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Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
#61
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
I sleep on my back, which is supposedly the worst position to be in for OSA.
The tennis ball ? sewn into a T-shirt is worth a try.  Thinking-about
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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#62
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
I don't think supine sleeping is much of an issue. Going back to your questions concerning palatal prolapse, it is a condition that should be pretty noticeable. People that experience this, can feel the airway shutting during exhale, and shunting from nasal to oral expiration. If you are not aware of a very abrupt shunt during exhale, this probably is not an issue for you. If you feel the door slam shut, then you probably know.
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#63
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-17-2022, 06:41 PM)Sleeprider Wrote: I don't think supine sleeping is much of an issue.  Going back to your questions concerning palatal prolapse, it is a condition that should be pretty noticeable. People that experience this, can feel the airway shutting during exhale, and shunting from nasal to oral expiration.  If you are not aware of a very abrupt shunt during exhale, this probably is not an issue for you.  If you feel the door slam shut, then you probably know.

Guess I was misinformed about back-sleeping. So I don’t need to find the tennis ball.

About the prolapsing palate, there’s been no obvious door-slamming. Will pay closer 
attention from now on.

If positional apnea is not evident, I keep the cervical collar on, and prolapsed palate
doesn’t apply either, what other things can I try?

Thanks, Sleeprider.

Harv
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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#64
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
You definitely have positional apnea (last nights data is a prime example). That doesn't mean apnea from sleeping on your back, it is just a term that has been applied to the clustered apnea you often have (since position of airway often caused by a tucked chin is the cause). In minor cases adjusting how you sleep on a pillow can help (using a thin pillow instead of thick pillow as an example), in major cases (like yours) cervical collars seem to be the usual solution.

Even when you aren't having obvious positional apnea your data regularly shows severe restrictions. Some of them may be partial obstructions for the same reason positional apnea is present but I think some are related to a palate obstruction. 

Imo your palate must be closing, the only question is if your body is doing so on purpose (expiratory mouth breathing) or not (palatal prolapse). Last night it appears you spent about an hour in that state and if it was mouth breathing I don't get how you could breath that way for so long without having some level of mouth leak present.

Although a stent would be helpful in keeping your palate open I doubt it would fully treat your positional apnea which is most likely lower down in airway.
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#65
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-17-2022, 11:54 PM)Geer1 Wrote: You definitely have positional apnea (last nights data is a prime example). That doesn't mean apnea from sleeping on your back, it is just a term that has been applied to the clustered apnea you often have (since position of airway often caused by a tucked chin is the cause). In minor cases adjusting how you sleep on a pillow can help (using a thin pillow instead of thick pillow as an example), in major cases (like yours) cervical collars seem to be the usual solution.

Even when you aren't having obvious positional apnea your data regularly shows severe restrictions. Some of them may be partial obstructions for the same reason positional apnea is present but I think some are related to a palate obstruction. 

Imo your palate must be closing, the only question is if your body is doing so on purpose (expiratory mouth breathing) or not (palatal prolapse). Last night it appears you spent about an hour in that state and if it was mouth breathing I don't get how you could breath that way for so long without having some level of mouth leak present.

Although a stent would be helpful in keeping your palate open I doubt it would fully treat your positional apnea which is most likely lower down in airway.
I sleep on my back on a foam wedge pillow. It's to keep stomach acids from backing up.
I wore the cervical collar last night. The AHI was terrible. So it's not "The Answer" alone.

Is there a way to see if it's mouth breathing? The leak rate is 0.0, but isn't that around the mask?

Is there a way to find out where in the airway the blockage occurs?

Have I asked enough questions?

Thanks, Geer1.

Harv
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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#66
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
Well, from bad (AHI 10+) to worse (AHI 16+).

The two thumbnails here are from the last hour of sleep.
I was curious about the AHI at the end in the original
chart, which rises steadily and looks like an inclined
plane. The flow rate looks like I regularly stop breathing.
(DUH!)

Please suggest what to explore.

Pulling back a little, things to look at for possible
interactions:


-- my other health conditions
-- the meds I take for them

Please add any sources / links.

Thanks, all.

Harv
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

Post Reply Post Reply
#67
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
The wedge pillow and inclined sleep is a major risk factor in "positional" clustered events. Whatever you are using for a collar is not working. Can you describe what you are doing? Thickness of the collar in relation to jaw to top of sternum, brand, type, image...anything but a link?.
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.
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#68
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-18-2022, 04:41 PM)Sleeprider Wrote: The wedge pillow and inclined sleep is a major risk factor in "positional" clustered events.  Whatever you are using for a collar is not working.  Can you describe what you are doing? Thickness of the collar in relation to jaw to top of sternum, brand, type, image...anything but a link?.
Can't eliminate wedge and incline.

Collar thickness: 3" at center notch
Jaw to sternum top: 3 1/2"
Brand: FitPro
Neck circum.: 16"
Collar length: 20"
Image:

[attachment=39068]
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

Post Reply Post Reply
#69
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
You could try elevating head of bed instead of a wedge pillow. I found with a wedge pillow I kept sliding down it and if that is happening to you and your shoulders end up near the base of wedge then your airway would be in a kinked position and cause this issue. In order for this not to be an issue the wedge needs to start in mid to lower back and you also need a thin if any pillow on top of the wedge, you want your spine/neck/airway to be straight.

Your first example shows the palate issue I mentioned before and it appears to have caused an arousal. I think both aspects are an issue but the positional apnea is the easier one to try and treat first.
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#70
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-18-2022, 11:54 PM)Geer1 Wrote: You could try elevating head of bed instead of a wedge pillow. I found with a wedge pillow I kept sliding down it and if that is happening to you and your shoulders end up near the base of wedge then your airway would be in a kinked position and cause this issue. In order for this not to be an issue the wedge needs to start in mid to lower back and you also need a thin if any pillow on top of the wedge, you want your spine/neck/airway to be straight.

Your first example shows the palate issue I mentioned before and it appears to have caused an arousal. I think both aspects are an issue but the positional apnea is the easier one to try and treat first.

My bed is a captain's bed, which has drawers and cabinets in the base. It's very heavy
and elevating the head would be unworkable.

When I slid down the wedge, I asked the vendor's rep for advice. She said to put a pillow
in front of the wedge. It seems to work.

You may be right about the wedge not hitting my back in the right place. And I have no
pillow on top of the wedge.

I will make those adjustments.

Thanks, Geer1.

Harv
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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