Curious question

[Wonderbeastlett]

Just have to say that I'm so glad I found a place I can post all my questions!

Ok anyway, my dad had severe OSA for almost 30 years and in 2010 he was diagnosed. He now is being treated but he spent almost all of his adult life not even knowing he had OSA! Growing up I remember every time he would eat he would cough really bad. It became a joke in our house my mom would say," chew your food young man." My dad would always say he felt like he was choking and would spit up tons of phlem. I started having the same symptoms and I tried to find a reason.

I read a article (wish I had the link) that basically said phlem is a common OSA symptom. Your throat will collapse and that causes the flap that blocks stomach juices from coming up to also collapse. The phlem ends up being your body's natural response to try to block the acid from burning your throat.

Has anyone ever heard of this or had these symptoms?

[greatunclebill]

you're talking about a hiatal hernia (not a flap) that has no direct connection a collapsing airway, although several people have both. if you have a hiatal hernia down at the bottom of the esophagus it will let reflux in the esophagus. having sleep apnea will tend to suck the reflux out when you are trying to breath, but the actual hiatal hernia and collapsing airway are not caused by one another.

[Wonderbeastlett]

Is phlem something that comes with a hiatal hernia? Can people have one and not know it? I was just questioning why phlem would be a OSA symptom.

[greatunclebill]

Is phlem something that comes with a hiatal hernia? Can people have one and not know it? I was just questioning why phlem would be a OSA symptom.

maybe you're talking about chronic post nasal drip then. the nose draining backward down into the throat. maybe something to dry the nose and prevent dripping would stop that.

reflux that comes thru the hiatal hernia is hydrochloric stomach acid. anybody that has the problem knows the horrible taste, burning sensation of it, etc. a hiatal hernia is a defect in the hiatus valve at the bottom of the esophagus that usually prevents stomach acids from coming up into the esophagus.

[Julie]

I think you should also google 'throat' and esophagus and airway Images... you don't seem sure about the anatomy, e.g. there are two completely separate 'tubes', one being your airway that allows air to go from your nose or mouth to your lungs, and the other being your esophagus, allowing food from your mouth to go down to your stomach. If you accidentally 'inhale' a tiny bit of food into your airway, you begin to choke, which is understandable and need to cough it up so it can switch to the esophagus and go to your stomach, just as when air accidentally ends up in your stomach, making you belch - less traumatic by far, but still a matter of the wrong thing in the wrong place.

[Wonderbeastlett]

All of this was written in the article that I read. I believe it was just this doctors theory as to why OSA patients tend to have phlem issues. She suggested the phlem is linked to heartburn/acid reflux that so many OSA patients deal with. What I was looking for was whether other patients have excess phlem like what my dad seemed to have? I understand the article was just her theory and has never been proven or even linked to acid reflux/ heartburn or OSA patients.

[tigrpal]

My theory, no scientific evidence for this, is that my excess phlegm was my body's reaction to snoring. My throat was sore almost every morning and the excess mucous was produced because of irritated tissue in my throat. I no longer snore and I have less phlegm since cpap.

[123.Shawn T.W.]

I have recently been diagnosed with OSA ... I have phlegm ... Most all day, but worse in morning ... Sometimes gagging which can lead to vomiting ... Not sure what it is from, but I would not miss it if it goes away!

I also have a constantly sore throat, seems parched, even after drinking water ... Dr only said it looks a fine bit irritated ... Much less than I was with him!

[BlackSpinner]

google "GERD" aka silent acid reflux. I had the same thing and it mostly disappeared after I started cpap. I also use an inhaler for bronchial issues, probably cause by years of reflux damage.

[purple]

my sleep doc was very clear that there is a relationship.

As he goes through his explanation. When I was small I had a very small nose, inherited from my father. Because of that, when I tried to breathe, I opened my mouth and sucked for air. Like a basement sump pump. As years went along this might have been made worse by tonsils and adenoids. This gasping for air kept my jaw from growing wider and projecting forward. As an adult, the back of my tongue and that area was larger than I would have had if my jaw had grown normally.

This gasping, sump pump effect, caused me to pull stomach acid up and damaged my Pyloric valve. He said many of his patients had both Gerd and Sleep Apnea. That a normal, healthy Pyloric valve would resist air pressure above 20.

When I started CPAP, the air pressure (usually during the exhale) could be pressed down into my stomach. Which makes the GERD worse. Not to mention the pressure causes my abdomen to swell. The best way to burp the extra air out, is to move about, walk. I suspect some people who wake up breathless in the morning actually have so much gas in their stomach that it presses back up on their lungs and heart.

This air in the stomach can also cause a machine on auto to keep increasing pressure, as it takes more pressure to inflate the lungs. Which is part of why some docs prefer to set a machine on a straight pressure instead of auto.

When I still had a bitter taste in my mouth in the morning (stomach acid) while on a straight pressure, he told his nurse to refer me to GI doc. My Primary Care Provider (PCP) opined that the first thing a GI doc would try is to give me a prescription level dose of Omeprazole (40 MG). The pharmacist suggested that the only downside of that dose is that it might keep me from getting enough calcium, as one needs stomach acid to absorb calcium, normally. However I could take Calcium Citrate, which would allow my body to get calcium without the stomach acid.

I still have stuff from my stomach rising up to my throat, but it not bitter.

I think I need a bi-level machine to have a very low pressure on exhale. Also for that machine to be a Resmed in that the algorithm that Resmed is rumored to use is more accommodating to my method of breathing. I have not tried a Resmed, nor can I afford a bi-level machine.

Sleep doc said that it would likely not be helpful to surgically repair the Pyloric valve if the gasping problem is not resolved. For What it Worth: Sleep doc also said that one can not titrate oneself by using a machine on Auto. Too many other variables, like this one, and the possibility of a patient hitting a Central which they would not wake up from. Plus some sleep apneas are not Obstructive Sleep Apnea, but would be revealed in a proper sleep study in a lab.

I did not ask, but I would be pretty sure he is also advocating that quick removal of tonsils and adenoids in the children/grandchildren of OSA patients would be a very good idea.

[kaiasgram]

Has anyone ever heard of this or had these symptoms?

Yep. I was evaluated for hiatal hernia and I don't have it, however in the last several weeks before being diagnosed with OSA I would wake up with a horrific phlegmy cough. After a couple of minutes of coughing I would go back to sleep. It was a scary experience.

[jjjmac]

Well, I have that symptom (and so does my dad) but I don't know technically if it's related or not. I've had a chronic cough for at least 20 years due to phlem. At first they diagnosed me with allergies and prescribed Zyrtec. That helped a little. I got retested and they said I didn't have allergies anymore, but still had all the symptoms - and now say it's chronic rhinitis (chronic post-nasal drip). I've tried neti pots, flonase, and sudafed...nothing really helps. I tried something for GERD a while back in case it was that - didn't work. I had my sinuses scanned - nothing abnormal found. :-/ fun

[Wonderbeastlett]

This is whats so confusing! This forum where everyone has OSA all tend to have some similar issues, yet not all of them are scientifically linked to OSA! I feel like we're getting the short end of the stick here! I wish more in depth studies would be done to find all the links OSA causes!

[jjjmac]

yeah, I just wish they could figure how out to get rid of the post-nasal drip! I really do think that's the main cause of my apnea. :-/

[Wonderbeastlett]

I wish I had more answers for that. I have never had major sinus issues except for some pressure here and there. I'm always coughing phlegm when I eat and sometimes during the day. Ive only just started to look into similar symptoms between my dad and me.