+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: Palatal Prolapse? Other advice welcome (/Thread-Palatal-Prolapse-Other-advice-welcome)
Palatal Prolapse? Other advice welcome - sleepyqueue - 10-02-2024
I've used a CPAP every day (minus weird events like power outages) since 2017. It has made some difference but I still feel exhausted every day. Around 2021 I had another sleep study was given a few adjustments to make, but I was still very tired. I was so frustrated I started adjusting my own settings looking for any relief I could, but got minor results at best. I have 100% compliance, I'm doing my best to exercise every day (I ran, err, jogged I guess, 50 miles every month June, July, August and September), have my bedroom cool and dark, and just about everything else I can think of. I never drank much (maybe once a week) but I stopped alcohol entirely for 6 months. My typical AHI is between 3 and 4, sometimes between 2-3 and occasionally >5(maybe once every week or two).
Earlier this year I went back to my sleep doctor and asked about Modafinil or any other possible options to help me feel better. He told me we should do another sleep study and decide from there what to do, so we did that in May. The report I got a few days later recommended I adjust my pressure settings from 14-20 to 13-16, which I did the next day. No difference in either recorded AHI or how I feel. I had to wait until September to have my follow-up to actually discuss the results with my doctor. He said my treatment is working just fine he can't give me Modafinil or refer me for any other sleep related treatment because I have no medical indicators it's necessary. His only recommendation was to try and get more sleep (I usually sleep 7-7.5 hours a night) and that I should get other non sleep related tests done to try and explain my fatigue, heavily implying I was exaggerating or lying. Anyway, I'm done with him and looking for a new sleep doctor, but in the meantime I'm back to trying to see what I can do on my own.
For the last couple of weeks I've been sleeping with a cervical collar again. I tried that a few years ago and it didn't seem to make a difference and that particular collar was mildly uncomfortable so I stopped using it. I decided to try that again and got one that's more comfortable and even though it doesn't seem to make a difference I'm going to give it at least a month.
Doing research brough me back here, this place is so great, thank you for everyone that runs and participates here, it's one of the few places that gives me hope I may not be doomed to a life of exhaustion. Anyway, I was reading the thread about palatal prolapse and was wondering if that might be what's going on for me. I'm attaching an Oscar screen shot of the full night, one zoomed in view of the flow rate when no events where nearby and a zoomed in view of a recorded hypopnea, clear airway event and another hypopnea. I can attach any other screenshots or data someone things might be helpful.
So my questions are this. Does this look like it might be palatal prolapse? Even if it's not, what other questions would you recommend I ask my new sleep doctor (when I find them) given that my AHI is pretty consistently under 5, I still feel exhausted all the time and my previous sleep doctor thinks I'm fine? I'm borderline desperate again.
RE: Palatal Prolapse? Other advice welcome - G. Szabo - 10-02-2024
(10-02-2024, 11:37 AM)sleepyqueue Wrote: So my questions are this. Does this look like it might be palatal prolapse? Even if it's not, what other questions would you recommend I ask my new sleep doctor (when I find them) given that my AHI is pretty consistently under 5, I still feel exhausted all the time and my previous sleep doctor thinks I'm fine? I'm borderline desperate again.
The magnified sections do not show palatal prolapse. However, there are some limitations in inhalation flow, which are usually addressed by fine-tuning the pressure setting.
RE: Palatal Prolapse? Other advice welcome - CPAPfriend - 10-03-2024
That does not look like palatal prolapse.
What's important is what physiological response you're having to any given amount of sleep-disordered breathing. Also, there is an entire other side to SDB that involves something called loop gain, which is overlooked 99.9% of the time but can be the issue at hand. I usually don't say this directly, because I try not to shill, but I recommend you watch a few of my videos just so that I don't have to transcribe the entire philosophy here in text. People can have short-cycle periodic breathing that doesn't flag as anything and / or they can have very subtle events that still cause significant physiological responses.
Maybe start here: How a Harvard Sleep Doctor fixes the Most Challenging CPAP Patients
or here: Low AHI and still feel like sh*t?
RE: Palatal Prolapse? Other advice welcome - sleepyqueue - 10-03-2024
I will absolutely check those videos out. Thank you!
RE: Palatal Prolapse? Other advice welcome - Phaleronic - 10-03-2024
As the others have stated those zoomed in waveforms aren't palatal prolapse, but you're having too many events to sleep well or deeply, I'd suggest moving over to constant pressure set to 15.8cm for a few nights and set EPR on 1cm fulltime sleepyqueue.