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[Treatment] Sleep apnea and nerves
#1
Sleep apnea and nerves
In 2012 I was diagnosed with severe sleep apnea, although I'm sure I had it for a long time before then. My sleep apnea is just plain old garden-variety, the tongue falls back against the pharynx periodically when I sleep - no unusual complications.

A couple years ago I was diagnosed with atrial fibrillation, where the nerves that control which chamber beats when go on strike so the chambers beat out of sync. And very recently it was discovered that my heart was stopping, sometimes for as long as ten seconds. Now, having your heart continue to beat is kind of important, so the doctors stuck a pacemaker in me to ensure that it does so. But here's the interesting part: My heart itself is strong, no valve problems, no heart disease, no cholesterol/plaque buildup - it could go on for decades. All my heart problems are because the nerves that tell the heart what to do are laying down of the job. It's a nerve problem, not really a heart problem.

And having just gone through the pacemaker experience, and realizing that it's all a nerve issue, I now think about my sleep apnea. Why does my stupid tongue fall back when I sleep? It doesn't fall back when I'm awake. It seems strong, I can talk, chew, kiss sexy people - there is no problem with the tongue. Isn't the sleep apnea problem really a nerve problem?

So now I'm thinking that most of my problems are because my nervous system is collapsing. If that is so, there are medications that help restore nerve function. Maybe that is something to think about.

I just thought it might be fun to kick around the idea of helping one's sleep apnea therapy with medications to restore proper nerve function. Thoughts anyone?
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#2
RE: Sleep apnea and nerves
No idea. But if anyone ever makes a pill to get rid of sleep apnea they will become very rich. There also will be a lot of Doctors and DME's losing lot's of income.
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#3
RE: Sleep apnea and nerves
What you have written makes little sense to me. 

To my way of thinking, Atrial Fibrillation is a heart arrhythmia usually caused by SA node issues or electrical conduction issues within the atrial portion of the heart as the electrical pulse wave travels in the tissue. The end result is that the atrial chambers do not completely pump all of the blood to the ventricles. 

The fact that you need a pacemaker makes me believe it might be a node issue. 

The part that I do not understand is how any nerve tissue associated with the tongue can be involved since it is almost always a "mechanical" issue causing ordinary apneas (with the exception of a brain-related mechanism involved in central and complex apneas). I know that peripheral neuropathy can be linked to sleep apnea, but I am at a loss to understand how this may affect your situation.

I am mystified and would like to hear more about your adventure in attempting to solve the mystery. 

BTW, have you had a cardiac MRI study to rule out any abnormal pathology?  Have you tried out your theory on a cardiologist (mechanical), electrophysiologist (electrical), and a neurologist to get a sense if this is even a viable hypothesis and route of discovery? 

Best of luck with your quest.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#4
RE: Sleep apnea and nerves
JJJ what you are describing is what we refer to here as positional apnea, and there are a few of us that have thought long and hard about the subject. This wiki has some of my thoughts as well as those of Bonjour. http://www.apneaboard.com/wiki/index.php...onal_Apnea

Apnea that does not respond to even high pressures is often very responsive to the combined use of moderate CPAP or BiPAP pressures along with a soft cervical collar or related positional therapy. Furthermore, while many doctors talk about your tongue falling back in your throat, we posulate that the real problem is an impingement of the soft tissues at the back of the throat (soft palate) that occurs when the neck tissues at the back of the jaw and front of the throat are compressed by what we often call a "chin tuck" positional problem. Two ways to check this are to sit relaxed in a chair and as you fully relax let your chin drop to your chest and note the increased airway resistance that may range from increased effort to a snore or full blockage. Another test is to gently push upward on the soft part of your jaw or neck right in front of the throat. If you airway easily closes from that pressure, positional therapy in the form of a soft cervical collar or wedge may significantly improve your results.

As you say, your tongue is normal and people don't choke themselves with their tongues unless they are really unconscious. While the ENT specialists have made a good living on tongue ablations and UPPP surgeries, the problem might be simpler to resolve with a collar.
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#5
RE: Sleep apnea and nerves
(01-16-2019, 09:43 AM)Sleeprider Wrote: JJJ what you are describing is what we refer to here as positional apnea, and there are a few of us that have thought long and hard about the subject.  This wiki has some of my thoughts as well as those of Bonjour. http://www.apneaboard.com/wiki/index.php...onal_Apnea

Apnea that does not respond to even high pressures is often very responsive to the combined use of moderate CPAP or BiPAP pressures along with a soft cervical collar or related positional therapy.  Furthermore, while many doctors talk about your tongue falling back in your throat, we posulate that the real problem is an impingement of the soft tissues at the back of the throat (soft palate) that occurs when the neck tissues at the back of the jaw and front of the throat are compressed by what we often call a "chin tuck" positional problem.  Two ways to check this are to sit relaxed in a chair and as you fully relax let your chin drop to your chest and note the increased airway resistance that may range from increased effort to a snore or full blockage.  Another test is to gently push upward on the soft part of your jaw or neck right in front of the throat. If you airway easily closes from that pressure, positional therapy in the form of a soft cervical collar or wedge may significantly improve your results.  

As you say, your tongue is normal and people don't choke themselves with their tongues unless they are really unconscious.  While the ENT specialists have made a good living on tongue ablations and UPPP surgeries, the problem might be simpler to resolve with a collar.

Very interesting!

Just now I tried the chin-drop, but there was no more resistance than when I am sitting normally. Still, I added 'cervical collar' to my shopping list. It's a cheap experiment, and I'm always game to try something new. I just wonder how I can quantify the results. If I sleep with just the collar, then how can I tell if it did anything? I guess I'll have to use it with the machine, and if the AHI goes down, then we might conclude that it did something. Still, I can't think of any way to get precise data that we know must be from the collar.

When I read what you wrote and the wiki I fully expected to have problems with the chin drop. I say that because about a year ago I developed bad nerve pain in my right arm and shoulder. The physical therapist who I saw noted that I am stooped forward, and also leaning to the right starting at the base of my neck. (The latter may be the start of mom's scoliosis - thanks for the scoliosis gene, mom!) The physical therapist gave me some position exercises and it didn't take long before the nerve pain disappeared. Still, my posture sucks.
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