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Is the problem here the nostrils or the tongue?
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metallikat36 Offline

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Post: #1
Is the problem here the nostrils or the tongue?
I've noticed my grandfather has some kind of apnea but I need to learn more in order to be able to discuss it with him in a way that he will be receptive to. I don't understand if his problem has to do with the sinuses, the tongue, or both. He's the kind of person you may only get one shot with in explaining something, so I want to be as helpful as I can. Here are two scenarios I have observed while watching him:

1. He is lying on his back. His mouth is slightly open. He is breathing and then kind of chokes and wakes up. I think in this case it obviously must mean his tongue is completely blocking breathing through both the mouth and the nostrils. Is this a correct assumption?

2. He is lying on his back. His mouth is totally closed. He inhales through his nose. Then when he exhales, the air dose not go out of his nose. Rather his cheeks inflate and this pressure then bursts through his closed lips, allowing the air out. Then his lips close again. This cycle repeats. This is what confuses me. If the cheeks are inflating, to me that means the air is not getting out of the nostrils. And yet the nostrils are the route in which the air came in successfully. So here I am having trouble understanding if the problem has to do with the nostrils, the tongue, or both?

I was thinking of suggesting some more conservative measures to him as I know he will simply not go for CPAP and probably won't ever submit to any kind of sleep study. To this end I have come across two interesting options:

1. Tongue suction type of appliances: These suction the tongue, and then the lip on the appliance goes over the front of your teeth, effectively pulling your tongue forward while you sleep. There are several brands available for this, as well as some knock-offs on Ebay.

2. Neurocranial restructuring is a lesser known chiropractic adjustment that opens up the sinuses by precisely inflating some balloons in your sinuses and allows one to breath easily through them. They claim it works well for many cases of apnea, but not all, and hence a need for me to understand more about what my granddads specific problem is.

Thanks for any insight!
David
12-17-2014 10:38 PM
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Ghost1958 Offline

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Post: #2
RE: Is the problem here the nostrils or the tongue?
This is a guess based on my own past. I had all sinuses full of polyps and eventually had to have surgery to remove them. However getting to that point before I could not breathe thru my nose at all, similar stuff would happen to me. I think just excess tissue moving around in conjunction with SA etc just caused some really weird inhale exhale cycles.

After the surgery I still had apnea but the sort of thing you are describing stopped. As I said a guess.
12-17-2014 11:13 PM
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PaulaO2 Offline
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Post: #3
RE: Is the problem here the nostrils or the tongue?
You don't think he would use a CPAP but you do think he would use a tongue stimulation or suction device? Or have surgery? Frankly, CPAP is the least evil of those options. No way would I even suggest someone get a tongue suction device off ebay or something like that. Holy crap, the things that could go wrong! And what a waste of time and money since no one is sure he even needs it.

Puffing air out the cheeks when on your back is common. It just happens. But my point is it may not mean there is anything wrong. It may just be something he does.

Get an oximeter. Have him wear it two nights. Download the data each night and see what the data says. If the blood desaturation rate drops below 88% during the night, then maybe you can talk him into a take home sleep test. They're less invasive and he gets to sleep in his own bed. Then he knows for sure if something is up and decide on his own what to do about it.

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12-17-2014 11:31 PM
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surferdude2 Offline

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Post: #4
RE: Is the problem here the nostrils or the tongue?
(12-17-2014 10:38 PM)metallikat36 Wrote:  I've noticed my grandfather has some kind of apnea but I need to learn more in order to be able to discuss it with him in a way that he will be receptive to. I don't understand if his problem has to do with the sinuses, the tongue, or both. He's the kind of person you may only get one shot with in explaining something, so I want to be as helpful as I can. Here are two scenarios I have observed while watching him:

1. He is lying on his back. His mouth is slightly open. He is breathing and then kind of chokes and wakes up. I think in this case it obviously must mean his tongue is completely blocking breathing through both the mouth and the nostrils. Is this a correct assumption?

Not exactly, it is generally the the tongue and the rest of the soft palate that tends to block the airway when some people relax fully and fall asleep. To be considered serious enough to warrant treatment, a person must have that breathing difficulty at least five times per hour. That may not be much consolation but it is the criteria any doctor will apply.

2. He is lying on his back. His mouth is totally closed. He inhales through his nose. Then when he exhales, the air dose not go out of his nose. Rather his cheeks inflate and this pressure then bursts through his closed lips, allowing the air out. Then his lips close again. This cycle repeats. This is what confuses me. If the cheeks are inflating, to me that means the air is not getting out of the nostrils. And yet the nostrils are the route in which the air came in successfully. So here I am having trouble understanding if the problem has to do with the nostrils, the tongue, or both?

This can happen in some people that have a certain mouth structure that when the jaw is held in a certain position, the lips form a one-way valve that closes against their teeth when inhaling and opens during exhaling. It also is dependent on a certain amount of nasal restriction. Some people just naturally do that for no particular reason but generally nasal restriction is a part of it.

