ~30 or so minutes later to see which allergens caused a skin reaction, & indicated the severity of each reaction on a scale of 1 to 5 (I think; could have been 1 to 3). I had a couple of pretty severe skin reactions to several allergens & they itched like crazy (but was told not to scratch them because that causes irritation in itself & if I scratched, the Allergist wouldn’t be able to give the reaction an exact rating. By the time I left his offic, though, he had applied a Hydrocortisone Cream or Benadryl Gel to the irritated sites & prescribed a single dose of Prednisone to calm the systemic reaction & gave me prescription s for Flonase & recommended Zyrtec to me. A few weeks later, I was able to start allergy shots (once again taking Prednisone & a medication called Montelekast before the shots. The shot schedule is pretty intense at first as we did what is called ramping up my dosages to achieve results faster as we were entering major Cedar & Oak & pollen season. My Allergist was able to use the allergy testing to formulate an allergy serum to use for my allergy shots that was tailored individually for my particular allergens. The Allergist was also able totell me what food allergens I had reacted to & that way I am able to try an elimination diet to see which foods made me feel particular badly & which foods I cut out that I could tell made a big difference in my allergy symptoms. All in all, seeing an Allergist will be well worth your while & could possibly help you tremendously.

So after day surgery from my ENT & allergy tests, I am using Flonase (a prescription corticoid antihistamine spray), taking oral OTC antihistamines (Zyrtec & occasionally adding Benadryl tabs, too), use prescription allergy eye drops, get regularly scheduled allergy shots (which have made a world of difference), but I have to honestly tell you that I still have to put up with occasional allergy smptoms that are very minor compared to what they used to be (they’re mostly airborne allergens since I live in a large city in South Texas which seems to be a crossroad of merging air streams, so we seem to get every allergen there is from both East & West Coasts, the Midwest States & even from Mexico floating here & in large quantities, plus our own city’s industrial & vehicular air pollution. Allergies are extremely common where I come from).

Lastly, I have found that falling asleep sleeping on my side seems to prevent the post-nasal drip from dripping towards the back of my throat, causing me to wake up feeling like I’m gagging & can’t breathe that I experience from sleeping on my back. I don’t know if this will help you, but it’s worth a try.

Good luck to you in your quest to solve this very aggravating problem.

My nose also plugs up after I’ve laid on my back for a while. I don’t have any nasal drip or allergies. Having to breathe only through my mouth makes my mouth so dry that I can’t stand it. And I use Biotene and I use XyliMelts

Side sleeping really does help out with this - and reduces apneas.

I had trouble this way with my full face mask when I first started CPAP 6 years ago. After a few months of struggle, I switched to a nasal pillows mask and this was way better. I’m still using the Resmed Swift FX For Her nasal pillows. It’s a great mask and very comfortable. This mask won’t be able to handle really high pressures though - like over 15 cm. I use a dab of AYR saline nasal gel in each nostril before masking up…very comforting and eliminates sores that newbies often suffer.