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Only Most doctors and therapist therapists think "positional" apnea means supinesleeping position resulting in the tongue rolling back and blocking the airway. We know it that is really only one mechanism of obstruction and many others may be at play, such as a chin tuck in any position. It happens a lot on your back because we like to rest our heads on pillows that elevate our heads above our shoulders, but this can facilitate chin-tuck, but we . We have seen positional apnea in any position and even while using so-called "ergonomic" or cervical support pillows, sleeping on your side, especially in a fetal position, or even prone with your head turned to the side. So the professionals erroneously attribute to gravity, what is really just a body position many people naturally have. The simple way to prove this is to sit comfortably in a chair and relax. As you relax further let your chin drop towards your chest. People If you don't brace your airway, individuals prone to this obstruction will sense more airway restriction, a snore or even complete blockage or apnea. This happens naturally during sleep, even sleeping on your side in a "fetal" position.

If it had not been a factor in at least 1/3 of the members of the [http://www.apneaboard.com/forums/index.php Apnea Board Forum], we would quickly dismiss it, but the results are amazing. We have seen some members go from AHI over 30 to less than one without changing any CPAP settings, but adding a [[Soft Cervical Collar]]. Someday, even the medical community is going to capitalize on this and start measuring patients for collars, but for now you can DIY for less than $20. Since we originally wrote this wiki article, an internet search for "positional apnea" has gone from none to many, but most articles are promoting a product like INSPIRE, V-Com or more radical surgery. At Apnea Board, we see this as a very common problem that is usually resolved by very simple and inexpensive modifications, such as avoiding multiple pillows, using a less firm or tall pillow, Avoiding inclined sleeping, being aware that acute angles in the head and neck can obstruct your airway, especially prone, with your head turned to the side to enable using your CPAP, or elevated on a pillow such that chin tucking will occur when you relax; and the most effective fix of all, the [[Soft Cervical Collar]].

The airway obstruction or positional apnea from chin tucking is more acute when nasal breathing and is typically overcome through arousal and/or mouth breathing. This mechanism of positional apnea appears to affect the same tissue set as palatal prolapse but in a different way. Palatal prolapse/collapse occurs during exhale as the palate prolapses upward into the velopharynx during expiration. In "positional apnea" the theory has been that the back of the tongue collapses into the airway at the same location, restricting the airway. With the chin-tuck theory, the soft tissues under the jaw are pressed upward causing a restriction or collapse during inspiration. It takes very little pressure to make this happen and the negative pressure of the airway during inspiration increases the restriction. You can simulate the chin tuck by pressing lightly upward on the tissues at the back of the lower jaw. Relatively light pressure on this tissue creates an increasing flow limitation ultimately resulting in a series of apneas. The series of apneas causes an arousal that either corrects the airway and/or causes mouth breathing. In addition, if the mouth drops open while the sleeper is on their back, the jaw will likely recede back, again obstructing the airway. While the tongue may be a player in this, we certainly don't encourage radical things like tongue ablation or uvulopalatopharyngoplasty (UPPP) surgery, we simply avoid the positions that cause the problem.