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Undiagnosed Symptoms  (Expert Forum)
 | 
Unexplained Pressure - Mostly When Trying To Sleep
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Undiagnosed Symptoms forum are answered by Dr. Kevin Pho. Topics covered include breathing difficulties, feeling cold, cough, diarrhea, dizziness, fainting, fever, indigestion, itching, nausea, numbness, pain (chronic), paralysis, rash, sweating, swelling, urination problems, and vomiting.

Unexplained Pressure - Mostly When Trying To Sleep

by Floridaguy800, Mar 18, 2008 06:36AM
I've seen many doctors/specialists and none have been able to help me resolve this problem.

I have no known allergies, and have recently undergone allergy testing to confirm.

It started a little over 2 years ago. I started becoming congested when I sleep, no mucus, just one side (right or left sinus) becomes TOTALLY blocked from air flow and pressurized and I get a terrible sleep, never seem to get into REM, anything wakes me up, I always wake up after 8 hours of sleep feeling like I got 2 hours sleep, eyes dry and bloodshot. Typically headaches in the morning and throughout the day one side is always slightly blocked. Air flow is typically ok in the evening but after I lay down for 5 minutes one side becomes totally locked. In the morning after I walk around for a few minutes, semi-regular air flow returns and the pressure is mostly gone. When I work out, I almost always have total air flow.

First ENT: Did a septoplasty (straightened out deviated septum) no resolve.

First ENT: Prescribed valium for me to sleep, helped very minimally, kept me asleep, but the quality of sleep was still garbage.

First ENT: Thinks I may grind my teeth at night, dialating the blood vessels causing inflammation of sinus, (why does it only happen on one side at a time?).

First ENT: Suggested I go on anti-depressants (what the hell does this have to do with it?)

Second ENT: Allergy tests, nothing, no explanation.

Regular physicians suggested my body thinks it has allergies and therefore exhibits allergy-like reactions (This person is a doctor?)

This problem is wearing me down greatly, I haven't had a solid night's rest in many years..

by Kevin Pho, MD, Mar 18, 2008 07:44PM
Difficult to say without evaluation.  

There clearly has been a comprehensive evaluation.  Valium can be considered for sleep, however it is relative long-acting and not typically prescribed for this purpose.

Shorter acting sleeping medications can be considered.  Ambien, Ambien CR, or Lunesta can be considered.  

Seeing a psychiatrist can help evaluate all the options to treat insomnia.

Further ENT evaluation can be made with a CT scan, as well as a referral to a major academic medical center.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
Member Comments (9)

by Floridaguy800, Mar 18, 2008 08:04PM
To: Kevin Pho
Thank you for your response.  A CT scan was done and shows clear.  The pressure in my head keeps me from reaching REM sleep 3 - 4 I only hover around 1 - 2 one of the ENTs told me.  I have tried Valium to help me sleep, but is an obvious short term and barely able to mask the problem.

by C124Ace, Mar 19, 2008 06:13PM
To: Floridaguy800
how about a SLEEP STUDY?  
Shouldn't sleep apnea be considered?

by Floridaguy800, Mar 20, 2008 08:09AM
To: C124Ace
Prior to the pressure problem, I did have a sleep study done in Orlando about 5-6 years ago because the quality of my sleep was still ****.  It was 7pm - 7am, they said all I did was snore a little...

by JazzyMom, Apr 14, 2008 09:49PM
To: Floridaguy800
You have described my nights for years perfectly!  I have been on Claritin, Seldane, all the different steroid nasal sprays.  Sometimes I feel like if I don't start sleeping better, I'll actually die!!!  Because of this, I got additced to Afrin.  It was the only way I could breath through the night and sleep.  My family doc [Alternative Medicine Doctor] said to try NasalCrom nasal spray. It says nasal allergy symptom controller/Prevents and relieves nasal allergy symptoms.  But it has helped me tremendously.  I am off the Afrin completely and can breath through the night.  If I do get up to go to the bathroom, I notice I am just a little stuffed on one side [about 40% or so] but I can still breath and no pressure. I fall right back to sleep!  NasalCrom is over the counter, SAFE AND WORTH A TRY!  Best of luck, from a fellow sufferer.  

by muskokagal, Apr 21, 2008 10:17AM
To: floridaguy800
I used to get severely blocked in my sinuses immediately upon laying down in  bed. I was asked if I used a down pillow and or comforter...yes I did. Evidently, down becomes moist when we use it, absorbing our body moisture. It then develops molds, which in turn cause a sinus and congestion problem. I was advised to get rid of the down and use a wool comforter and a non allergenic pillow. It immediately resolved the problem and I have been free of these symptoms for 2 years!

by zanahorias, Apr 21, 2008 11:27PM

II agree with the comment above. That can easily happen. - but, you say it's happening outside of your bedroom? As far as the sleep - seems directly related, but I would rule out sleep apnea. Some of your symptoms sound like my father's. After he went on treatment his life was restored. Just putting it out there - have you had them watch what happens after 5 minutes? There are soft structures, not just bone. The ear canal is like that also - maybe goofy, but how about a mild structural collapse? It happens to some people in the ear when they put headphones on.

by penwill65, May 08, 2008 09:21PM
To: Florida guy
Yes i agree with the person  above also, cause i have had this same problem for years, i had a  scan , allergy shots, meds, nothing worked, Then a different doctor did MRI and seen i had a deviated septum and I had a bone that had to be moved over a little to center airway better. It did not completly take care of my problem. I would say 50. %. I still use over the counter nasal spray to. I DID  use  affrin but it stopped working , now i use dollar store brand only, and i use itduring the day and at night , depending on my surroundings and enviroment. You should have a MRI done . And most importantly I have fms and most people with fms have this chronic sort of nasal condition. Im very curious though about the person who told you about the grinding of the teeth causing inflamation???? I have to check that out cause i do grind my teeth......and fms has a lot to do with inflamation problems................If ya get a chance check out a few sites on fms. Do you have other health problems? Such as all over body pain?