CPAPtalk.com

williamco wrote:thanks for showing up what I really wanted to say but was trying to save the folks here

What ever dude. I hope you got your jollies for the week.

akcpapguy wrote:I will attempt to clear a few things up for those that are still interested.

I worked for the National Institute of Health for a couple of years as a sleep tech/researcher. One particular assignment I went on was to observe a study done on the physical affects of CPAP on the body during sleep. The study was done over 4 months and hundreds of OSA subjects, not all of them under went a sleep study but many did, I believe around 70%. We would hookup the test subjects and throughout the night the Radiologist would turn on the xray machine (They used the same types of xray machine that is used in cardiac cath procedures so the image was real time and moving.) and observe as we would titrate the pressure on the CPAP. In 90% of the subjects the tongue was the cause of obstruction, and in 100% of those subjects we visualized the CPAP pressure lift the tongue and move it forward. In every case after the obstruction was relieved by titrating the pressure up, the pressure would then be reduced and we would see the tongue once again slide back on the lower palette and obstruct the airway. As I said we actually visualized this on the monitor of the xray machine in real time as the subject was sleeping. So there is NO QUESTION in my mind that CPAP does infact provide enough pressure to move the tongue forward and prevent it from obstructing the airway. Would I say that it does this 100% of the time with 100% of patients, ofcourse not that would be a foolishly ignorant statement.

I hope that puts to bed the theory that CPAP doesn't move the tongue.



AKCPAPGUY

Thanks for that info - it supports what DreamStalker was saying & provides an interesting insight.

Cheers - DSM

akcpapguy, did they test any difference between nasal and full face masks?

dsm wrote:

akcpapguy wrote:I will attempt to clear a few things up for those that are still interested.

I worked for the National Institute of Health for a couple of years as a sleep tech/researcher. One particular assignment I went on was to observe a study done on the physical affects of CPAP on the body during sleep. The study was done over 4 months and hundreds of OSA subjects, not all of them under went a sleep study but many did, I believe around 70%. We would hookup the test subjects and throughout the night the Radiologist would turn on the xray machine (They used the same types of xray machine that is used in cardiac cath procedures so the image was real time and moving.) and observe as we would titrate the pressure on the CPAP. In 90% of the subjects the tongue was the cause of obstruction, and in 100% of those subjects we visualized the CPAP pressure lift the tongue and move it forward. In every case after the obstruction was relieved by titrating the pressure up, the pressure would then be reduced and we would see the tongue once again slide back on the lower palette and obstruct the airway. As I said we actually visualized this on the monitor of the xray machine in real time as the subject was sleeping. So there is NO QUESTION in my mind that CPAP does infact provide enough pressure to move the tongue forward and prevent it from obstructing the airway. Would I say that it does this 100% of the time with 100% of patients, ofcourse not that would be a foolishly ignorant statement.

I hope that puts to bed the theory that CPAP doesn't move the tongue.



AKCPAPGUY

Thanks for that info - it supports what DreamStalker was saying & provides an interesting insight.

Cheers - DSM

Your welcome DSM, that was my intent, the OP's theory is wrong on many levels.

DS, there was really no movement of the mandible, the soft tissue of the base of the tongue is what was moved.

FRH, the subjects were on both nasal and full face masks, nasal pillows hadn't really hit the market hard yet, atleast in the UK, which is where this study was done. Ahh many fond memories of those 4 months!!

I am hesitant to join this thread but here goes.
I believe that the air stent created by the cpap keeps my tongue out of the way and the throat clear to breathe. This is on my experience only. Before cpap I slept with my mouth open and when I woke up I had the dry mouth miseries, and oddly also would find that I drooled on my pillow. In my sleep study I was given a nasal pillows mask and surprisingly slept with my mouth closed. From the beginning I had no air leaks and have not needed to tape my mouth or any other measure. My tongue somehow managed to find the correct position at the roof of my mouth and stayed there. Lucky, for sure. I am a stomach sleeper. Last week I had surgery that will require me to sleep on my back for 6 weeks. I anticipated problems with my mouth opening (gravity if nothing else) and bought a chinstrap and full face mask to deal. Well, guess what?!! After 2 nights with chin strap slipping around on my head, I found that my tongue has learned to stay out of the way. No more chinstrap. Back to my deconstructed Headrest mask with 2 lightweight stretchy straps! I again say that FOR ME the stent keeps the airway open and there is no longer any need to open the mouth to get enough air.
I am not educated in physics or any scientific study that I could argue or even attempt to explain how it works. I just have my experience that shows me that if I try to sleep on my back (or stomach for that matter) and try to do so without my cpap, I have to open my mouth to get enough air and start with the snoring, gasping, non-sleeping of sleep apnea. Put on that cpap and my airway stays open and my mouth stays shut. Maybe someone can explain what I have just observed.

Catnapper - Joanie

williamco wrote:thanks for showing up what I really wanted to say but was trying to save the folks here. you cussed your self publicly on my behalf

How about we stop feeding this troll!

carbonman wrote:It's very sad that JNK is not here to
create a poll to set this poll straight.

well where IS he?

frh wrote:

Hope1952 wrote:I think I stop breathing because I'm a nose-breather and my nose is stopped up.

