Blockage during exhale - Uvula/Soft Palate

[terriergal]

I strongly second the recommendation to see an ENT about it...the sleep tech wasn't qualified to handle your problem, threw the chin strap at you just to get you out the door.  ENT should definitely be able to figure out what the problem is.  GP or Internist might be able to figure out and fix problem, if not can refer you to a good ENT.

Whatever is going on, I don't think blockage on exhale is a very common problem and it really needs to be addressed/checked out by a good doc.

I talked to two, they both seemed clueless.  I couldn't believe it. It is NOT that hard to understand!

[terriergal]

Sewing a tennis ball into the back of an old t-shirt is a good way to keep you from sleeping on your back.  My apnea is much worse when I'm on my back.  I think I've conditioned myself over the years to instinctively avoid sleeping on my back because it does cause my airway to collapse.  I have noticed that, like you, I get a blockage on exhale.  It happened during my sleep study.

the problem is that a lot of people need to be able to sleep on their back due to arthritis issues.

 I am seriously thinking of buying a M.A.T. (medical and therapeutic) positioning system to just sleep on my stomach comfortably from time to time.

[terriergal]

Sewing a tennis ball into the back of an old t-shirt is a good way to keep you from sleeping on your back.  My apnea is much worse when I'm on my back.  I think I've conditioned myself over the years to instinctively avoid sleeping on my back because it does cause my airway to collapse.  I have noticed that, like you, I get a blockage on exhale.  It happened during my sleep study.

the problem is that a lot of people need to be able to sleep on their back due to arthritis issues.

 I am seriously thinking of buying a M.A.T. (medical and therapeutic) positioning system to just sleep on my stomach comfortably from time to time.

I tried the M.A.T. and it was hard as rock, sent it back.  I  do have a portable massage table with face cradle that i set up when I'm desperate, in order to sleep on my front without having to have my neck in a bad position. But it's not as comfortable as an actual mattress.

[ajack]

Have you tried increasing the min pressure 1cm at a time to see if the increased air splint will clear it? It worked for me and may be worth trying.

[yrnkrn]

For me, increasing EPAP up to 15.2 did not resolve the exhale blockage nor showed much improvement over regular EPAP=9, 10.
Even higher EPAP pressure might splint it but that high pressure was already very disruptive to sleep, much more than the few episodes of palatal prolapse.

[terriergal]

Yes.  I had it up to 13 and all I ended up with was a stomach full of air (if i prevented air leaking from my mouth) or (without such prevention) my mouth  blowing open and waking me up. And the palate still flapped shut like a heart valve sealing against the back flow.

[terriergal]

For me, increasing EPAP up to 15.2 did not resolve the exhale blockage nor showed much improvement over regular EPAP=9, 10.
Even higher EPAP pressure might splint it but that high pressure was already very disruptive to sleep, much more than the few episodes of palatal prolapse.

I agree, I have the same exact problem.

[PattyCarol]

Rich,
Thank YOU!!  I am having the same problems as Cornelia.  Even when taking a sigh my airway shuts off if exhaling through my nose.  I cannot blow my nose unless I hold my tongue between my front teeth.  I puff snore when I sleep.  My family doctor sent me to an ENT who sent me to a pulmonary doctor.  I am currently undergoing tests.  It seems that the doctors are unfamiliar with this--or so they say.  I have had the swallowing tests, breathing tests, tomorrow having the sleep test, being sent to a speech pathologist and being sent to a neurologist (neurologist ordered by my new family doctor--previous one retired).   I have explained in great detail what was happening.  None have mentioned soft palate surgery nor anything regarding the soft palate.  I questioned it but they seem to ignore my thoughts.  I told them that I can feel it collapse.  Hoping someone with listen to me.
PattyCarol

[gcritchley]

I have this same issue and hadn't given it much thought, except that I'm still feeling daytime sleepiness despite good numbers and have been trying to figure that out. research into lingering sleepiness led me to this thread, and brought back a wave of intuition and a thought balloon screaming - "has this been the issue all along?"

The last few weeks, I've been exploring flow limitations, which requires pressure support on exhale to eradicate (i.e a reduction in pressure during exhale only) BUT the one thing that seems to keep the expiratory blockage at bay is MORE pressure during exhale - so I'm caught between a couple of issues. Also, higher pressure on exhale introduces a plethora of issues with mask fi (I can't tolerate a FF mask), my nasal pillows (which I love) and chipmunk cheeks from mouth taping and higher pressures. I feel caught in a torture chamber.

I showed my ENT this issue in the office many months ago, and he didn't flinch. He put a camera down my nose, and said everything looks normal. My wife says that when I nap without a mask on, I breathe in and then puff air out my mouth - THAT seems like it is the exact issue of Palatal Prolapse happening. I can even readily replicate it while awake just by lying down, or even sitting up. if it happens awake, and I'm told it happens when I sleep - why wouldn't it wake me?

So - I too would LOVE to see if any progress has been made here. Please OP, come back and report. log in one more time!!

any new ideas or info?

[coachhamil]

I have the same problem.  It feels like a flap closes when breathing out of my nose with my mouth closed.  I have to make sure I don't sleep on my back, even with nose pillows mask.  I can cause it to close on purpose when I'm awake also.  Very scary if sleeping on my back.  Wish I knew what the flap is that is closing.