Apnea on *exhalation*

[terriergal]

"The whole point of a FFM is that one can breathe either through one's nose, or one's mouth, or both."

Yes. I know. lol how many times do i have to tell you it doesn't work for me to breathe out through my mouth? Even without a mask pressing on my face, when i exhale through my mouth it goes through the cheek and corner of my mouth, so when I put a FFM on, it's cutting that route off by the PRESSURE OF THE EDGE OF THE MASK. The air NEVER MAKES IT TO THE MASK.

Really how hard is this to understand?

Omg I just read the rest of your response. What the hell is wrong with you?

"Then stop making up nonsense statements that mean nothing to anybody that actually does know how things work."

YOU DO NOT UNDERSTAND AT ALL.

Your "cheeks" are not involved *IN ANY WAY* with breathing. They are not part of your nasal structure, they are not part of what controls where air goes.

REALLY. Then HOW COME THE AIR ESCAPES OUT OF MY CHEEKS. Do you think I DO NOT KNOW WHAT MY CHEEKS ARE?

You know what is really and truly not part of the respiratory structure? The esophagus. but hey people get air forced down their esophagus too, I suppose that is also 'nonsense'?

"Your "palate" is the roof of your mouth,"

No duh. And the hard palate is the bony part and the soft palate is the non bony part. Palate may also refer to one's dietary tastes. If you really wanted to be a dictionary you might have included that.

Do you not really think that there are some people for whom CPAP may not work? Seriously? lol just because it works for you doesn't mean someone who has been trying for 6 months with limited success is somehow stupid. I guess we all should be the same as you?

[palerider]

"The whole point of a FFM is that one can breathe either through one's nose, or one's mouth, or both."

Yes. I know. lol how many times do i have to tell you it doesn't work for me to breathe out through my mouth? Even without a mask pressing on my face, when i exhale through my mouth it goes through the cheek and corner of my mouth, so when I put a FFM on, it's cutting that route off by the PRESSURE OF THE EDGE OF THE MASK. The air NEVER MAKES IT TO THE MASK.

Unless you have a hole in your "cheek", it is physically impossible for air to go out through your "cheek",

Really how hard is this to understand?

Quite difficult, when you're posting NONSENSE.

[terriergal]

"Unless you have a hole in your "cheek", it is physically impossible for air to go out through your "cheek",
"
Sweetie. I explained NUMEROUS TIMES. It goes OUT MY CHEEK (as opposed through the center of my mouth/through my teeth) TO THE CORNER OF MY MOUTH.

You really must be English comprehension challenged.

[palerider]

"Unless you have a hole in your "cheek", it is physically impossible for air to go out through your "cheek",
"
Sweetie. I explained NUMEROUS TIMES. It goes OUT MY CHEEK (as opposed through the center of my mouth/through my teeth) TO THE CORNER OF MY MOUTH.

You really must be English comprehension challenged.

I can't help if if you're using words incorrectly.

The fact that nobody can figure out what the hell you're gibbering on about should tell you something.

Go find a picture of facial anatomy, and learn what the right word is for whatever structure you think air is 'going out'.

Then when you've learned some terminology in common with normal people, feel free to come back and try to lucidly communicate.

[Barbee]

I'm scheduled for a CPAP titer test next week. The thing is I know how to adjust my settings. No matter what I increase the pressure to, it doesn't prevent my palate from closing. In a strictly mechanical way it doesn't make sense that increasing pressure will hold the palate open on exhale. They all think it should. You still have to overcome that pressure (essentially negating it) to exhale

I do know what you’re talking about as I have that, too. Since using the cpap machine, I can feel my palate dropping and then I will feel it being pushed back up by the pressure. Its like a little poof feeling. The cpap pressure has taken care of it for me. I do wear a full face mask which allows me to inhale or exhale however I need to.
Prior to cpap, i was snoring almost immediately when I fell asleep and many times I woke myself up snoring and fighting to expel air.

