Post Reply 
Blockage during exhale - Uvula/Soft Palate
Author Message
mikemky Offline

New Members

Posts: 2
Joined: Dec 2013

Machine: ResMed S9 VPAP S (BiLevel)
Mask Type: Hybrid
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i
CPAP Pressure: 11/7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #1
Blockage during exhale - Uvula/Soft Palate
Hello,

I was just recently diagnosed with sleep apnea. During the titration study, I used a nasal mask. I noticed then that when laying on my back, I often couldn't exhale through my nose - my uvula and/or soft palate would close off the nasal pathway.

Unfortunately the study wasn't very good - I only slept for the first two hours, and was awake the rest of the night. I didn't think to mention the problem with exhalation, and they didn't mention it either. But they prescribed me a BiPap machine anyway, which I started using this past Saturday.

Having done a bit of research after the titration study, I decided to go with the Quattro face mask - figuring that would solve the exhalation blockage issue. And it did - I could just breathe through my mouth - but the mask was very uncomfortable - it was a struggle to keep it from leaking all night.

So, yesterday I went and got a nasal pillow (Swift FX). Much more comfortable. However - I keep breathing through my mouth, as I keep getting blockages during exhale when on my back (I'm mostly fine when on my side).

Now, I mentioned my exhalation blockage problem to the DME, and they just gave me a chinstrap to use, to keep my mouth shut. However, I'm a little concerned that it might be a bit dangerous to use it - when I'm on my back, I simply can't exhale out my nose much of the time (with BiPap going). If I wear the chinstrap, I might not be able to breathe, and can only hope that I wake up before suffocating!

I can't find a lot of information about this particular problem - blockage during exhalation. It seems to be confused with 'Catathrenia', which is a moaning/groaning during exhalation, and classified as a parasomnia (as opposed to a physiological problem.)

The only relevant link I could find that was this one (well, I can't post links, so search for the following in quotes):

Dr. Steven Park: "expiratory-apneas-with-or-without-catathrenia-presenting-as-central-apneas"

So - my questions:

1. Anyone else have this problem? What did your doctor tell you? It doesn't seem to be a well documented condition. I'm wondering if surgery might be necessitated to resolve this.

2. Anyone using the 'Oracle' (intra-oral mask) for this purpose? I'm thinking this might be my best option.

For the people that don't like the Oracle mask - why? Does it leak much? Is it comfort regarding the fit, or is the problem more to do with breathing through your mouth? I don't have a problem breathing through my mouth - I've done it for years...I'm used to having a very dry mouth at night.

Thanks for any help...

--Mike

ResMed VPAP S (BiLevel) 11/7 pressure, ramp time 20 mins.
12-18-2013 03:13 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PollCat Offline
Apnea Board Polling Administrator
Monitors

Posts: 1,576
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: H5i Cleanable with ClimateLine
CPAP Pressure: 10 - 18
CPAP Software: SleepyHead

Other Comments: CPAP-ing since 1995; Type 2 Diabetes; Chronic Asthma; Gout

Sex: Male
Location: Westfield, IN

Post: #2
RE: Blockage during exhale - Uvula/Soft Palate
Welcome, Mike. While I do not know anything about the Oracle mask, I would suggest that you talk with an ENT doc about your exhalation problems. Those people usually have an explanation and a 'cure' for those kinds of problems.


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.
INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-18-2013 03:30 PM
Find all posts by this user Post Reply Quote this message in a reply
jgjones1972 Offline

Preferred Members-2

Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #3
RE: Blockage during exhale - Uvula/Soft Palate
I strongly second the recommendation to see an ENT about it...the sleep tech wasn't qualified to handle your problem, threw the chin strap at you just to get you out the door. ENT should definitely be able to figure out what the problem is. GP or Internist might be able to figure out and fix problem, if not can refer you to a good ENT.

Whatever is going on, I don't think blockage on exhale is a very common problem and it really needs to be addressed/checked out by a good doc.

Sleep-well
12-18-2013 03:44 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
DocWils Offline

Members-b

Posts: 1,271
Joined: Jul 2012

Machine: Philips Remstar series 60
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10
Humidifier: same as machine
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Switzerland

Post: #4
RE: Blockage during exhale - Uvula/Soft Palate
The problem isn't new - I have it, a lot of people do, it is a common form of Apnoea - sleeping on your side helps, as does the correct pressure. The ballooning of the uvula or the soft tissue behind the pharyngeal recess is not all that unusual, but it may be necessary to see an ENT in case there is a more profound problem. Normally, though, the correct pressure on the CPAP should be enough to deal with it.
(This post was last modified: 12-18-2013 07:18 PM by DocWils.)
12-18-2013 05:01 PM
Find all posts by this user Post Reply Quote this message in a reply
trish6hundred Offline

Advisory Members

Posts: 6,450
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #5
RE: Blockage during exhale - Uvula/Soft Palate
Hi mikemky,
WELCOME! to the forum.!
I've never heard of the condition you mentioned; you might consider getting it checked out by an ENT.
Hang in there for more responses to your post and best of luck to you.

trish6hundred
12-18-2013 05:55 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
justMongo Offline

Monitors

Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #6
RE: Blockage during exhale - Uvula/Soft Palate
(12-18-2013 03:13 PM)mikemky Wrote:  ....I decided to go with the Quattro face mask - figuring that would solve the exhalation blockage issue. And it did - I could just breathe through my mouth - but the mask was very uncomfortable - it was a struggle to keep it from leaking all night...

