SLEEP HYGIENE TIP OF THE WEEK: Using CPAP with a head cold

When the cold and flu season hits, the inconvenience of dealing with viral symptoms can be magnified if you're also using a PAP device (CPAP, BiPAP, APAP). Some people think it is better not to use your PAP therapy at this time, but the truth is, you still need it, even if you experience more discomfort while asleep. Your body will get through a respiratory illness more quickly if you continue your therapy because it will have more sleep (even if it doesn't consciously feel like it).

Here are some tips to stay the course through those nights when sore throats, runny noses, congested sinuses and coughs crop up this winter.

1. Adjust your sleeping position. A runny nose or congestion can make breathing very comfortable while you sleep. Try sleeping on your side, which will use gravity to drain your sinuses (one side at a time). If you have a reclining chair, that might also be helpful for the same reason. You don't want phlegm collecting in the back of your throat, which will just worsen matters. Avoid sleeping on your back or completely flat; even elevating the head of your bed by 3 inches can make a big difference.
   
2. Make sure you use your humidifier. The warm moist air will really help your passages remain pliable and comfortable through the course of a virus.
   
   If you don't know how to use your humidifier, ask the CPAP specialist who initially set you up with your current machine. Some people normally don't use the humidifier, but may turn it on just for head colds or allergies.
   
   If you have an older machine, it may not have a humidifier, or if it has a humidifier, it may not have a heated setting. If you get a lot of respiratory illnesses during the winter, you should ask your doctor about updating your machine to one with a heated humidifier.
   
3. Try using nasal sprays. These can be a quick, easy and affordable solution. Look for sprays which are designed for decongestion. Even a simple saline nasal spray (or gel) can help relieve stuffiness. If you have allergies, opt for a spray with an antihistamine in it, if you don't already have one.
   
   Avoid any over-the-counter spray which causes sedation; this can worsen your apnea. Unsure which spray is best for you? Ask your pharmacist.
   
4. Similarly, consider menthol. Menthol can help to clear blocked nasal passages pretty swiftly.
   
   You won't want to suck on menthol drops while trying to sleep, as that is an obvious choking hazard, but you could have a drop right before bed to help open up your airways.
   
   Also, 15 minutes before bed, try rubbing a little menthol ointment on your chest and let the vapors rise and help decongest your airways before applying your mask.
   
   Sometimes the challenge is just getting to sleep; once asleep, the humidity from PAP therapy can often take over and keep everything clear.
   
   Please do not add menthol products to your PAP humidity reservoir without first checking with your mask and PAP machine user's manuals to ensure you can safely do so; if so, they will also advise on which kinds of menthol products and how much to use.
   
5. Try cleansing your sinuses with a neti pot. These are little bulb- or teapot-shaped vessels that help you to flush your nasal passages out. They can be found in most drugstores and are often an effective pre-sleep solution for anyone with a problem with congestion.
   
6. Switch to a different style mask. There are many patients who have more than one mask. They use their nasal or pillow mask for normal use but switch to a full-face mask if they find they are breathing through the mouth, as full-face masks cover both mouth and nose and allow for oral breathing. Pillow masks are sometimes difficult to wear if the nose it sore and swollen; a nasal mask might be a good alternative if you aren't mouth breathing. However, having a head cold leads to mouth breathing even in those who don't normally do so; it might be worth it to look into having a spare full-face mask on hand for this reason.
   
7. If you use CPAP, consider APAP. This is a more expensive solution but if you suffer from seasonal allergies or viruses on a regular basis, the "smart technology" in an AutoPAP (or APAP) might help you breathe better when congestion is a regular problem. The APAP delivery system senses your need for more or less pressure and automatically adjusts, unlike the CPAP which, as its names suggests, only delivers one continuous pressure. Discuss this option with your physician; you will need a prescription in order to acquire one of these.

Here's what a simple neti pot looks like; there are also
more extravagant ones, but a simple over-the-counter
product can be just as effective.

Finally, keep everything clean! You should be vigilant about cleaning your PAP tubing and mask anyway, but if not, NOW is the time to change that bad habit to make it a regular part of your daily routine. Learn some basics here.
Keeping your tubing, masks and accessories clean and sterile is necessary to prevent the growth of bacteria inside your equipment, which can actually make you even sicker (or cause illness when you aren't sick).

Follow manufacturer's instructions for cleaning your PAP-related items or, if you know you are just not going to follow through on a daily regimen, look into one of the new PAP cleaning kits now available which sanitize all of your items with the push of a button.

Sleep Hygiene Tip of the Week: Humidify

You've got a fire in the stove. Maybe you've cranked up the heater. It's winter, right? And outside, the relative humidity plummets with a new high pressure zone, leading to high blue skies, but dry air. Bone dry. 

Having trouble sleeping? Even worse... have you noticed that is everyone in your house catching the same virus?

Here's why this could be.

A household humidity level of 43 percent or higher can significantly reduce the incidence of airborne viral infections, whereas a lower level of humidity leads to more disease transmission via coughing because... guess what? The air is too dry! You cough to encourage mucus flow, introducing more germs into the environment at the same time. 

Humidifying your household air can be done through a whole house system (very common in dry weather winter climates) or via tabletop humidifier units.

In either case, that added boost of moisture in the air is not only going to help keep you and your family healthier, it's also going to help you keep your upper respiratory system--the sinuses, the nasal passage, the tongue and insides of the mouth, even the vocal cords--soft, pliable, moist and comfortable. Even your eyes and skin will feel better.

The result? Less coughing, sneezing and sore throats throughout the season.

What's more, humidity can be the ticket for people who snore when the air runs dry. Add some moisture, et voila! No more snoring (or at least it won't be as loud)! Good not only for snorers but for people who have to sleep with them!

