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

Palate still closing on exhale
#1
Sad 
Palate still closing on exhale
Ok we have been super busy - I had started another thread - my  intro thread - and not sure if it really ever got me any answers.  Well i know it hasn't because I'm still having the same trouble.  But hubby hasn't had time to get screen shots of the data either.

My doc had kinda just said I need to do my research to find a sleep specialist. Annoyed-and-disappointed

But  I did, and in the meantime when I did my research I found this forum which told me how to adjust my pressures myself.  I had put my minimum up to 10 which was only slightly better and got rid of the ramp time.  I still get a stomach full of air. I can inhale great, no problem, even at lower pressures.

What I can't do in almost all comfortable positions is exhale. I can breathe in and out fine on my stomach with no machine (with my chin on a neck roll because I can't sleep with my head to the right or left because of spinal issues).  But this gives me pressure sores on my lower lip and chin from pressing on my teeth and I can't stay in this position too long usually.

I did find a sleep specialist who seems very compassionate. He looked at my original script and said let's start with 9  and set it to CPAP not Autoset, but I had forgotten I'd already gone up to 10 minimum.  He says the machine isn't reading that my palate is closing.  I don't know why, unless I wake up so quickly that it doesn't have a chance to register. 

Last night it started at pressure of 9 as he had them set it.  Then I got so frustrated within 20 minutes of dozing off and waking up with my palate snapped shut, I switched it to 10.  Then 11.  Then 12.  Then 13 which gave me about a 5% improvement  so I fell asleep briefly.  Or something like sleep.  It was probably about 2 am by that time. I didn't sleep well  after that (this goes without saying, been like that for years now) Tossing and turning and rearranging the hose and whatever else, making sure i can still breathe for at least a short nap.  And finally about I think 6am I just took it off and laid there on my stomach with my chin pressed into the neck roll until about 730.  I'm using 13 and classified as "mild apnea" and still not getting relief?  Come on, what is wrong with this picture?  The machine has stopped my snoring and that is a welcome relief but it hasn't really actually helped me sleep that much more and I've traded one form of sleeplessness for another.

Sometimes I'll wake feeling the palate closed (especially as it happens repeatedly when I'm falling asleep) and deliberately lay there NOT opening my palate for at least ten seconds to give something for the machine to notice.  I don't know if it helps.  It closes even if I'm still awake, in a reclined position, if i relax my throat. Happens even on my side most of the time.  I can't sleep on my side long either because of my neck issues (those are being addressed gradually but that's also been a fight with my insurance). I have had better luck with that the last few days because I had a cortisone shot/C7 nerve root block but who knows how long that will last.  It's already fading, I could tell last night.

I can demonstrate the closed palate simply by relaxing my throat when I'm awake and reclined even partially.  Don't need a titration test for this.  It sometimes does this even if I exhale too quickly while I'm upright.  I find that I am automatically holding my throat open for exhalation even when awake like a singer opening their throat to sing (think of the sensation just before you yawn).  But it obviously doesn't matter that much if it happens when I am awake.

So I woke up this morning and left a message for the sleep doc.  I was bawling as I left it.  So he just called me back and now I have to go for a titration test to see if they can figure it out.  He said maybe a BiPap would be better.  I told him I'm still trying to figure out how any amount of pressure is going to help me *exhale* if i have to *overcome the pressure* to exhale, I'm still going to flop that palate closed.  And then I have pressure from the machine fighting against pressure from my lungs and the palate just stuck there in the middle at neutral. And the air goes down my stomach in the process if I don't open my mouth. It was already going down my esophagus I think at much lower pressures and it's highly uncomfortable.

Doctor-no-get-it
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Palate still closing on exhale
I don't quite understand you when you talk about your palate closing.  I think some of us can raise our tongues and keep them raised while we sleep, and some have epiglottal tissue that we can sag or induce to sag so that it closes off our rear nasal passage, but I have yet to see some complain about their palate which I take to be a bony structure, the roof of our mouths.
Contrite, and wiser.
Post Reply Post Reply
#3
RE: Palate still closing on exhale
Have you been to an Ear, Nose, and Throat specialist?

When you talk about palate, I envision a blockage of sorts at the back of your throat. A specialist may be able to help with this.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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.
Post Reply Post Reply
#4
RE: Palate still closing on exhale
You might be a candidate for the INSPIRE implant. It is implanted into the soft palate, and electrical stimulation tightens the tissues to keep the airway patent. It seems like a good option for those with aerophagia from CPAP pressure. Is it possible that this is related to dropping the chin toward the chest? Many members have cervical collar to mitigate that problem and improve results.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Palate still closing on exhale
the palate is the soft part behind the bony structure, to which your uvula is attached.

(12-11-2018, 03:38 PM)OpalRose Wrote: Have you been to an Ear, Nose, and Throat specialist?  

When you talk about palate, I envision a blockage of sorts at the back of your throat.  A specialist may be able to help with this.
 Have been to two ENT's they shrugged it off after telling me i have a long palate.