I use that mask and love it. It has a soft cushion; and I cinch down the straps 'til I do not get leaks. I am a mouth breather anyway. I get a new mask cushion every 3 months.


FYI, most folks don't get a good night's sleep in the lab -- strange surroundings and all the wires and hoses.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-19-2013 09:53 AM
Find all posts by this user Post Reply Quote this message in a reply
Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #7
RE: Blockage during exhale - Uvula/Soft Palate
(12-18-2013 03:13 PM)mikemky Wrote:  Now, I mentioned my exhalation blockage problem to the DME, and they just gave me a chinstrap to use, to keep my mouth shut. However, I'm a little concerned that it might be a bit dangerous to use it - when I'm on my back, I simply can't exhale out my nose much of the time (with BiPap going). If I wear the chinstrap, I might not be able to breathe, and can only hope that I wake up before suffocating!

You will not suffocate in your sleep. If that was going to happen it would have happened to you a long time ago. I recently calculated that I've had to wake myself up to breathe about 1.3 million times during the 20 or so years that I had untreated OSA.

The chin strap should be adjusted so that it's still comfortable for you to open your mouth, but tight enough that chewing is uncomfortable. Chin straps stop you from mouth-leaking, a situation where the pressurized CPAP air hisses out through your mouth. If you are still mouth breathing with it then you'll have to go to either a full face mask, a hybrid mask, or an oral mask.

The only way to find out is to try them, and the medical providers are set up to allow you to do that because it's a common practice. Most people try several masks before finding one that works for them.

Sewing a tennis ball into the back of an old t-shirt is a good way to keep you from sleeping on your back. My apnea is much worse when I'm on my back. I think I've conditioned myself over the years to instinctively avoid sleeping on my back because it does cause my airway to collapse. I have noticed that, like you, I get a blockage on exhale. It happened during my sleep study.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-19-2013 10:33 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PollCat Offline
Apnea Board Polling Administrator
Monitors

Posts: 1,576
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: H5i Cleanable with ClimateLine
CPAP Pressure: 10 - 18
CPAP Software: SleepyHead

Other Comments: CPAP-ing since 1995; Type 2 Diabetes; Chronic Asthma; Gout

Sex: Male
Location: Westfield, IN

Post: #8
RE: Blockage during exhale - Uvula/Soft Palate
(12-19-2013 10:33 AM)Sleepster Wrote:  Sewing a tennis ball into the back of an old t-shirt is a good way to keep you from sleeping on your back.

Of course this only works if you remember to wear the t-shirt to bed each night; some of us can only sleep 'au naturel'. Laugh-a-lot


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.
INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-19-2013 10:59 AM
Find all posts by this user Post Reply Quote this message in a reply
justMongo Offline

Monitors

Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #9
RE: Blockage during exhale - Uvula/Soft Palate
(12-19-2013 10:59 AM)PollCat Wrote:  
(12-19-2013 10:33 AM)Sleepster Wrote:  Sewing a tennis ball into the back of an old t-shirt is a good way to keep you from sleeping on your back.

Of course this only works if you remember to wear the t-shirt to bed each night; some of us can only sleep 'au naturel'. Laugh-a-lot

[Image: useless.gif]

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-19-2013 06:01 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
mikemky Offline

New Members

Posts: 2
Joined: Dec 2013

Machine: ResMed S9 VPAP S (BiLevel)
Mask Type: Hybrid
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i
CPAP Pressure: 11/7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #10
RE: Blockage during exhale - Uvula/Soft Palate
Thanks for all the replies! I made an appointment with an ENT on Monday. Btw, I'm not sure if CPAP can prevent a blockage on exhale - by definition, the air is flowing in the other direction when you exhale. Maybe if there is some leakage, but in my case, I'm completely blocked on exhale - like a cork was put there...Once it is blocked, the force of my exhale seems to keep it shut against the pressure of the CPAP (well, BiPap in my case), until my mouth blows open. I suppose if the exhale pressure of the BiPap was increased, that might help; but then again, I have to 'beat' the exhale pressure in order to actually exhale...

Anyway - thanks again. This is a very helpful forum.

--Mike
12-20-2013 12:58 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Soft cervical collar: a tip for mouth breathing and chin tucking Visitor 44 3,682 12-06-2016 11:43 AM
Last Post: PaytonA
  Airfit P10 - condensation collects on exhale ports Possum 7 396 11-02-2016 02:54 PM
Last Post: Possum
  Occasional problems with exhale relief function SLongridge 1 264 10-24-2016 05:29 PM
Last Post: trish6hundred
  Exhale Pressure William2000 7 607 09-26-2016 05:21 PM
Last Post: surferdude2
  A Question of Exhale Pressure Relief thecpapguy! 9 873 09-09-2016 07:36 AM
Last Post: thecpapguy!
  Airsense 10 Autoset Comfort/Response/Soft = "For Her" algorithm? Carbon 11 1,692 07-18-2016 10:30 AM
Last Post: Mosquitobait
Question wrong time in apnea bord soft natyprueba 2 263 07-15-2016 12:13 PM
Last Post: natyprueba

Forum Jump:

Who's Online (Complete List)