Can CHRONIC RHINITIS and SINUSITIS aggravate SLEEP APNEA?

Hello.

Thank you for your query at DoctorSpring.com.

After going through your history, I have noted that you are suffering from anxiety/depressive disorder and are on medication for this.

You also have symptoms of reflux (GERD), and have been started on omeprazole. The medications you are on can exacerbate an existing reflux. They do not directly cause GERD as such. Reflux can be associated with anxiety, stress, or obesity. Also it can be due to lifestyle associated with smoking or alcohol consumption, and consumption of spicy food. You can continue omeprazole for 3 months safely and you should make sure you follow lifestyle modifications to reduce reflux such as head end elevation, no meals two hours prior to bed, avoiding smoking and alcohol etc.

Sinusitis, if present can aggravate symptoms of sleep apnea, but first we have to confirm that you do have sinusitis. This can be confirmed by taking an X-Ray or CT Scan of paranasal sinuses.

Please write in with these details about symptoms of throat and nose – do you have any nose block/nasal discharge/sneezing/throat pain/difficulty in swallowing/ change in voice/breathing difficulty/wheezing? If yes, please mention the duration and severity.

Hope this was helpful. Feel free to ask if you have any further queries.

Thank you. 

Regards,

Dr. Sunil Jalan,

MBBS, DLO, MS(ENT), DNB, DAA.

Please write in with these details about symptoms of throat and nose – do you have any nose block/nasal discharge/sneezing/throat pain/difficulty in swallowing/ change in voice/breathing difficulty/wheezing? If yes, please mention the duration and severity.
WIthin the past year I notice, I can only have short conversations, and anything longer than a few minutes my throat becomes dry and voice changes to point where I have difficulty pronouncing certain words.

Since first deployment, I have had a chronic cough since 2003, and constantly sneezing throughout the day since 2003. When a lung capacity test was done, I was able to only blow out for a very short period of time.

On throat issues, I always seem to be coughing up some sort of abnormal sputum (since 2003 as well), that actually feels thick and chunky, when swallowing I sometimes hear several crunching sounds like 3 of the same sounding crunches right in a row. I often take my medications and seem as if they get stuck in back of throat, where I then need another glass of water to have the feeling of something being lodged in my throat to disappear. I know pills get caught in my throat at times, because at times the pill begins to disolve and seems like I can taste it in the back of my mouth.

I had paranasal x-rays in Jan 2014, and they said appear clear no fractures evident. and other findings were. Issues used to be much worse, then tried netti pot, and first couple of times I used my sinuses discharged, and thick orangish mucous, this occured for seven consecutive kleenixs on the first time, and each discharge literally filled the klenix each time.
Positive or maxill ary sinus tenderness to palpation
Nasal swollen fpalr nasal turbinates bilateral third drainage (Not sure what this means)
Oral moist tongue midline some posterior pharyngeal drainage noted (Not sure what this means)
In addition:
The veteran's primary care provider Dr. Raul Valor MD wrote a note this
past year stating the veteran is had recurrent URIs since first deployment, sleep disturbances, sleep obstructive apnea,
Also had recent upper endoscopy, and found a 2cm Hiatus Hernia, identified me as ASA II and ASA III, had upper endoscopy but didnot indicate much of anything on esophagus

Thanks for writing to us again.
Hello,
You have voice change worsen with continuous talking (worse in evening). You have excessive sneezing for 10 years.
You have chronic cough with thick sputum.
your xray pns is normal but you had sinus tenderness.
You have postnasal drip (thick secretion on posterior pharyngeal wall or posterior part of throat)
You have allergic rhinitis (nasal allergy). So you have excessive sneezing and secretion which trickle from nose to throat. This causes throat irritation/cough and voice change also.
Same allergy can cause breathing tube constriction (bronchoconstriction also).
so we can start following medication for allergy:
Tab. levocetrizine 5 mg once in night for 10 days.
Tab. Monteleukast 10 mg once in night for 1 month.
Mometasone nasal spray 1 spray in each nostril once in night for 3 months.
For investigation you can do CT Scan of paranasal sinus - this will provide more detailed information of sinuses , and if normal we can definitely rule out sinusitis.
You can do pulmonary function test (PFT) to rule out any obstructive pathology.
Hope this helps. Feel free to ask if you have any further queries.
Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA

But could any of these conditions or a combination of these conditions cause sleep apnea or agravate beyond normal progression?

Hello.

Nasal allergy and/or sinusitis, both can aggravate sleep apnea. So they need to be under control. However, most important factors for sleep apneas are obesity and anatomical factors.

Hope this helps. Feel free to ask if you have any further queries.

Thank you.