Info from sleep doc.

[comatose]

I visited my sleep doc today, mostly to get the results from my split sleep study that I had on the 6th of Jan, ha......it hadn't been sent to the sleep doc......slack b's couldn't even fax it coz it's not written up
The doc said he will post it to me when he gets it so no big deal I spoze, I mean....it's not as though I am dying anymore eh...

Think of that for a second......................I got more help from this forum and the internet that I did from a "state of the art" "multi-million dollar modern medical centre", I reckon the mortuary there would be busiest place in the hospital.

Anyway I thought I would mention the short conversation that we had about AHI's and mask types. I told him about how my full face mask fitted pretty good and the leak levels were below ResMeds threshold of 24 cmH2O but I couldn't get my average AHI lower than 10 or thereabouts, yet as soon as I changed to nasal pillows my AHI skyrocketed downwards, 30 days AHI = 1.0, and often/sometimes my leak rate was higher than than the full face mask...
He responded by saying, do you wear a chin strap now?
Yes I do I.
He said that the chin strap stops the tongue from collapsing back into the throat and reduces AHI.
I hadn't thought or read about that before so I thought maybe others in here hadn't either, I'm thinking if there are hose heads out there that are mouth breathers with full face masks and struggling to get your AHI's down then a chin strap might be worth a punt.

Second thing, I told him about my crook gut and wheat intolerance, I showed him in the data where my AHI spiked up after eating tucker with wheat in it and asked him if he reckoned the wheat would cause that type of inflammatory response?
Sure can he said, he then wrote me out a short list of other foods/additives to remove from my diet that may cause an inflammatory response, particularly because if a person is wheat intolerant they are often intolerant of other foods also and the medical testing is quite inaccurate, so the best test is to eliminate them and see how the body responds.
1/ wheat - gluten
2/ Salicylates
3/ Sulphite preservative 200-220
4/ Fodmaps - fructose
5/ caffine
6/ MSG (621)
This list likely won't make any difference to my already low AHI, and I am sure that most won't be interested in the food list but I thought it worth mentioning as it might click with someone and help them with their AHI, stomach pains, body and joint pains or headaches.

Dunno what I know what I'm gunna eat now, air?

[justMongo]

Sounds like to people at the sleep lab are a bunch of "Dags."

May I suggest a book by Permutter called Grain Brain.

[PaytonA]

I do not understand how a chinstrap might keep the tongue from collapsing back into the throat. Could someone explain that to me?

PaytonA

[justMongo]

I do not understand how a chinstrap might keep the tongue from collapsing back into the throat. Could someone explain that to me?

PaytonA

Neither do I Payton... unless one bits the tongue as one cinches down the strap. OUCH.

[PaytonA]

Double OUCH!!

[comatose]

ok guys I'll do a 5 minute lookie on google for yerz,

Here is a small study that demonstrates the effectiveness of a chin strap.

"Treatment of Severe Obstructive Sleep Apnea Syndrome with a Chinstrap"

Down the page a bit there are a couple of pretty little endoscopy pictures.
"Figure 1a
Without chinstrap (mouth open). Notice narrow anterior to posterior airway space as a result of the tongue base and the posteriorly positioned epiglottis."
and
Figure 1b
With chinstrap (mouth closed). Notice significant improvement of the posterior airway space with the tongue base and epiglottis rotated forward.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556917/

Here is another study that compares mouth open to mouth shut, http://www.atsjournals.org/doi/abs/10.11...0OLPlcSQ1o

and this technique has similarities to using a chin strap.
"head-tilt, chin-lift airway technique,
a method of providing maximum airway opening in an unconscious person. With the victim lying on his or her back, the rescuer pushes down on the victim's forehead with the palm of the hand, tilting the victim's head back. With the other hand, the rescuer lifts the victim's lower jaw near the chin. The technique opens the airway by moving the tongue away from the back of the throat and the epiglottis away from the opening of the trachea. This technique is not recommended if a cervical spine injury is suspected and therefore should not be encouraged. The proper technique for all is chin-lift, jaw-thrust."
http://medical-dictionary.thefreediction...+technique

There is plenty of info confirming that when your mouth is open your tongue moves further back into your throat and can obstruct the airway, particularity when on your back.
It looks like there are a few studies in the medical literature (Anesthesia) regarding body, head and mouth positions in regards to not constricting the airway, much of which relates to tongue position.

So..........chin straps seem to have a dual function, to restrict or reduce mouth breathing, and they may/probably also help to stop your tongue restricting your airway.

justmongo, thanks for the heads-up about the grain brain,

[VisitorX]

This is great stuff. That story about the 75 year old man was incredible...and doubly so the part that said the chin strap alone did not induce central apneas (which happens pretty often when CPAP is applied: "complex" sleep apnea [a.k.a. treatment-emergent central sleep apnea]) Thanks so much to you, Comatose, for both your original post and the follow-up with links. I'm going to try this. I've read other posts on this site saying that cervical collars are good substitutes for chin straps (some say they are better and work even for people for whom chin straps don't work) and serve the additional function of preventing "chin tuck," which people say also tend to close up the airway. I'm going to start with a cervical collar. There are tons of them available from Amazon. I just ordered one of the black 3" ones...not sure of the right size but I'll find out soon enough. By the way, I like the sound of your sleep doctor. Can you post his name / locaton here or if you don't want to do that send me a private message?

[VisitorX]

Hmm...I just saw this later study, on 26 people, which suggests that the chin strap alone really does not work. I've read only the abstract so far; I'll read the whole thing a post again if I disagree with the conclusions of the study:

http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=29594

either way, I'm going to experiment for myself...