[terriergal]

Yeah that sounds about right. Except a full face mask doesn't work for me either because I hate breathing through my mouth at all. My mouth stays closed at night as much as possible. If air does come out it comes out through my teeth into my cheeks and out the corners of my mouth. So a full face mask cuts that route off.

UPDATE
I talked to the Inspire certified ENT. She realized the Inspire wouldn't work for me and she did suggest UPPP. But she did not sell it hard. She knows it is not always a good solution. She requested approval from insurance, but she knew they would probably deny it at least the first time (they did), and she said she would appeal. In the meantime I asked for a sleep endoscopy which we did today.

Result,she talked to me afterward with her preliminary observations. She said I am right, my palate is REALLY loose and floppy and stretched out. She even saw it was quite wrinkled up on the back side which she said she has never seen (or hardly ever seen, I was still a little sleepy so not sure which she said).

She's quite sure UPPP would help a lot with that but it would not be a panacea. I also have some significant collapse from the sides of my throat. She said they did a maneuver with my jaw (pulling it forward) that really opened things up so I have to try a jaw advancement device I think first to see if I can tolerate that. I seriously doubt that will work for me from a comfort standpoint but... ya know you have to jump through the hoops. And I'm willing to try. I did try an over the counter JAD but it didn't stay in very well. I'm sure a good one would overcome that. However just having my jaw thrust forward did get uncomfortable very quickly. So we'll see.

I also am going to ask her to look into the AlaxoStent as well. I have a follow up with her on Friday. I still want the turbinate reduction since i quite frequently am dealing with nose stuffiness even aside from any real allergy flare ups.

I personally don't think CPAP does much for this problem at least in the way I have it. Maybe for some whose palate is not quite as stretched out as mine, I don't know. I have a friend on CPAP and she says she never has this problem even sleeping on her back. It does relieve my snoring and inhalation problems but substitutes a different problem that seems for me to be far more sleep disturbing. I spend what seems like hours trying to fall asleep in a position i can be comfortable in, only to be jolted awake by that sensation of my palate slamming shut and me having to consciously open it. It never shows up in the numbers. (It does show up in the waveforms which they don't seem to care about, and I can't for the life of me understand that. Don't they know we have to inhale AND exhale!?

If waveform is not important why do they chart it? I get frustrated when doctors tell me I don't have much of a problem with apnea. I was sitting here at the table yesterday falling asleep with my eyes open about 3 in the afternoon. I usually start fighting the sensation of foggy headedness by midmorning.

I found a thread entitled "Flow Rate Waveform Examples using a Nasal Mask" that shows a similar (but more rounded) flattening when people switch from nose on inhalation to mouth on exhalation. But with this problem the flatlining is very sudden.

It's very easy for me to snore on exhale even when awake in certain positions, if I relax my throat.

[Julie]

Do NOT get a UPPP - many have done so and sooo few have succeeded... and you can't put back what's gone once it's gone. Do a forum search on it and see results. You can't know how you breathe when asleep unless you film yourself or a partner is awake all night. You may simply need higher air pressure to deal with floppiness, but it would help us a lot to help you if, after you read the first 'Announcement' main pg, you post graphs etc. of Sleepyhead so we can see what is going on and then advise. ENT's LOVE to cut... it's how they get paid!

[ajack]

Try this..keep raising the min pressure, till there is enough to stop you obstruction on exhale and keep your throat open. I have this and need 12cm, I checked it by when I go to sleep. I can tell if the airway is open enough or if I still get the obstruction as I breathe out and it arrouses me from the partial sleep state. I then add another 1 CM. pressure to be sure. the auto function doesn't respond to this type of obstruction and ignores it.

[zoocrewphoto]

"Unless you have a hole in your "cheek", it is physically impossible for air to go out through your "cheek",
"
Sweetie. I explained NUMEROUS TIMES. It goes OUT MY CHEEK (as opposed through the center of my mouth/through my teeth) TO THE CORNER OF MY MOUTH.

You really must be English comprehension challenged.

I've been reading your posts, and I don't understand them either. I think you are using different meanings for the words you are using. I keep reading, hoping it will make more sense, but you keep repeating several things that just don't make sense.

