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Could physical therapy exercises for neck muscles worsen AHI?
#1
Could physical therapy exercises for neck muscles worsen AHI?
I don't know human anatomy beyond the basics but this coincidence is making me wonder: Could my fifth day of strengthening my neck muscles through physical therapy slightly constrict my airway to an extent whereby it raised my AHI?  Can increasing the muscle tone of the neck muscles put more pressure on the airway?

I had assumed no because I figured that the location of the typical airway obstruction is somewhat above where that increased tone might be an issue---but my intuition on this is probably flawed.

I have a deteriorating cervical disk at C3/4 and some other irregularities in the neck area of the spine (causing pain and sensation/motor losses in extremities as a result) so I asked my doctor for a physical therapy referral.  Those PT exercises were starting to help my neck feel better when my AHI suddenly doubled from an average around 2.5 to about 5.2---with a lot more arousals due to the higher BIPAP pressure. I've not had a night's AHI below 4.5 since the multiple-PT-sessions-per day started.

[By the way, I typically have zero or nearly zero central apneas---ever since raising my trigger setting to the highest level---so CAs are irrelevant to my AHI doubling.]
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#2
RE: Could physical therapy exercises for neck muscles worsen AHI?
I can see how it might be possible. Perhaps it will fade away as you adapt to the PT.

When you say a lot more arousals due to higher BiPAP pressure, how much higher is the pressure? What was it before the PT?
Sleepster

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.
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#3
RE: Could physical therapy exercises for neck muscles worsen AHI?
It is always a good idea to add an OSCAR chart to help with data. Maybe there's something to be seen that can help.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Could physical therapy exercises for neck muscles worsen AHI?
I would suggest it's less likely to hinder your breathing because your muscles are stronger, but perhaps the PT is causing some change in your sleeping position/head position (maybe because of residual soreness or tension or whatnot) and THAT is causing you some positional apnea? Hard to know without comparing charts, though. Your neck muscles that high aren't really a part of respiratory effort, and they wouldn't constrict your airway from anything I know (but also NAD and this isn't medical advice etc).


See my comparison of Viatom/Wellue and CMS50F oximeters here.

Not a doctor, definitely not your doctor, all advice is given as-is and represents simply my own understanding as a fellow patient and OSCAR user.
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#5
RE: Could physical therapy exercises for neck muscles worsen AHI?
(05-26-2021, 04:20 AM)Ratchick Wrote: I would suggest it's less likely to hinder your breathing because your muscles are stronger, but perhaps the PT is causing some change in your sleeping position/head position (maybe because of residual soreness or tension or whatnot) and THAT is causing you some positional apnea? Hard to know without comparing charts, though. Your neck muscles that high aren't really a part of respiratory effort, and they wouldn't constrict your airway from anything I know (but also NAD and this isn't medical advice etc).

Agreed with Ratchick and Dave.
Post your graphs, the community is very knowledgeable and helpful

Safe exercise should never affect your health. Just don't over do it
If anything, it should improve your sleep quality

For example, strong core muscles improves our sitting posture. Thus reducing neck and back pain
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#6
RE: Could physical therapy exercises for neck muscles worsen AHI?
Read our wiki article on positional apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea Consider if you have changed your sleeping position in any way that might be increasing the curve in your neck or chin-tucking. It is a very common cause of increased obstructive apnea, and in your circumstances might not be unexpected.
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#7
RE: Could physical therapy exercises for neck muscles worsen AHI?
(05-26-2021, 07:46 AM)Sleeprider Wrote: Read our wiki article on positional apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea  Consider if you have changed your sleeping position in any way that might be increasing the curve in your neck or chin-tucking.  It is a very common cause of increased obstructive apnea, and in your circumstances might not be unexpected.


I have never had a positional apnea issue in any of my recent sleep studies (nor longer ago studies),  and 100% of my sleep time is in supine position with a relatively low pillow. Also, I have used my own camera surveillance to check my positioning. 

Several had asked to see OSCAR summaries so I have attached a typical pre-physical-therapy sleep session from May 12, a sleep session from the period of daily neck PT (labelled May 25), and then a May 28 post-PT session (i.e., after several days without PT segments.)

I'll provide a close-up of an obstructive apnea event in a second post.

(05-25-2021, 10:30 PM)SarcasticDave94 Wrote: It is always a good idea to add an OSCAR chart to help with data. Maybe there's something to be seen that can help.


I've attached a zoomed-in screenshot.


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#8
RE: Could physical therapy exercises for neck muscles worsen AHI?
The typical positional apnea shows up in either or both O it H chart. They show up as clusters of apnea one after another. Your last OSCAR shows positional apnea.
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#9
RE: Could physical therapy exercises for neck muscles worsen AHI?
Yeah, May 25th definitely looks positional to my (not very experienced) eye. I suspect that perhaps the PT just left you with some residual soreness or stiffness perhaps that altered your head position enough to trigger more positional apnea bouts. That would be my guess, anyway.


See my comparison of Viatom/Wellue and CMS50F oximeters here.

Not a doctor, definitely not your doctor, all advice is given as-is and represents simply my own understanding as a fellow patient and OSCAR user.
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#10
RE: Could physical therapy exercises for neck muscles worsen AHI?
(05-31-2021, 10:21 PM)staceyburke Wrote: The typical positional apnea shows up in either or both O it H chart. They show up as clusters of apnea one after another. Your last OSCAR shows positional apnea.

Interesting.  Baffling but interesting.  I checked my video feed during those time intervals and I can't see anything out of the ordinary about my head positioning. 

How do positional apnea data patterns ("They show up as clusters of apnea one after another") differ from just the usual textual relaxing/sagging of airway tissues? Do not the latter also show up as clusters of apnea?

I've attached a close-up of a cluster of OAs from last night, a reasonably good sleep session.  (I consider anything under 3.0 AHI a good night if I got at least 6.75 hours of sleep.) Does that cluster appear positional as well?

I resumed my neck PT two days ago but I'm going a little more gradual this time. [After sequestering for the pandemic, I resumed 3hours/week weight machine exercise about two months ago and there is some muscle target overlap between my gym routines and the more recent PT exercise. Thus, my recent PT is not necessarily a big change for my body and its movements.]  I hope to contact a friend who is a retired anatomy professor to see if increased muscle tone in the head supporting muscles can possibly have a constricting effect when there is stenosis and spondylitis at work. (In a "normal" neck, I would think no---but my neck structure is no longer normal.)  I don't see my pulmonologist until July.

Thank you VERY MUCH for the willingness of all of you to help me out.  Assistance from this board virtually eliminated my central apnea and I am especially grateful for that.


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