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Can Palatal Prolapse be treated with CPAP
#21
RE: Can Palatal Prolapse be treated with CPAP
(02-17-2020, 09:43 AM)NightVigil Wrote:  
Surgery options: Radiofrequency treatment of the soft palate and uvula (uvulopalatopharyngoplasty (UPPP)), also the "pillar Procedure". Both very promising - pillar procedure seems to be reversible, even.

My daughter had the UPPP procedure when she was 18. It helped for the first few months. But it all grew back and she was back to the CPAP. Would love to know a more permanent solution.

Cheers,
Damian.
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#22
RE: Can Palatal Prolapse be treated with CPAP
Hi,

I'd like to join your WhatsApp group re: OSA/ palatial prolapse.  Can you send me details?

Thanks,

Jim
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#23
RE: Can Palatal Prolapse be treated with CPAP
Hi Geer1,

I know this is an old thread - but I'm desperate so I thought I would jump in an add my two cents.  

I think your analogy to a partially closed door is a good one to help visualize the problem, but with some tweaks.  We're in a room with a partially closed door and we need to vent the room of smoke.  We have a fan blowing in to help keep the door open.  But since we need to exhaust the room, we need a fan blowing out (lungs) to create a pressure greater than the external fan in order to accomplish that.  Whatever pressure the fan blowing in creates, there must be a net outward pressure on the door to vent the room - which will push the door closed.

In short, the external fan is useless.

I've have had a DICE procedure to confirm the problem is retro-palatial blockage and many years being awakened repeatedly as my palate flops closed on exhale.  I even experience this when I lie on my back and relax.  

My doctor wants to do a modified expansion sphincter pharyngoplasty and I would desperately like to avoid this.

Have you (or anyone) found a conservative solution that works?
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#24
RE: Can Palatal Prolapse be treated with CPAP
(01-12-2021, 12:17 PM)JimRobert Wrote: Hi,

I'd like to join your WhatsApp group re: OSA/ palatial prolapse.  Can you send me details?

Thanks,

Jim

Hey Jim, the link is a cuttly link: https colon double-slash cutt.ly slash YrVlWF1


Hope that helps.
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#25
RE: Can Palatal Prolapse be treated with CPAP
(01-12-2021, 12:46 PM)JimRobert Wrote: I've have had a DICE procedure to confirm the problem is retro-palatial blockage and many years being awakened repeatedly as my palate flops closed on exhale.  I even experience this when I lie on my back and relax.  

Have you (or anyone) found a conservative solution that works?

Question: Did the (you probably meant "DISE") confirm the retro-palatal prolapse?


As for a conservative solution. Look into Velumount - if you can get it, it will probably give you some relief. I've been using it a couple of months now and the difference has been day and night. While probably not a great permanent solution, it will give you time to find a cure.

NightVigil
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#26
RE: Can Palatal Prolapse be treated with CPAP
(01-12-2021, 01:20 PM)NightVigil Wrote:
(01-12-2021, 12:17 PM)JimRobert Wrote: Hi,

I'd like to join your WhatsApp group re: OSA/ palatial prolapse.  Can you send me details?

Thanks,

Jim

Hey Jim, the link is a cuttly link: https colon double-slash cutt.ly slash YrVlWF1


Hope that helps.

Thanks for this link - one document, correct? Any treatments for this issue?
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#27
RE: Can Palatal Prolapse be treated with CPAP
(02-17-2020, 09:43 AM)NightVigil Wrote: I think I have palatal prolapse as well (for 10+ years) and thanks to this post and another one over at the  [[ Auto Word Filter: links to DME-owned sites not allowed ]]  forums, I was finally able to identify my issue as palatal prolapse. Other terms I've come across during my research are:

* Expiratory palatal obstruction (EPO) (This is what Dr. Steven Park refers to on his blog. He has an article about it and I encourage you to read it, very insightful stuff.)
* Expiratory velopharyngeal obstruction

* Soft-palatal / palatal obstruction
* Obstructive palatal prolapse

Needless to say, that after a decade of insomnia, I'm eager to find a solution and wanted to let you guys know, that I have created a WhatsApp group for this purpose.

Unfortunately I am not allowed to post links as a new member, but I'll give you two tips. 1: Cuttly (this is an URL shortening service) and 2: ZrVxQ60  :-)

I made a list of possible solutions (which I have gathered from different forums and sites):

CPAP therapy: Some people have found that enabling the expiratory pressure relief (EPR) (C-Flex on Philips) setting on your CPAP machine makes things worse for EPO. This makes sense, since pressure is the thing that is keeping your excess tissue in place upon exhalation. Unfortunately that means, that people that suffer from EPO cannot use this setting. Obviously CPAP relies on a closed loop system and this only works if you can keep a good seal. If you are using a nasal mask and your mouth keeps opening, look into mouth-taping. I'm not sure yet, if a full face mask will do good for EPO, but I remain skeptical, because you'd want the pressure behind your velum / tongue area and not in front of it for it to stay out of the nasopharynx. APAP, BiPAP, ASV are probably not a good solution because of the same problem (like EPR), but that's just my personal opinion. I have not experimented with these.

Nasal stents: AlaxoStent / Nastent. Not tried 'em yet.

MAT Body positioning system / Massage table with face cradle - not tried, either. Might be worth a try.

Mandibular advancement devices - Haven't tried one, but if I move my lower jaw forward, I can still very reliably reproduce the EPO - so I suspect it's of no good use for this special problem.

Velumount / Ronchex: These are basically clips made of wire in silicone tubing that are supposed to stabilizing your velum and uvula during sleep - currently looking into this!

Shifting your sleep position: Sleeping on your side (lateral position) seems to be better. This makes sense to me, because gravity will not additionally pull your uvula/velum back into your throat (like in subpine position). I have never been able to fall asleep in subpine position.

Playing Didgeridoo (combined with 'circular breathing') is said to help as this trains muscles in the respective areas. Might look into this.

Surgery options: Radiofrequency treatment of the soft palate and uvula (uvulopalatopharyngoplasty (UPPP)), also the "pillar Procedure". Both very promising - pillar procedure seems to be reversible, even.

Please let me know, if you have found something that works for you or if I have forgotten something which I could add to this list.

I have a sleep study due in march and hope that I get more insight as to what I might do about it. My sleep has been really bad the last few months and it sure as hell can't stay that way. Now that I finally understand what the problem is, I'll put every energy I can raise towards finding a solution. Please help and consider joining my WhatsApp group. Let's science the sh*t out of this!

NightVigil

@NightVigil - are you suggesting that using the "MAT Body positioning system / Massage table with face cradle" while sleeping on your stomach would be helpful? I imagine lying facedown would help the palate from falling backward.
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