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.

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

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.