(12-11-2018, 03:40 PM)Sleeprider Wrote: You might be a candidate for the INSPIRE implant.  It is implanted into the soft palate, and electrical stimulation tightens the tissues to keep the airway patent.  It seems like a good option for those with aerophagia from CPAP pressure.  Is it possible that this is related to dropping the chin toward the chest?  Many members have cervical collar to mitigate that problem and improve results.

I sleep with a cervical roll.  I cannot sleep on a regular pillow. I can't breathe with my chin tucked.  I can hardly breathe when I have dental work done.   I can't sleep without cranking my head all the way extremely back, whether i am on my side or back.  this gets very uncomfortable. I need to be able to sleep comfortably and breathe at the same time. I get one or the other or neither. I have tried sleeping with a cervical collar, (have tried many kinds but the traccollar is the most comfortable) i feel like i'm choking because it presses on the front of my neck, and wake up with an painful upper back/neck due to my spinal degeneration. I can't wear it that long at a time. Even when I do wear it when i am awake it is uncomfortable and i only get relief after taking it off.
Post Reply Post Reply
#6
RE: Palate still closing on exhale
(12-11-2018, 03:33 PM)mesenteria Wrote: I don't quite understand you when you talk about your palate closing.  I think some of us can raise our tongues and keep them raised while we sleep, and some have epiglottal tissue that we can sag or induce to sag so that it closes off our rear nasal passage, but I have yet to see some complain about their palate which I take to be a bony structure, the roof of our mouths.

I have actually seen a few posts on here of someone having the same issue. I will see if i can find it. It is probably an old post

Ok there is one post on a different forum under the title "Newbie question about obstructed exhalation" You'll have to find it yourself as the link isn't allowed.

And some discussion also on this forum.

http://www.apneaboard.com/forums/Thread-...oft-Palate

and 

http://www.apneaboard.com/forums/Thread-...ing-exhale
Post Reply Post Reply
#7
RE: Palate still closing on exhale
Oh the condition is called Palatal prolapse and if you look that up you will find a lot of people talking about having this problem.
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: Palate still closing on exhale
This description helps, and I have seen this profile in Sleepyhead flow graphs a number of times.  In the past we have simply considered it oral expiration, but apparently it is the signature of expiratory flow limitation by palatal prolapse (pp).  Have you also seen this in your Sleepyhead flow charts?

[Image: nihms959132f1.jpg]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#9
RE: Palate still closing on exhale
Thanks, Terrier Girl.  I haven't seen these discussions, but being somewhat new to the topic of PAP and apnea/hypopnea in general, hadn't known to look for them.  So, I am sorry you have to deal with this, but I do appreciate your taking the time to scout these discussions out for my 'larnin'.  Grin
Contrite, and wiser.
Post Reply Post Reply
#10
RE: Palate still closing on exhale
(12-11-2018, 05:10 PM)terriergal Wrote: I sleep with a cervical roll.  I cannot sleep on a regular pillow. I can't breathe with my chin tucked.  I can hardly breathe when I have dental work done.   I can't sleep without cranking my head all the way extremely back, whether i am on my side or back.  this gets very uncomfortable. I need to be able to sleep comfortably and breathe at the same time. I get one or the other or neither. I have tried sleeping with a cervical collar, (have tried many kinds but the traccollar is the most comfortable) i feel like i'm choking because it presses on the front of my neck, and wake up with an painful upper back/neck due to my spinal degeneration.  I can't wear it that long at a time.  Even when I do wear it when i am awake it is uncomfortable and i only get relief after taking it off.

I really think your best odds for success may be finding a collar that provides the fit and support to be both comfortable and effective.  The inflatable Trac Collar just looks like it would cause constriction, and I'm sure a different device could solve much of this. I'll leave specific suggestions to others, because we have many members that have resolved severe positional obstruction using collars.  Although your Palatal Prolapse is a variation on positional apnea, it shou,d respond to the right device.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Blockage during exhale - Uvula/Soft Palate mikemky 81 52,298 02-18-2021, 02:56 PM
Last Post: Kujessie
  [Equipment] Adding a diffuser to the exhale holes zenmaple3 2 233 01-08-2021, 03:45 PM
Last Post: Crimson Nape
Sad Mask fluttering on exhale kellyjon15 6 331 12-22-2020, 04:13 PM
Last Post: multicast
  Hard to exhale with P10 on auto BiPaP Hazzinator 3 385 05-23-2020, 10:24 AM
Last Post: Hydrangea
  Throat feels like it's closing after starting CPAP tiredguy1 10 722 01-14-2020, 03:52 AM
Last Post: embryo
  Extremely difficult to exhale, even with the machine off. spenc938 40 3,506 10-31-2019, 08:14 PM
Last Post: SarcasticDave94
  Struggling to exhale NapsAreMyHobby 12 1,353 10-31-2019, 03:17 PM
Last Post: spenc938


New Posts   Today's Posts






About Apnea Board

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