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Not too loose, not too tight. You should be able to insert 2-3 fingers under the collar.
It should be able to move a little. Should your mouth drop open, your mouth/chin area should not be able to fall below the collar.
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05-12-2024, 09:38 AM (This post was last modified: 05-12-2024, 09:45 AM by HalfAsleep.)
RE: How to place cervical collar
I discovered it's easy to make it too tight. Then, it inhibited my breathing. I discovered from looking at Oscars, that it was actually cutting off my airway. I guess I was strangling myself. For the sake of surviving the night, I had to make it looser. However, though it does help at this level of looseness, it doesn't eliminate mouth drop altogether. I never had a big issue with positional apnea that couldn't be addressed without a collar (e.g. with pillow height); for me, the collar is about minimizing leakage.
I never had the collar as tight as recommended, even when strangling myself. There are anatomic considerations, so no one instruction suits everyone IMO, and it takes some trial and error to meet your goals.
(05-12-2024, 05:24 AM)OpalRose Wrote: Not too loose, not too tight.
(05-12-2024, 09:38 AM)HalfAsleep Wrote: I discovered it's easy to make it too tight.
Both thanks for your reply.
If I understand correctly, there are two possible purposes of the Cervical Collar: 1. The chin does not drop to the chest 2. Preventing leakage, I suspect due to an open mouth
And it is clear not to loose, not to tight.
My issue is that I think wearing thight reduses AHI. That seems strange to me.
05-12-2024, 02:23 PM (This post was last modified: 05-12-2024, 02:24 PM by PeaceLoveAndPizza.)
RE: How to place cervical collar
Good advise from OpalRosea and HalfAsleep.
To me, I use and recommend the collar for a few reasons.
1. Mouth drop - for those who do not like taping
2. Chin tucking - keeps from dropping your chin to your chest reducing positional apnoea
3. Neck bends causing FL’s - helps keep the airway open
Even with a full-face mask, an SCC can be of good use to help keep the airway open and mouth closed. It is not just for nasal masks/pillows.
Use the attached chart to check on the SCC size. Getting the right length and height is critical to its effective usage.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Think of a picture of your throat as a tube. When a garden hose "kinks" it reduces the flow of the water through the hose. If it is severe enough, it can completely block the flow of water. The most destructive position is head straight down towards the chest. (But not everyone is affected by this position). Moving your head/neck to the side can "kink" it slightly also. The soft cervical collar can help prevent these things from happening. Tilting the head too far backwards can even cause a "kink".
One other important point that I learned was that my collar needed to be tall enough to work. My collars are all either 4.5" tall or 5" tall. If the collar is too short, the head can tilt and cause a bit of resistance in the airway.
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To me the correct size is more important than placement. I buy my collars from corflex. They offer collars by neck size and height. I went through many collars until I found these.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas.
05-22-2024, 04:02 AM (This post was last modified: 05-22-2024, 04:13 AM by Jan Flikweert.)
RE: How to place cervical collar
Hi all,
I struggle with the placement of the collar. The difference between tight and less tight is small. The fingers cannot get between the collar and the chin cannot drop to the chest. Yet there is a difference in AHI. I have more obstructive stops, more central stops and Cheyne Stokes Respiration with not as tight. That's strange.
That's strange. I'm assuming there is no obstruction or trauma in the neck.
The strange thing is that the difference between tight and not so tight is the collar pressing on the Adam's apple. It really shouldn't be, but it gives the best results.
