parameters that cause sleep apnea

[mckooi]

Hi All,

This is interesting to know that if one sleep at the supine position (back) the changes of sleep apnea occuring is high. Can anyone tell more what are the 1) main parameters that cause sleep apnea 2) Secondary parameter? Please help on these lists below. Thank you.

1) Main parameters that cause sleep apnea [better with]

- Sleep Position (Supine/back) [Better with: sleep on the side]
- Body Weight (BMI) [Better with: less BMI less than 25]
- others.....?

2) Secodary parameters that cause sleep apnea
- Height of pillows (less than 2) [Better with: 2+ pillows]
- Block nose (both blocks) [Better with: both breathing (no block)]
- Others....?

Mckooi

[socknitster]

There are tons of contributing factors to apnea, many of which cannot be reversed without serios intervention.

A naturally narrow airway.

Huge tonsils and/or adenoids,

Receded jaw resulting in smaller oral cavity,

Large tongue

Deviated septum, enlarged turbinates,

Large, floppy palate,

damaged/inflamed esophogus from GERD or Silent GERD

And there could be many, many more undiscovered contributers.

This isn't simple. That is why there is no simple cure. You have to discover what exacltly is your personal combination of problems and address them. That alone may not cure you.

In my case, treating silent GERD and having my tonsils out cut my pressure needs almost in half, but did not cure me. I'm told the MMA/GA surgery may be a cure but it is a radical surgery! One not to be entered into lightly. For me, cpap is now comfortable enough I don't think I will ever consider it as a possibility.

Don't be tempted to oversimplify. It isn't as easy as sleeping on your back and losing weight. The damage leading to full blown apnea may have started for many in childhood and is now irreversible for many.

Jen

[mckooi]

Hi Jen,

Can you please edit on the 1) Main and Secodary and the [.....for better with as one of the methods to correct/prevent/relieves] for each parameters. Thank you.

Mckooi

[SisterShotgun]

I have a naturally narrow airway, damaged/inflamed esophogus from GERD

and to top it off I am not considered to be overweight by my doctor..I would love to lose 20 more pounds but that is just me..

[socknitster]

Hi Jen,

Can you please edit on the 1) Main and Secodary and the [.....for better with as one of the methods to correct/prevent/relieves] for each parameters. Thank you.

Mckooi

One person's primary cause could easily be another person's secondary cause. Apnea can't be put in a clearly labeled and defined box. It isn't that easy. Many have more than one, or all causes complicating each other.

Jen

[mollym]

- Height of pillows (less than 2) [Better with: 2+ pillows]
Mckooi

The fewer and/or thinner pillows you use the straighter
and therefore more open your airway will be.

[split_city]

The less pillows the better --> better to have your neck extended rather than flexed. Tilting your back (while keeping your neck in the same position) also helps in many cases.

As stated by socknitster, there is no one simple cause for OSA. The development of OSA is probably the result of several pathways.

One area not mentioned includes a term known as "loop gain." This is an engineering term and can be quite difficult to understand. Simply put, someone with a high loop gain will overcompensate for a disturbance. For example, get someone to breathe an air mixture with slightly higher CO2 levels. A patient with high loop gain will significantly increase their ventilation, so much so that they will overshoot their "set" CO2 levels in their blood. Subsequently, they will stop breathing i.e. central apnea, until their CO2 levels rise to their baseline level. Eventually, their CO2 levels might rise above baseline levels which triggers hyperventilation --> followed by overshoot in blood CO2 levels --> central apnea. This is commom in a condition known as Cheyne Stokes Respiration.

A seperate area of research looks at the importance of an arousal to restore airflow or terminate an apnea. Recent work suggests that arousal actually might perpetuate sleep apnea events. Here's what can happen:

1) Apnea
2) CO2 in blood builds up
3) Arousal is triggered
4) High levels of CO2 in blood trigger increased ventilation
5) Increased ventilation reduces CO2 levels in the blood
6) The individual may blow off enough CO2 that they stop breathing i.e. central apnea when returning to sleep
7) As CO2 levels are low, upper airway muscles are turned off
Eventually, CO2 levels increase and breathing is switched back on. However, muscles are still switched off and cannot keep the airway open.
9) Airway collapses and an obstructive event occurs
10) CO2 builds up
11) Arousal is triggered followed by hyperventilation
12) Cycle continues

Check out the article by Amy Jordan which shows the "overshoot" in ventilation following tone-induces arousal in OSA patients

http://www.pubmedcentral.nih.gov/picren ... obtype=pdf

[mckooi]

Hi Split_City and All,

Interestingly enough from your observation and comment of over shoot of CO2 due to hyperventilation that cause center apnea but dont forget under the normal circumstance the Hb/O2 on the Bohr Effect when the O2 increases due to hyperventilation that cause CO2 to reduce will increase the PH level in the blood as Bohr effect taken place hence O2 reduction (hypixia) that cause to compensation of sleep apnea, see more on .....

http://www.anf.org.au/04_anf_anj_public ... lin_update.

This is the key to fundalmental of all cause of sleep apnea besides physical barrier (devaite septum, enlarge tonsile etc.). One need to breath correctly is the way is the key/passage to reduce/cure/prevent sleep apnea (Evidence). This is the holy grail!

Mckooi