RE: Chin Tucking as cause of apnea
r.e. GERD: CPAP helped me with reflux... the pressure seems to help keep the food in the stomach. I do take Prilosec OTC 20mg/day... mostly for the other end, I get hemmorhoid flare-ups otherwise. Been a long time since I puked into my lungs and woke up coughing. I used to put a Tums in my cheek every night... my dentist asked me 'do you chew tobacco?'... of course no... 'well, that's what it looks like'... dern! So that had to stop. Life-long affliction of acidosis, helped by proton-pump inhibitors and CPAP. Also, no frito pie after 7pm!
r.e. chin tuck: Just this morning I discovered that if I let my cheeks puff up and my tongue go slack I get hellacious obstructions... like slapping my face. Of course my AS10 did not record these as OA's since I was awake. When I was younger I did not have mouth leaks that I noticed... started having dry mouth wakeups about 2 years ago (I'm 65)... correlated with REM sleep and loss of muscle tone. Two months ago I started taping (thanks Jason!)... no more dry mouth, leaks on Oscar look great (except for mask, of course). So looks like I'll have to get a chin strap to try to stop jaw dropping... the tongue can fall back whether I'm on either side or on my back. I was able to change pressures and get the obstructions again... even at 18cm I could induce them... so it's the back of my tongue that's the problem, and if I can keep it firmly on the roof of my mouth I'll do a lot better. My AHI numbers are tiny, but I do have flow limitations and cupped-top waveforms. Maybe tape the tongue? Or get cut on... ouch.
Also, my O2Ring tells me I'm peaking near 200bpm heart rate at night! I've verified with both FitBit and Apple Watch that that's not happening... had a perfunctory EKG at my GP and no signs of problems... the FitBit is set to alert you to atrial fib, no warnings etc... so glad to read I'm not the only one not able to trust the O2Ring. My hands are big, I had to cut the straps on the ring and tape it on, I think I've gotten one good night of readings out of two months' worth... the O2 sats look fine although yesterday it did vibrate to tell me I was below 80% sat... this while I'm climbing into bed.
RE: Chin Tucking as cause of apnea
Learning to do a sort of sleep study through OSCAR and an oximeter gets very complicated for me, but I am catching on. CPAP machines, OSCAR, oximeters, and help here at ApneaBoard are truly amazing.
This research publication gave me insight into Flow Limitations expressed by Flow Rate wave forms:
Published online 2015 Sep 3. doi: 10.1016/j.slsci.2015.08.003
I am doing experimentation with higher Min. pressure and consideration for changing to a BPAP machine. I see now how it is not just apnea events, it is also flow limitations disrupting sleep that cause a lack of good sleep and possibly a reduction in O2.
I only give suggestions from experience as a fellow CPAP user, not professional advice.
RE: Chin Tucking as cause of apnea
Thanks for the link.
I've recently found that when I lose muscle tone the back of my tongue gets in the way. When I increase pressures this makes the OA worse... it becomes a short sharp shock, like a knock in the face... had a pretty bad night last night (ate too late too, spicy). You definitely don't want to become aware of this, it was better at lower pressures because the events were less violent. The event happens on expiration, you can see the graphs of it. I can feel it trying to trip, definitely causing the flow limitations I see on the tops of the waveforms (little dips).
I was finally able to get to sleep by *decreasing* pressure from 13 to 12 and turning on EPR 1. I can't sleep supine at all with 13... I've tried upping the pressures to 18 and it just makes the shock worse... a definite RERA. The AS10 doesn't register these, completely useless AHI. I'm fat and have bad shoulders so I toss and turn with arms going to sleep, more fun.
I finally received my full-face mask (Simplus) today... gonna try it tonight. Probably go back to 13 with EPR of 2 or 3. Definitely not gonna eat garlic-stuffed olives at 10pm either!
01-17-2024, 05:31 AM
(This post was last modified: 01-17-2024, 05:33 AM by ejbpesca.)
RE: Chin Tucking as cause of apnea
Can anyone explain what causes these jagged peaks on inhale?
I only give suggestions from experience as a fellow CPAP user, not professional advice.
RE: Chin Tucking as cause of apnea
_ same thing down here: no collar, lots of extremely dry- mouth breathing!
RE: Chin Tucking as cause of apnea
(12-10-2023, 12:11 PM)daves677 Wrote: I also use a FFM and ResMed Airsense 10 and notice that I will mouth breath if I don't use a collar. I used the
Dr. Dakota one and now use the smaller one, The Eliminator Sleep cushion. If I forget to put it on, I will have periods of mouth breathing and higher AHIs
_ same thing downhere...FFM...no collar leads to extremely dry-low quality mouth breathing!
good luck
RE: Chin Tucking as cause of apnea
The struggle continues. My AHI scores vary greatly. There is so much to consider: AHI, flow rate/limitations, O2 drops, and large leaks along with attempts to tape the mouth and wear a collar. 15 years into CPAP therapy and I've never found a successful routine or optimum setting for my machines. My sympathies and empathy to all concerned.
