Redundant Palate: Need Help With Nasal Stent

[cpap90000]

Ive been using cpap for a year or so and its been very difficult. I have severe apnea witha AHI of 48. Its not the machine i have a problem with I just
get severe blockages and vibrations when exhaling through my mask using my resmed 10 cpap machine. Inhaling is fine however. The blockage when i exhale through the nose is the worst and get extreme vibrations when i breathe out through my mouth. I can only think that is my soft palate vibrating. The back of my throat is not visible anymore as it is below my tongue and my uvula is down my throat so to speak. I have tried all resmed pressures and it seems to be related to my soft palate.It feels like I am breathing through a plastic bag and its causing severe insomnia.


Recently I went private with SPIRE in the UK. Not something i can afford btw. But the Private ENT said I have a redundant palate, Is this the same as a palatal prolapse? He could not say which procedure would be best but standard UPPP is not advisable as it does not fix the problem and can make cpap use less usable. He told me to lose all my weight and go back when i am my ideal weight. I am 14 stone / 90kg and need to be 12 stone. It will take a year or so to lose all my weight and i am so exhausted with insomnia. Cpap is making breathing more problematic so i am looking for surgery options.
I recently tried a back2sleep nasal stent which stopped the palatal blockage when i exhale but its not great and really only for moderate sleep apnea. Its not enough to exhale through but it works a little bit.
What kind of procedure / surgery would be best if UPPP is no longer used? My palate does not seem to work so i assumed a UPPP would atleast help in opening up the thoat.
Any advice would be great.

[THEVGE]

If palatal prolapse is your issue you can try Alaxo Hybrid stents or Velumount soft palate stents. Both are discussed on this forum.

[jdougc]

Welcome to the forum,

Are you on any medications that affect your breathing or sleep?
Do you have any health issues that  affect your breathing or sleep?
Are you a side sleeper? Avoid sleeping on your back as gravity will pull your tongue and soft palate into the airway.
Can you post a copy of your sleep report with your personal info redacted.
Did you have Central Apnea during the sleep study?

The constant rapid airflow past the soft palate and associated vibration can cause the soft palate to become swollen, longer, and more redundant over time. In fact, patients may wake up with a swollen uvula after a night of snoring. So in essence, reason number 1 for snoring and OSA (nasal and sinus blockage) creates reason number 2 (A redundant long floppy soft palate and uvula). This then creates a worsening of the snoring and/or OSA.

Consider a pillow mask, they provide the pressure more effectively to the nostrils, but use lanolin.
Also Consider using 2x5 strip of the Kinesiology cotton elastic athletic tape or
SomNoSeal  a soft, flexible mouthpiece that prevents mouth breathing and dry mouth during sleep.

https://www.youtube.com/watch?v=1u_S1ADwVmA

Download Oscar and get an sd card for the cpap machine.
Finally, you need anew doctor, one that is compassionate, understanding that weightless is difficult when you are exhausted dealing with sleep apnea.
Good luck.

[cpap90000]

I tried a nasal stent called back2sleep recently and it opened the airway and stopped the nasall blockage on the exhale. But I have severe apnea and the device is only for mild to moderate osa. the nasal exhale was a little bit hard to do, very tight. however it stopped the blockage. Maybe i need a bigger or wider nasal stent?

so is this a good indication that i have palatal prolapse ?

[cpap90000]

I will try to get the data from the resmed 10. I only get a few hours sleep with the cpap. Its difficult to fall asleep with it on. when i exhale with my mask i get horrible vibrations as air is trying to escape out of the mouth. my soft palate and uvula are causing the vibration i assume.
I used a nasal stent and that stopped the nasal blockage on the exhale but it is for mild to moderate osa. I used the back2sleep stent but it does not open the nasal airways very well for me.

[Sleeprider]

When you used the backtosleep stent, were you using a CPAP or bilevel positive air pressure therapy? The individuals using the AlaxoStent on this forum were combining therapy.

[cpap90000]

Thanks for your reply. 
I used the stent without cpap. spent a week with it. As i said, it stopped the nasal exhale block/palate blockage or whatever it is. 
It was however too tight to breathe though. Also had issue of extreme mucus production and it dripping inside the tube. each morning the mucus was caked on and dry at the end of the tube. (where it was placed near the uvula) Maybe i should try it for longer and combine it with cpap as you suggest
So could this be palatal prolapse?

[Sleeprider]

Your situation matches my experience with other members of this site that experienced palatal prolapse, and their experience with the AlaxoStent. Initial discomfort with the stent includes having to overcome the gag reflex and excessive mucus production. Most users here have used this with CPAP or bilevel PAP therapy to also treat obstructive sleep apnea, hypopnea and flow limitation. Here are few related links:
https://www.apneaboard.com/wiki/index.ph..._for_Apnea
https://www.apneaboard.com/forums/Thread...AlaxoStent
https://www.apneaboard.com/forums/Thread...se-results
https://www.apneaboard.com/forums/Thread...asal-Stent
https://www.apneaboard.com/forums/Thread...bstruction
https://www.apneaboard.com/forums/Thread...asal-stent

[cpap90000]

Thanks for your reply. I tried the back2sleep stent which stopped the palate blockage but not enough nose exhalation was possible. It was also quite uncomfortable to swallow. I was thinking of getting the velumount palate device. I need something that removes the blockage but also allows enough space for expiration out of the nose.

[cpap90000]

Thanks for the reply. So it looks like palatal prolapse which is why i have had such a bad time with cpap and terrible insomnia. I will read the links, thanks very much for your help. 
Do you use any devices such as ronch@ap or velumount? The back2sleep stent worked succesfully and unblocks the soft palate to the nose but its really for mild to moderate apnea. nose expiration worked but it was quite forced and difficult. The stent also failed to fix the elongated and flappy palate and uvula that causes so much vibration when i mouth exhale using the cpap. 

looks like i will need the cpap but need to combine it with a device that lifts and unblocks the soft palate for nose expiration. I want the soft palate lifted and brought forward a little. Velumount or ronch seem to have devices that do this quite succesfully.
I am considering going to germany/netherlands to get the ronch@ap or velumount fitted. I live in the UK so they do not have the devices here. If this does not work, maybe UPPP. If its a palatal prolapse problem, UPPP may just work for me. Need to test more devices first however. Thanks