I was thinking of suggesting some more conservative measures to him as I know he will simply not go for CPAP and probably won't ever submit to any kind of sleep study. To this end I have come across two interesting options:

1. Tongue suction type of appliances: These suction the tongue, and then the lip on the appliance goes over the front of your teeth, effectively pulling your tongue forward while you sleep. There are several brands available for this, as well as some knock-offs on Ebay.

These devices are not generally successful and would be my least desirable method since it will be uncomfortable and cause drooling.

2. Neurocranial restructuring is a lesser known chiropractic adjustment that opens up the sinuses by precisely inflating some balloons in your sinuses and allows one to breath easily through them. They claim it works well for many cases of apnea, but not all, and hence a need for me to understand more about what my granddads specific problem is.

This would be out of the question since the proponents of it make such radical claims that you would be foolish to trust them.

Thanks for any insight!
David

You have your work cut out for you and the first step is to convince him that he has a problem that is serious enough that it requires attention and that fixing it will make him feel better and enjoy life much more. Then you need to tell him that he is lucky that there are several things that he can try that may help him.

Don't go for cpap therapy right away but suggest he try the nasal expander devices that you can get at your local drug store. They are called Sleep Right and I get mine at Walgreen's although I first got them from Amazon. They are soft and comfortable and work very well to open up the nasal passages, especially if there is a deviated septum problem, which I have. They might be all he needs.

With that as a first step, if it doesn't work then you will at least have gotten him into a dialog about his possible problem. I don't envy you the job of selling him on cpap therapy, so good luck with that. It will depend on whether he feels this is causing him any problems other than making you uncomfortable.

[Image: Sleepright_zpsce5484ae.jpg]
(This post was last modified: 12-18-2014 12:42 AM by surferdude2.)
12-18-2014 12:25 AM
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trish6hundred Offline

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Post: #5
RE: Is the problem here the nostrils or the tongue?
Hi metallikat36,
WELCOME! to the forum.!
To me, CPAP therapy would be the easiest out of the options you suggested.
I would try like anything to convince him to get started first with an in-home sleep study, so he can have the benefit of sleeping in his own bed, and then, if you find out from that, that he has sleep apnea to get started with a CPAP mask and machine. Present it as a new adventure.
Hang in there for more suggestions and good luck to you.

trish6hundred
12-18-2014 03:18 PM
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Peter_C Offline

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Post: #6
RE: Is the problem here the nostrils or the tongue?
You forgot that MR. Flappy may also be a touch too long (one of my problems). I've been on CPAP for 12+ years, had both nose and throat surgery, and thank God daily for my sleep machine. The problem is, your grand-dad has made it this far without serious issues (that he knows of), which will be used against your arguments. Whereas I, at age 40-something, started having way-serious heart issues, which caused my Docs to force testing til they learned about my OSA.

I loved my nose surgery and would do it over again in a heart-beat! Throat surgery was rather painful, and *I* do not see any benefits, other than a 4-5 drop in CPAP pressure(which in itself can be a big deal, now years later I am on an ASV machine at 18 +).

OSA *can* be a big deal, depending on how severe it is. Mine was labeled 'life-threatening', so everyone dropped what they were doing and got me all hooked up, re-tested, and all supplies within 2 days in the beginning. And my life changed the next day.

Other folks, not so much. Many people do not see a benefit for a long time, if ever. Harder for them to believe. The facts are there, but many people just don't feel a difference, so they quit. Compliance is a real issue with CPAP, and sadly, treatment needs good compliance.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

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12-18-2014 03:54 PM
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Jim Bronson Offline

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Post: #7
RE: Is the problem here the nostrils or the tongue?
(12-17-2014 10:38 PM)metallikat36 Wrote:  1. Tongue suction type of appliances: These suction the tongue, and then the lip on the appliance goes over the front of your teeth, effectively pulling your tongue forward while you sleep. There are several brands available for this, as well as some knock-offs on Ebay.

I tried one of these, and it didn't work at all. They make it sound like you won't even know it is there, but I couldn't get to sleep with that thing hanging out of my mouth. I tried it a few times and threw it away. IMO don't waste your money. CPAP works great for me.
12-18-2014 05:55 PM
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archangle Offline
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Post: #8
RE: Is the problem here the nostrils or the tongue?
(12-18-2014 12:25 AM)surferdude2 Wrote:  Don't go for cpap therapy right away but suggest he try the nasal expander devices that you can get at your local drug store. They are called Sleep Right and I get mine at Walgreen's although I first got them from Amazon. They are soft and comfortable and work very well to open up the nasal passages, especially if there is a deviated septum problem, which I have. They might be all he needs.

With that as a first step, if it doesn't work then you will at least have gotten him into a dialog about his possible problem. I don't envy you the job of selling him on cpap therapy, so good luck with that. It will depend on whether he feels this is causing him any problems other than making you uncomfortable.

While you might try those things, most apnea is in the throat, not the nose, and these won't do anything for "normal" apnea. They may help folks with some sort of restriction in the nose.

Some people get some relief from sleeping on their side, their stomach, or sleeping in a recliner.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
(This post was last modified: 12-19-2014 12:54 AM by archangle.)
12-19-2014 12:38 AM
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