Soft cervical collar for flow limitation?

[Sleeprider]

I am admittedly not a big fan of Steven Park who is a big advocate of surgical solutions.  His cult-like following is like trying to counter Dr. Oz.  It's hard to not agree a lot of his suggestions regarding eating and alcohol make sense for people with GERD,  but for CPAP patients, there is pressure threshold that makes the problem worse. Avoiding that threshold may increase apnea and require counter-measures. You have mostly a positional obstructive apnea problem, and at higher CPAP pressure experience a lot of central apnea which has nothing to do with this "vacuum effect". 

Well, that's really good to know! I'm NOT a fan of surgery, either. I was just wowed by his explanation of the sinus inflammation I experience.
It's also good to know the positional problem is not a vacuum effect problem. I don't do cults. I'm a question-authority patient, and some docs appreciate that, some don't.

You & Bonjour have mentioned the cervical collar, and that's why I'm shopping for one. For a neck that's just under 12", but 4" from top of clavical bump to jawbone. Perhaps I'm a giraffe.

Shall we return to the other thread, Possibly dubious things my sleep doctor said, for the oxygen discussion? It fits better there, and I've replied to your comment there.

We can get back to the other thread anytime, but I'm curious about your experience with "positional apnea" as a thin person. Sadly, I'm not. I do not suffer from positional apnea or aerophagia, so I have to rely on others to explain their experience.  My current "theory" of positional apnea is that it is a compression of the tissues behind the jaw and in front of the throat. They can be displaced upward and interfere with teh soft palate causing clusters of apnea. 

With many members on the forum I have suggested relaxing in a sitting position and letting everything get relaxed,.  Breathe through your nose, then allow your head to tilt forward. As your chin dips toward your chest you may experinece increased airway resistance, a snore or even apnea. Another way to simulate the effect is to press lightly upward at the back of the jaw just ahead of the throat.  I think this is the most common source of the clusters of obstructive apnea, but of course you need to be fully relaxed tot to resist that slight pressure. I think it is possible for a thin person to experience the same obstruction or airway resistance.  What do you get?

[picante]

Hi Sleeprider, I'm still shopping for a cervical collar, sigh. And I'm getting over my first overdose of Zantac, which made me ditch CPAP altogether last night: a massive diffuse gut-ache with distension (and intractable sinus constriction). That's in contrast to the localized crampy air-pocket gut-aches that travel through my intestines. The former predates the latter by 26 years. Aspirin is a big help.

I'm going to run your experiment instead of just guessing, and I'll let you know.

This sounded very familiar to me, though:

http://www.apneaboard.com/forums/Thread-...oft-Palate
During the titration study, I used a nasal mask. I noticed then that when laying on my back, I often couldn't exhale through my nose - my uvula and/or soft palate would close off the nasal pathway.

And my sleep doc told me on our very first phone visit that my blockage occurs on the exhale. But then I found out that he only  looks at "sub-pharyngeal" area blockage. He's not concerned about back-of-throat tongue blockage, and dismisses it every time I bring it up.

I suppose that's why he hasn't recommended a soft cervical collar. He sure is leaving a lot of responsibility on me. Oh well, I'm a better problem-solver, and so are you. You're dynamite.

[Gideon]

Just so you know I am closely following you here.

Fred

[Sleeprider]

Unfortunately the medical community has for the most part, not turned on or tuned into soft cervical collars yet. Eventually the success of individuals on this forum may lead to an inquisitive researcher studying the efficacy of this method and shedding some daylight on the simplest and least expensive method of significantly reducing some forms of obstructive sleep apnea. Meanwhile be aware that the price of entry is about $10 to $30 to find out if it works for you. A pattern of clustered obstructive apnea can be treated with CPAP and a soft cervical collar to reduce events from 5 to 30 AHI to less than one. I suspect it would be effective in untreated individuals, and those intolerant of CPAP, but we have no way to measure the results other than the CPAP data we see.

I think the mechanisms of obstructive apnea the soft cervical collar target are exactly what you are talking about. The tests I suggested above actually target the sub-pharyngeal area blockage. If it affects you, the collar will help. I think the reply to you by Sidesleeper here was very very helpful http://www.apneaboard.com/forums/Thread-...#pid281826

[picante]

With many members on the forum I have suggested relaxing in a sitting position and letting everything get relaxed,.  Breathe through your nose, then allow your head to tilt forward. As your chin dips toward your chest you may experinece increased airway resistance, a snore or even apnea. Another way to simulate the effect is to press lightly upward at the back of the jaw just ahead of the throat.  I think this is the most common source of the clusters of obstructive apnea, but of course you need to be fully relaxed tot to resist that slight pressure. I think it is possible for a thin person to experience the same obstruction or airway resistance.  What do you get?

I got blockage at 2 different areas. Maybe more.
Upon pressing on the mandible just forward of the joint with the maxilla, I get my tongue cleaving to the soft palate forward of the uvula.
When sitting relaxed and letting my head tilt forward (my brain reaaallllyy hates that, btw, and sends don't-do-that!! signals), my tongue seals off the opening to the pharynx and puts pressure on the uvula. Gaaaaaah. I never sleep sitting up.

As to the hypopharynx, I don't know. It's probably involved, but I wasn't focusing on it. The other blockages are far more obvious.

[picante]

Just so you know I am closely following you here.

Fred

I don't know how, with your eyes shut like that. 
I'm off to practice my uvular trills. (That's the last phoneme in the word 'bonjour'. Excuse the phonetics terminology.)
Julie

[picante]

 I think the reply to you by Sidesleeper here was very very helpful http://www.apneaboard.com/forums/Thread-...#pid281826

Yes, I'm going back to that thread. It was.

[Gideon]

Just so you know I am closely following you here.

Fred

I don't know how, with your eyes shut like that. 
I'm off to practice my uvular trills. (That's the last phoneme in the word 'bonjour'. Excuse the phonetics terminology.)
Julie

Julie, that is so much more than a word

Fred Bonjour

[picante]

ROFL. Excuse-moi, Fred, tu as certainement raison.