CPAP since March 22, still dealing with aerophagia, wakings, and heart rate problems

[manacles]

Ah I see, that is a shame. While I do agree that specific changes in SpO2 and PR probably aren't measured accurately enough to be helpful, I've noticed lots of specific periods in my sleep where my pulse will reach 90-100 BPM for an extended period of time which I think is an issue. But I still don't have a very good idea at what's causing them. For example my last night's data has a huge spike at 3 AM and many smaller ones across the night. Good SpO2 and AHI values but I was waking up every hour and I'm sure the heart rate contributed to my lack of restful sleep.

[manacles]

I've been continuing on 9 cm constant pressure for the past week or so and it has felt better than APAP, it feels like especially when the pressure would decrease on APAP it would really disturb my sleep.

I'm still having some aerophagia that mostly just leads to burping, but not bad enough to cause any pain. I've decided to shelve the collar for now, as it was kind of challenging to wear it correctly every night. There was a thin margin for me between putting enough pressure on my throat to stop myself from swallowing air and having it too tight and messing with my airflow. I'm going to try to find a GI doc to help me figure out my situation with possible GERD/LPR. 9.0 seems like a good value to settle on for now until I can figure out how to better deal with my aerophagia. (conventional advice like not eating before bed, left side sleeping, and incline sleeping didn't help)

My main concern now is just trying to figure out why my heart rates are so crazy through the night. While some of my spikes I've seen on my O2Ring are most likely artifacts, I'll consistently have moments lasting up to an hour where my heart rate is continually elevated. I've attached the last three nights of OSCAR data where I've tried to find correlations between the recorded spikes with my flow rates. It looks like the flow does look different when my heart rates are low vs high, but I couldn't identify any consistent patterns. I don't experience anything like this during the day so I feel it does have something to do with my CPAP settings rather than a heart condition but I'm really out of ideas. Would really appreciate any insight, and can provide additional charts or zooms as requested.

[zzzdeprived]

Thank you so much for posting the link to the cervical collar. i bought one and tried it out for the first time last night. You may have just given me my life back!

My apnea may be different from many or most on this board, as to the cause of it. I have believed for over 20 years that my nighttime breathing difficulties are primarily due to post-thyroid surgery trauma to my neck. I could never prove it or pinpoint it, and no doctor ever listened to me or gave that notion the slightest validation, (in fact, one sleep doctor told me point blank "Those two things [neck surgery and apnea] have absolutely nothing to do with each other.") but I slept fine all night on my back before the surgery, and only had problems after it. They didn't start right away, but continuing to sleep on my back several years after the surgery became something I just could not do without pain to various parts of my body. I got started with a CPAP seven years after the surgery, and that has always been a treatment of the symptoms, but not the cause. And no doctor could ever really pinpoint the exact cause of my air blockage. It was several years later, around 2014, that I intuitively pulled the skin around my scar together, and felt something release inside, below my Adam's apple, that I had until then been unaware was a problem. But I could never figure out how to get that area of my neck to scrunch together while I was sleeping. I tried taping the skin, but that didn't work too well, and caused other problems. It never occurred to me until reading this thread that just some gentle pressure on the area would do the same thing.

So, last night, I made sure to get the collar to put gentle pressure on the area of my neck scar, as best as I could, and I was able to sleep the whole night without a CPAP, and could definitely tell my body was getting much more oxygen than it has every night for the last 20 years! For now it seems like a Godsend, but long term I would like to find or develop some sort of device that I can just apply to the area of my scar to put gentle pressure on it, and stay on unaided, of course, all night. Like a patch or something, but not too sticky, as the skin on that part of my neck is sensitive. But, if I don't have to use a CPAP again (time will tell on that), then my problem has basically been cured, and that would be a miracle. If indeed the main cause of my restricted airflow all these years has been located below my Adam's apple, around the scar on my neck (and externally very close to my upper esophageal sphincter) this would explain a lot, and it would also mean that in my particular case, my apnea could be not just treated, but essentially cured. I imagine there are very few people who have blockage caused by having their thyroid removed, but if it happened to me, there must be others it has happened to.

Now, I do have other things that can also block my airway somewhat, like GERD and sometimes post-nasal drip. Also allergies can sometimes cause my tongue or parts of my soft palate to swell somewhat. So I still need to keep an eye on those things. But the main blockage seems to have always been lower, below the Adam's apple, and the collar pressure is affecting that in a positive way. It feels like old times to have plenty of oxygen in my head and body, and I could not be happier.

Thanks again, and I hope you are able to also find help from others on this board for your own situation.

zzz

[gainerfull]

have you considered talking to your sleep doctor or a cardiologist about your wild heart rate while sleeping?

[manacles]

Thanks for your reply zzz, I'm so glad that solution worked so well for you! I definitely feel an improvement of my aerophagia from having something bracing my throat but having a collar around my entire neck seems to really disturb my sleep. I've been trying to maybe make my own device that can specifically target my throat without constricting anything else.

I've talked to my sleep doctor about it and he feels that it is likely related to my sleep and treatment problems/aerophagia. I'm inclined to agree because it seems connected to my sleep quality and aerophagia and I'm probably going to hold off on contacting a cardiologist until I can get my aerophagia in check, and see if that solves my heart problems. I just feel that right now it's likely that a cardiologist will just tell me what my sleep doc did.

[zzzdeprived]

Sorry I haven't replied in a while, I was out of the country for a few weeks. I am curious about your comment about creating your own device. I am also thinking of the same thing, but have no idea how to proceed. What do you have in mind? Have you been able to create anything that works?  I have been unable to replicate the curative results I had for two nights a few weeks ago with the cervical collar, so am wondering what could affect the area below the Adam's apple in a different way than the downward pressure the collar affected. Ideally I would find or create something that would stay in place on my lower neck, and kind of pinch the skin inward on all sides. Don't know how this would be achievable.

[manacles]

Hey, I haven't been on here in a while but it's because I've mainly figured things out for me. What ended up working was using the collar normally and velcroing one of the eye paddings from this mask
https://www.amazon.com/Manta-Sleep-Mask-...B07PRG2CQY
towards the middle. For me, this helped give pressure specifically to the center of my adam's apple while relieving the rest of the pressure around my neck, especially my sides. My aerophagia has pretty much gone completely, and I can pretty reliably get it work by making it just tight enough to where I feel it pressing on my throat. I know that your specific situation is different but maybe that may help.