Effect of Heated Humidity With Thermosmart™ Compared to an Intranasal Steroid in Improving Compliance and Nasal Symptoms in Patients Using Continuous Positive Airway Pressure

Inclusion Criteria: * Between the ages of 18-65 * Diagnosis of obstructive sleep apnea (OSA) with apnea/hypopnea index (AHI) \> 15/hr * Currently using CPAP therapy and within 3 weeks to 12 months of initial CPAP titration * Based on the CPAP nasal symptom questionnaire, a score of at least 3 (sometimes) for at least one of the following nasal symptoms related to their sleep apnea and CPAP usage: nasal congestion, runny nose, sneezing, or nasal irritation * Willingness to tolerate and continue therapy with nCPAP * Successfully titrated on nCPAP in a sleep center to a pressure between 6-16 cmH2O * Willingness to comply and complete study related procedures * Fluent in the English language Exclusion Criteria: * Co-morbid medical condition that is either medically significant and unstable, would interfere with the patient's ability to routinely use CPAP, or is a contraindication for use of a nasal steroid * Women who are pregnant or who may potentially become pregnant during the course of the research trial. * CPAP compliance over the past three weeks at screening \> 5 hours/night, suggesting no compromised CPAP usage due to adverse nasal symptoms * Wake resting SaO2 \< 90% * Currently using Bi-Level therapy, supplemental oxygen with CPAP therapy, or using a pressure outside inclusion criteria * Currently using a Full-Face mask for CPAP therapy * Current or prior use of the Fisher Paykel 604 CPAP machine with Thermosmart™ heated humidity. * Patients who were never prescribed a heated humidifier with their CPAP machine (i.e. no humidifier or passover humidifier). * Intranasal steroid treatment within the previous six months. Patient's currently taking intranasal steroid treatment cannot wash-out of steroid treatment to be included nor if patients have used nasal steroid treatment while on CPAP therapy * Current upper airway tract infection, influenza, respiratory infection at time of screening or nasal surgery within 90 days of screening * Prior surgical intervention for obstructive sleep apnea * Currently taking medications that would be contraindicated to using a nasal steroid. Patients taking hypnotic or wake promoting therapy can participate if they have been on a stable dose prior to CPAP therapy and willing to maintain current dose as prescribed. * Shift or rotating shift workers or individuals who routinely cannot contribute at least 6 hours/night to sleep/attempting therapy * Additional sleep disorder that would interfere with routine use of CPAP