If you are using a humidifier, please remember that you need to keep it clean to avoid developing bacteria and mold.

For personal humidifiers, using distilled or demineralized water can help keep your humidifier cleaner longer and reduce the chances of bacterial growth. A weekly clean is easy and should do the trick. Also, look for filters that may need regular replacing.

Check with your owner's manual if you are using a whole-house humidifying system to determine its care schedule. This can include replacing filters.

Also, make sure you don't overhumidify. You can have too much humidity, even in the winter. This can lead to problems with condensation and mildewing.

The best way to check humidity is to use a tool called a hygrometer in the room where the personal humidifier is being used, or set your whole-house system to maintain a level between 40 and 50 percent.

Portable hygrometers are not hard to find: look at discount or hardware stores. There are also decorative "weather stations" many people hang on the walls of their homes that include a hygrometer along with a thermometer and barometer.

In Case You Missed It: January's most popular posts at SHC

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Posts

• Alternatives: Using sound as a bedtime sendoff
• Definitions: What is normal sleep?
• Alternatives || Sleep Hygiene Tip of the Week: How meditation can help
• ALTERNATIVES || Dr. Scott Theirl suggests biomarker testing before you take an Ambien
• Alternatives || Sleep better when you have the flu with these tips
• Sleep Hygiene Tip of the Week || ALTERNATIVES: Aromatherapy
• ABCs of Sleep---C is for CPAP
• Alternatives || Sleep Hygiene Tip of the Week: Move, to rest

Pages

• SLEEPYHEAD CENTRAL || Sleep Disorders
• SLEEPYHEAD CENTRAL || Why Sleep Matters

Alternatives || Sleep better when you have the flu with these tips

Most people understand that when they have the flu, one of their best defenses is to get some quality sleep. However, between the coughing and the congestion and other symptoms of flu, it's awfully hard to get some quality sleep. Here are some easy ways to help you achieve sleep while you are suffering from flu symptoms.

DECONGEST
If you're congested or experience an increase in mucus, it can make it difficult to breathe while in bed. Try some of the breathing strips or a nasal spray to help keep your airways clear. It's important to breathe through your nose, as mouth breathing can lead to uncomfortably dried out oral passages and coughing.

Elevate the head of your bed or sleep in a recliner, or prop yourself up by pillows behind your back to allow your sinus passages to drain effectively. Avoid just adding one more pillow to behind your head; you might just be pushing your chin further into your chest, resulting in an even more restricted airway. [Curator's note: I often have patients with sleep apnea in the lab for studies who use two or more pillows; when I ask them to reduce their pillows to only one, they sometimes are surprised to discover they have more space in their airway to breathe.]

A humidifier or vaporizer can help restore humidity if your household climate is extremely dry, and this can provide comfort, but be vigilant about keeping your devices absolutely sterile. Unclean humidifiers and vaporizers often just put more allergens and other substances in the air that will further antagonize your condition rather than alleviate it.

Placing your face over a bowl of hot water and covering your head with a towel can also catch steam that can help relieve your congestion. Even a hot shower without washing your hair can do the trick.

Menthol products are also safe and very useful for helping with congestion. Either a menthol chest rub, lip balm or nasal inhaler can be effective in keeping mucus thin enough to expectorate or blow from the nose.

HYDRATE
Drink plenty of water. Water can help flush out the system and rehydrate your passages,and 100 percent fruit juices with some vitamin C content can be helpful. Warm liquids are even better--think of broths and decaffeinated teas. Some people do better to avoid milk products, which may increase unpleasant phlegm, but others like warm milk as it helps them to fall asleep. Warm almond or soy or rice milk might be good options. Avoid caffeine as it also contributes to dehydration and can interfere with sleep.

CHOOSE MEDICINES WISELY
Be wary of over the counter cold medicines. Some of them will interfere with sleep, such as the common decongestant pseudophedrine, which can leave you feeling jittery, and the popular allergy medication, diphenhydramine, which causes jitters in some and sleepiness in others. The alcohol in some liquid cold medicines will also mess with your ability to achieve deep sleep and can lead to dehydration, which can make your airway passages uncomfortably raw while you are running a course of flu.

Stick to simple pain relievers for aches, pains, fever and chills (aspirin, Tylenol) rather than choosing a multi-purpose cold medicine so you don't unwittingly mix medications that, together, might make it harder for you to achieve sleep.

Don't take sleeping pills, as they won't allow you to get the healing sleep you need and may have dangerous interactions with any cold medicines you do decide to take.

PRACTICE GOOD SLEEP HYGIENE
Use several light blankets that you can throw off or pull on depending upon your symptoms. Make sure they are easily washable so you don't "share" your flu with anyone else.

A dark, slightly cool room is perfect for sleeping while you are sick. Too warm a room can contribute to nasal stuffiness and dehydration (overly dry air and sweating). Darker is better because you will wake up less once you do fall asleep; try an eye mask if you can't achieve dimness in your sleeping space during the day.

Finally, try not to sleep too far off your normal schedule. Stay awake and do quiet tasks like read or watch TV during most of daylight; you could unintentionally mess with your circadian rhythms if you sleep all day long and wake up to find you aren't sleepy at all when bedtime rolls around. Of course, let your body be the judge; if you are extremely fatigued, then let your body rest however it needs to rest. But try to avoid long marathon sleeps during the daytime if you can.

Avoid your blue-spectrum light sources (all electronic devices) after the sun goes down. When these specific kinds of light rays reach your eyes, they signal the pineal gland in the brain to stop releasing melatonin, which is critical to sleeping at night. Keep your home dimly lit and avoid stimulating music, video games or television so that your body can naturally fall into its normal sleep rhythm.

A friendly reminder that links to websites offering products does not imply endorsement by SleepyHeadCENTRAL.com.

SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.