Hope1952, I am the least qualified person here to try to give advice, but my sinuses have been congested for years. I have pretty bad nasal allergies on top of a deviated septum and very small nasal airways. (On friday I have an appointment for an MRI of my sinuses.)

A steroid allergy shot several times a year kept the sneezing at bay, but never helped with my sinuses. My sleep study was done on a very rare un-congested night with a Swift FX mask. That congestion came back full force when I started on CPAP. Nasal irrigation and saline spray didn't help at all, so my GP started me on 2 puffs of Nasonex a day. It took about 2 weeks to start working.

I keep the humidity on my Resmed S9 (with climate line hose) turned up as high as possible because it eases irritation in my damaged esophagus (from many years of GERD) and also helps keep my sinuses open.

If you haven't tried Nasonex, you might ask your doc for a prescription for it or Flonase. (I'm pretty sure they work the same.)

Thank you for sharing your experiences and for the suggestions. Your story sounds so similar to mine. I use a neti pot but often it doesn't clear my nose for sleeping. Ny nose also worked great for the sleep study. I have migraine disease and I've tried Flonase but it triggered migraines for me. Now I'm trying Nasacort and it has been giving me a headache almost every day for a week but I'm still using it and just taking pain relievers. I had allergy testing done and have started on two shots per week for the next year. My nose and the constant disintegration of my mask (Liberty) are making life difficult. I wish they'd both work like they're supposed to! Right now, I'm trying LOWER humidity on my machine to see if that would help, setting it on 2.

My understanding is that UARS is caused by the same phenomena that can cause OSA--anatomical and dynamic collapse of any and all parts of the airway. I'm not sure anymore what the distinction is between a RERA or a hypopnea, as it appears to depend on the definition of a hypopnea. They are manifestations of Sleep Disordered Breathing (SDB).

BTW, not to say no one should use Nasonex or Flonase... but during my septoplasty my surgeon discovered that I have thinner than expected septal cartilage, which she thinks is due to long-term use of nasal steroid sprays. She would like me to take oral antihistamines down the road instead of sprays (not sure how that's going to work out for me, but haven't recovered enough to be doing either yet, so we'll have to revisit that). So maybe ask your doctor how to avoid that. I know you are supposed to spray away from the septum (which I might not have known a decade ago)...

Have you had fibromyalgia and chronic fatigue syndrome ruled out? The CFS has been the source of my continued fatigue. I started taking Nuvigil about three weeks about and its made a tremendous difference.

Wow! A flame war about sleep apnea!?

FWIW, I can relate to catnapper's experience. I was also a mouth breather (asthma, allergies, severe apnea and slightly deviated septum.) I use the Swift FX nasal pillows and find my mouth seems to automatically seal shut allowing unhindered breathing through the nose. In fact, just opening my mouth is enough to startle me awake and remind me to close it. I've been on CPAP for about a month now and while not really getting a huge energy boost like I hoped for, my mind is clearer and I'm not as tired in the afternoons. Hopefully I will continue to improve over time. So I would say that in my experience, the pressure does push the tongue into a normal, relaxed position and keeps it from obstructing my airway.

I just want to say that Sleep Apnea Ia all in your head.

hannah01 wrote:Wow! A flame war about sleep apnea!?

Seems crazy doesn't it!? I guess lack of good sleep makes people cranky!

williamco wrote:
However only mouth air delivery can push the back of the throat a bit more, because air is going in straight direction at back of the throat, opening more space for the relaxed tongue.
this aerodynamic can't happen with nasal air delivery as the air going down not hitting the back of the throat in a straight head on direction, yes transmitting pressure all around but in not as much as direct hit

Further more air going down (nasal delivery) might push the tongue down even further, while air going backward (mouth delivery) will not be in line of the tongue relaxation path, and will not push it further down, as air is bouncing off the back of the throat into trachea, might even push tongue forward.

the bottom line, I need to check if aerodynamic of nasal air delivery versus mouth air delivery inside the throat, has any impact of those people who are still tired. knowing that it might be many factors involved, so the poll might help to shed light by showing the percentage of usage in this group.

Thanks for participation

Actually I find that the nasal mask is a bit better for keeping my airway open. There seems to be around 1 or 1.5cm difference between the nasal mask and the full face mask in my personal experience (with the nasal mask allowing more pressure). When I use just the nasal mask I sometimes turn the machine down by 1cm otherwise I swallow a lot of air. I still get similar (and often better) results from the nasal mask. The only reason I use the FFM is because I find it more comfortable.

Also, I was still very tired over a year into my CPAP therapy. It turns out I was experiencing other health issues and now that those are resolved I feel great whether I use the nasal mask or the FFM. My AHI is consistently below 2 and often below 1.

If you're still tired, I'd bet you need to adjust the machine or you need to check into other health problems.

If you are not using a full face mask you are simply a sissy and don't appreciate the comforts of smooshing your face into a soft pillow. Asides from which recents studies have shown that nasal fixtures cause you to swallow more air and fart more, although I am sure for those of you on nasal contraptions that does not present a problem.