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I am not aware of any literature worth reading but it is a known issue and the reason UPPP surgery exists. UPPP surgery gets a bad rap because at one point doctors thought it could be a cure for apnea but it usually doesnt curr apnea good enough to stop CPAP
because most people (like yourself) have a mixture of apnea/restriction. Unfortunately I don't know of any members with palatal prolapse that had the surgery done, I assume it solves the problem but no proof I know of. One member has treated his by using a 6 inch alaxo stent (expanding mesh you insert into nose like a covid test swab, the mesh is left in place overnight holding palate open). I can't help but think it wouldn't be the most fun to use every night though.
Too bad about the limited options for prolapse apnea.
Will post last night and the nap later.
Thanks to everyone who helps us get a better night's sleep. Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor. An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies. Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.
The four screenshots are: the full night with the morning gap between last night and the nap,
an expanded piece of the nap, the nap, and an expanded piece of last night.
New tape, new collar, old wedge, old pillows mask. min/max 7, EPR 1.
The first two of four.
Thanks to everyone who helps us get a better night's sleep. Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor. An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies. Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.
Thanks to everyone who helps us get a better night's sleep. Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor. An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies. Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.
Question from another direction... If I understand what's going on with the PP, what about going all-in on the mouth breathing and trying a full-face mask?
I have given up on the nasal/pillows masks, because I have catastrophic leaks, and my machine shuts itself off even though I've got the auto start/stop turned off. Sometimes it knows I'm leaking, while other times it's just a mess and it records all sorts of just absurd nonsense. Everybody here says that minor leaks are not a problem and the machine can adjust, but what I see is that the machine looks completely bewildered. It's recording clear regular exhales but also recording a respiration rate of zero. It's recording a respiration rate of zero for way longer than 10 seconds, but not flagging any kind of apnea. It shuts the machine off and then comes back on without returning to the min pressure, and sometimes it shows a new sleep session and sometimes not. And through all of this the machine records all of this bizarre stuff happening but it doesn't report that anything unusual happened AT ALL.
Anyway, given what I understand about the mechanics of palatal prolapse, it seems to result in sealing off the nose and removing your nose from your airway path. If the machine is hooked into a nasal mask and your uvula has sealed off your nose, then the cpap machine isn't actually connected to your airway! If the mask isn't over your airway, then your machine has no way of knowing what's going on with your breathing.
My solution is a full face mask. That way if my nose seals up and the air is moving in and/or out my mouth, the mask is over my mouth and so the machine records what it's seeing even if it doesn't understand what it's seeing.
He tried a FFM and had high apnea and leaks. Since then he went back to nasal mask and tried taping to get leaks under control but in doing so apnea is still being recorded more than when he used a nasal mask previously. If I had to guess it is because with nasal mask and no tape he does some mouth breathing especially on exhale and that keeps palate from fully closing so apnea doesn't get flagged but restriction is still occurring and treatment is not ideal.
Part of the problem with FFM was that because it controlled this breathing it started flagging more issues and driving his pressure up which didn't appear to help improve things hence why I am currently trying lower pressures.
My idea was to try and fine tune which EPR setting works best for him, do a couple tests with pressure up and down to confirm if it has any effect and then assuming it does not reintroduce the FFM at a fixed low pressure to see if that works.
Here's the night of 3/16. No bathroom breaks. "Snoring" was off the map.
I'll contact my sleep doc to see if he knows anything about palatal obstruction.
I'm happy to continue posting these as long as they're useful.
Best,
Harv
Thanks to everyone who helps us get a better night's sleep. Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor. An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies. Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.
I have noticed your snore goes off the chart during that palate obstruction. If you look close at that data I am pretty sure you will see lots of examples where there is little to no exhalation present.
Out of the EPR settings tried 0,2,3 did any feel more comfortable, natural etc?
In terms of "comfort" I can't pick any EPR value that's better.
All I know is that I'm wiped out by 2:30 or 3:00. I should
have done a better job of recording results.
I read SleepyCPAP's therapy thread. He gets amazing results
with the Alaxostent. His breathing waveforms early in his therapy
strongly resemble mine. They seem to confirm palatal prolapse
as my problem. The big question -- whether the Alaxostent is
the solution.
Wandered around in the NLM / NIH to see what the science
dudes had to say. It appears that surgery has very mixed
results. The post-op experience is terrible.
Best,
Harv
Thanks to everyone who helps us get a better night's sleep. Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor. An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies. Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.
Lets stick with EPR of 2 like you were originally using and try a higher pressure so lets say min/max = 12 cm, EPR 2. Now that you have learned how to control the leaks perhaps the higher pressure will help avoid this apnea.
The surgery does have mixed results and it rarely gets performed because CPAP is considered the best treatment for apnea. I think its safe to say that surgery should have a higher chance of success when there is data like this supporting palate obstruction/prolapse as being part of the issue, in short it is tough for your palate to prolapse if the part that would prolapse is no longer present.
Alaxo stent would be an interested test if you were willing to try it and benefit of it compared to surgery is that it is temporary. Tthey aren't cheap and I don't know how insurance coverage works for it though (or if you have coverage). We still have a couple more tests we can do with PAP but if they don't work and you are up for it then it would definitely be something worth trying.