Suggestions are always appreciated.
I only give suggestions from experience as a fellow CPAP user, not professional advice.
RE: Chin Tucking as cause of apnea
I've ordered a tongue-sucker, a knightsbridge strap, and I've scheduled an appointment with an ENT. I'll talk to my dentist tomorrow about a MAD... not ready to spring for that yet, try the strap and boil-n-bite first. Same with iNAP... both of those are more expensive than a new CPAP machine.
The full-face mask turns out to work for me... I can mouth-breathe when the EFL tongue hits, that's helping. Last night not so good... I did an extra session from 8-noon yesterday and that threw me off... long hours of laying there not sleeping. Up at 8am, going to work (get some steps in), avoid a nap until tonight... lay off the caffeine.
I've also scheduled a new sleep study, they'll get back to me after insurance blesses it. For several days the EFL was very bad... it's lessened now, although you can see it in the Oscar waveforms... AHI below 1! Bullcrap... AHI means nothing, you can lay there awake all night and get a great AHI. I think sometimes my tongue can swell... food allergy? Bananas? Nuts? Life?
RE: Chin Tucking as cause of apnea
Today's OSCAR report is not very good in Flow Limitations and terrible for that as compared to some I see here. Flow Limitations are worse than usual @ .29 - 95% Large Leaks better at 9 events. O2 drops were 22 events but the drops were not in the danger zone so over all decent O2. No thick cluster of apneas...yay.
Something I have not seen mentioned here is Total Time in Apnea. I will search for it. That figure from my OSCAR looked encouraging @ 2 minutes :43 sec. spread out over 10 events. Maybe that figure and a decent O2 report are why I am feeling better today for the first time in several days.
Not sure how to proceed to seek better Flow Limitation results. I raised the Min. pressure to 14cm and got so many large leaks, I backed down to 13. UARS seems present. I think I understand a higher Min. pressure may treat that, but if it is caused by chin tucking, I read nothing will blow through a restricted airway from that. I also read on another forum that some of its experts do not believe chin tucking restricts airflow. Chin tucking severely limits airflow when I mouth breathe, and does not when I nose breathe. Mouth taping does not improve my Flow Limitations. I think even with the strongest of tapes, my jaw works open just enough to let air pass through my partially opened mouth because that's the state I find it in upon waking.
I may have to just accept my Flow Limitations and hope to keep that O2 up. Still considering BiPAP, but if I can't keep a mask from large leaking due to high min. inhale pressure I don't know if BiPAP would be useful unless the greater exhale pressure relief will reduce large leaks.
Chin up everyone!
Doctor: "How are you sleeping?
Patient: "Not well at all."
Doctor: "Sad to hear that, are you compliant in using your CPAP?"
Patient: "Yes, OSCAR says I use it >4 hours per day."
Doctor: "What then is the problem with your sleep?"
Patient: "I do not get restful sleep due to my CPAP treatment. Headgear, mask, tube, tape, O2Ring, are irritating."
Doctor: Silence then.."Okay, see you next year."
I only give suggestions from experience as a fellow CPAP user, not professional advice.
RE: Chin Tucking as cause of apnea
ejbpesca, the leaking is the first thing... if you can't get the leaks down you're not getting treatment. What mask are you using? You might need a DISE to determine exactly what your obstruction(s) are.
I was on Zest Q but found that moving from nasal to full-face (Simplus) cured the leaking. I found that I have to warm the Simplus for a while before it can conform to my face... it leaks like crazy at first, going to try a warm water rinse before bed (good policy anyway). I got the biggest size, it fits from nasium to below lower lip with mouth slightly open.
I was doing mouth taping with a nasal mask but found that my EFL was too great... moving to the FF mask allowed me to mouth-breathe when I had to. I was able to move to higher pressures, found that they weren't helping with the tongue obstruction... just made the glottal *slam* harder on exhale, since I'm pushing harder against it (tried 16cm).
On 13cm now... had no EFL's last night, but I couldn't sleep well... cutting out caf and trying not to nap, getting some steps in at work. Seeing the ENT tomorrow.
I've found that chin tuck actually helps me keep my jaw up and my tongue in my mouth-roof. Lanky Jason has recommended chin tuck to folks as an experiment. As I get older I'm losing more muscle tone during REM... jaw fall down, tongue fall back, slam on exhale.
|
