Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

I choke awake immediately on my back or sitting up - is this unusual?
#1
I choke awake immediately on my back or sitting up - is this unusual?
I'm currently working on getting PAP therapy to work for me, but I'm having huge issues with aerophagia. I do hope to get to the point where I can sleep enough to post results and get help tweaking everything.

In the meantime, my question is: Is it unusual to not be able to sleep even for a second on my back? Or even sitting up?

in both of those positions, the very second I fall asleep I immediately wake up choking! I can fall asleep on my side (but obviously with sleep apnea and an AHI over 30.)

I have reason to think that I might have some unusual anatomical issues contributing to the sleep apnea ... About 7 years ago I had a very major flare of Ankylosing Spondylitis. It attacked my thoracic and cervical hard. When the flares were over and the disease process was under control (thanks to Humira) I was left with severely limited range of motion in my neck. Limited motion in every direction. My head is also slightly hunched forward (If I lie down on my back my head is about six inches off the floor). All of this damage is almost certainly permanent . Also, and this may be important, my anterior longitudinal ligament in my neck is fully ossified. Technically this means my neck is "fused."

It was around that same time that I noticed I couldn't fall asleep on my back.

I'm considering a "Sleep endoscopy" just to figure out if I have some unusual reasons for the SA. I should add that I'm not overweight or underweight.

Thanks for any insights!
Post Reply Post Reply
#2
RE: I choke awake immediately on my back or sitting up - is this unusual?
I'm going to throw this in here for consideration in case (I hope) one of the SA experts reads my post.

The subject below has a bunch of stuff in common with me: similar age (I'm early 50s), ankylosing spondylitis, ossification of anterior longitudinal ligament (not altogether common in AS), severe SA (his AHI is 41 and mine is 31.

QUESTIONS:

1) What do they mean by "complete closure of the oropharynx during sleep" ... would that be only in certain positions (e.g. supine) ... or maybe it happened sporadically during sleep?

2) Is there a reason why his structural abnormalities would require "Nasal continuous positive airway pressure (nasal CPAP) with the use of chinstrap, but not nasal CPAP alone"?


Abstract
A 66-year-old man who had received a diagnosis of ankylosing spondylitis at the age of 50 was referred to our hospital for further evaluation of sleep apnea experienced for the last 3 years. Polysomnography yielded a diagnosis of obstructive sleep apnea syndrome with an apnea index of 41/hr. Computed tomographic scans demonstrated complete closure of the oropharynx during sleep at a site of marked ossification and hypertrophy of the cervical anterior longitudinal ligament. Nasal continuous positive airway pressure (nasal CPAP) with the use of chinstrap, but not nasal CPAP alone, dramatically decreased the patient's apnea index to 2.4/hr. We reported this case because, to the best of our knowledge, it is the first to demonstrate a causative association between ankylosing spondylitis and obstructive sleep apnea syndrome
Post Reply Post Reply
#3
RE: I choke awake immediately on my back or sitting up - is this unusual?
Welcome to Apnea Board,

2 definitions that maybe will help some...

oropharynx-
the part of the pharynx that lies between the soft palate and the hyoid bone

pharynx-
the membrane-lined cavity behind the nose and mouth, connecting them to the esophagus

This is just a guess, but I think you'll need medical expert opinions on this, but it sounds like a high level of something like an airway collapse in or near your throat due to your medical conditions. I'm thinking you'll need to get imaging done or similar to see what's actually happening. Have you consulted with your primary or ENT?

We can certainly help if or when you get a PAP machine. But this sounds like you'll need pro help on this. However we'd like you to stick around and learn as much as you can.
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.
Post Reply Post Reply
#4
RE: I choke awake immediately on my back or sitting up - is this unusual?
Hi Dave,

Thanks for your reply. It helps to have someone listening. I am wrestling with my cpap now every day and I will plan to see an ENT.

I do have a couple of questions:

1) Is it safe to say that this type of 100% complete airway collapse both supine and sitting up is unusual? I think it might help me approach doctors if I knew how unusual this is.

2) Have you ever heard of imaging the airway via CT scan as mentioned in that case study?

Thanks for your help with this.
Post Reply Post Reply
#5
RE: I choke awake immediately on my back or sitting up - is this unusual?
I'd agree it's unusual but probably has been faced by someone before.

CT scans can be used in a lot of image for diagnostic reasons. Have I heard of it specifically for this? No, but I myself have had CT imaging for other medical needs. I'd think it couldn't hurt to do it and see if it helps to identify your needs. I'd try any means required to resolve this, within reason.
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.
Post Reply Post Reply
#6
RE: I choke awake immediately on my back or sitting up - is this unusual?
I appreciate your help with this!
Post Reply Post Reply
#7
RE: I choke awake immediately on my back or sitting up - is this unusual?
Hi Dave,

Well I have an update: I saw an ENT yesterday. I was pleasantly surprised that he seemed to have it together and he listened very well. He stuck some sort of scope up my nose and was able to visualize my airways.

He said the narrowing of my airways is due BOTH to
A) damage to my cervical spine (extra bone growth, ossified ligaments) as well as
B) the impact of silent reflux on the soft tissues.

Sounds like a pretty crummy double whammy.

Oh, and he seems to think my deviated septum is a bit more deviated than other docs have told me.

Anyway, he ordered a barium swallow test for the reflux and also a CT scan of my neck. He would also like to do a new sleep study since the last one was in 2018.

So, I guess I'm making progress with all of this. Still fiddling around with my CPAP in the meantime. I had to get a new nasal mask and now I'm using it during the day. I'll try to sleep with it soon.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
Question I'm back, tired, and hopeless. But is Bilevel the answer ?? weuw 83 4,973 03-23-2024, 08:16 AM
Last Post: Sleeprider
  [Health] Pulse oximeter readings while asleep and awake - what do these readings mean? SleepyButHopeful 11 674 02-26-2024, 03:17 AM
Last Post: srlevine1
  Wake and can't get back to sleep hydra 11 521 02-23-2024, 12:05 PM
Last Post: Lucid
  [Symptoms] Help my symptoms got better at first but then they came back after a month LordofthStrings 14 934 02-22-2024, 03:28 PM
Last Post: LordofthStrings
  Side sleeper vs. Back sleeper readings Bob Cali 4 402 02-21-2024, 09:54 PM
Last Post: PaulaO2
  Help figuring out why symptoms are back Jess2117 1 294 02-21-2024, 06:39 PM
Last Post: MikeR20
  Back at it after a few years HomerJ 7 543 02-18-2024, 12:08 PM
Last Post: Sleeprider


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.