[Treatment] Positional Apnea and Soft Cervical Collar

[becker44a]

Several years ago, I had a sleep study and was diagnosed with "Moderate Obstructive Sleep Apnea", with an overall AHI of 36.  During the study, the supine AHI was appx 59, the non-supine AHI was 3, a ratio of almost 20.  So my Apnea was VERY strongly positional.  Initially, I had a lot of trouble getting my AHI under 10; many nights were 15 or higher.  I started reading this forum to discover how people avoided back-sleeping.  I tried several of the suggestions:  large memory-foam pillows to lie against, tennis balls fastened to the back of a snug tee-shirt, etc.  Nothing really worked.  Finally, I got a school backpack, loaded it with light, lumpy items like plastic dog toys, and strapped it on.  BINGO!  My AHI went down well below the target of 5 per hour, and stayed there.  For years now, I have averaged around 0.5.  On occasion it might kick up a little over 1.0, but that is very unusual.  I check the SD card daily, primarily to make sure that the leaks are under good control.

I recently started reading the forum again, and I noticed that the current advice for treating obstructive apnea often includes using a soft cervical collar.  The implication is that tucking one's chin down toward one's chest is bad, leads to airway collapse and obstructive apnea events.  So I thought, maybe this can help me . . . maybe I could stop using this backpack . . . maybe I could sleep on my back again (my body REALLY prefers this position).  So I went out and purchased a cervical collar.

The 1st night, I started off with just the scc, no backpack.  When I woke up to use the washroom, I checked the machine's sleep report:  after about 4.6 hours, my AHI was almost 9 - about ten or more times the usual.    I finished the night with the backpack, and there was only 1 hypopnea during the remainder of the night.  Since then I have taken to using a scc along with the backpack, and it seems to help reduce the times I wake up with a dry mouth, so I'm happy with that.  

The message I would pass along, is that there are some of us whose Obstructive Apnea is sufficiently positional, that while a cervical collar certainly may prevent chin tucking, this alone may be inadequate to prevent the event clusters that occur when supine.  It may be necessary to employ one of the older techniques to avoid supine sleeping.

[sheepless]

great point. thanks for passing it along. my takaways: while there may be common themes, nothing works quite the same for everyone; getting this treatment down requires a fair bit of trial and error (usually a lot more than we get from the system); and each of us must determine and use whatever works for us.

[2SleepBetta]

I tried several of the suggestions [in AB Forum]….nothing really worked.  Finally, I got a school backpack [backpack equivalent], loaded it. [….?] I [too] have taken to using a scc along with the backpack, and it seems to help reduce the times I wake up with a dry mouth....  

[….T]here are some of us whose Obstructive Apnea is sufficiently positional, that while a cervical collar certainly may prevent chin tucking, this alone [is] may be inadequate to prevent the event clusters that occur when supine. 

I've reworded a key part of your post to fit almost exactly my own experience and method. Once AHI was mostly below 5.0 RDI ( it was near 60 in 2015) it plateaued thereabouts until my backpack kept me 30 degrees away from supine. Long term, now, it is 0.2 and there have been strings of up to six 0.0 nights and great sleep overall. Many thanks are due AB experts for answers for me and for others, all  of which informed me.
2SB