What difference does it make whether the air exhales via the side of your mouth or the center? That is still exiting from your mouth. It doesn't make sense to say "doesn't work for me to breathe out through my mouth" Clearly, you ARE breathing out of your mouth if the air is exiting via your lips(regardless of what part).

You also say "The air NEVER MAKES IT TO THE MASK"

What the heck does that mean? The air comes from the machine and goes through the mask to your nose or mouth (or both). When you exhale, it goes back to the mask. If it does not go to the the mask, then you would have to be swallowing it ALL. That makes no sense. If you are using a full face mask, the exhaled air WILL go to the mask.

Now, perhaps you could explain what the real problem is? Are you trying to use a nasal mask and having problems exhaling? Or are you trying to use a full face mask and leaks?

tell us which mask you are using and what problem you are trying to solve. Then we can help you.

[ajack]

I think she means chipmunk cheeks, where they balloon.

[zoocrewphoto]

I think she means chipmunk cheeks, where they balloon.

Quite possible. But she has never mentioned chipmunk cheeks or leaking mask. If she is talking about something that we are familiar with, she is using different lingo. Otherwise, she has something totally different that nobody here has experienced.

[ajack]

It takes awhile to learn the lingo. I'm aussie and didn't even have a clue what chipmunk cheeks were, when I started. Heck, we don't even have chipmunks. Cheeks like when you blow up a balloon, makes more sense to me.

[Dog Slobber]

chipmunk_cheeks.jpg

[terriergal]

I have the same problem as you although without the machine I also have it on inhalation. The machine fixes inhalation but not the exhalation part contrary to what some here had said. I can’t turn the pressure is up very high because then the air just goes down my stomach or comes out the corners of my mouth.

I literally can’t breathe if my face is parallel to the mattress basically on my side I have to be leaning a little bit into the mattress which as you can imagine makes it hard to keep a mask on in the right position.

Anyway not much has changed in two years since I logged in, I had neck surgery which did help somewhat in that it made it less painful to sleep on my side. But there are some days I still really just want to sleep on my back. Even partially on my back.

I have a little bit of an update, as I mentioned, not much has changed until today. I went to another ENT in October at a big research hospital in my state of MN, I’m not sure if we are allowed to name hospitals. He did a scope into my nose and had me lay back and demonstrate what it is I’m talking about that happens when I’m in the dentist chair or trying to fall asleep even partially supine. (I did forward all of my relevant records there before I went) And you could see the uvula flip right back up into the nasopharynx and block it. So he recommended that UPPP surgery. (

He is the second one to have suggested this . No actually he’s the third one to have suggested it and only one other one tried to get it approved once.)

He explained the problems with older techniques and showed me a diagram of their current technique which results in fewer problems and he thinks this will help a lot, although I will probably still have to use the CPAP. However because of Covid everybody’s elective surgeries are being put off so I have to wait till at least March, assuming my neck surgery doesn’t go through. If my next surgery happens then it’ll probably be at least late spring before I can do the UPPP.

He says the way they do it now it’s just taking a V-shaped dart (ask a seamstress what a dart is if you don’t know) around the uvula and then stitching those edges together so that line of scar tissue where your uvula used to be and then slightly up into your palate is going to make it stiffer plus they also take out your tonsils since they’re in there already, and they do something with drawing the sides up tighter where the soft palate attaches to the sides of your throat. That way you don’t have a big line of scar tissue along the back edge of your uvula which causes fewer swallowing problems.

So if you are having this palatal prolapse issue, I would encourage you to get to a really good ENT and have them push the issue with your insurance.

Some thing I’m curious about from anybody who has had this surgery done in the last few years, does it change singing voice at all? Because once Covid stuff is in the past I would like to get involved in choir again.

[Julie]

Why not name hospitals - I worked there at Swedish in '67 and another one that was torn down around the same time. You're not acting as their salesperson are you.

Many people were talked into paying their ENT's mortgages and had UPPP's. Then 6 or 10 mos later came back to re-learn Cpap, only it was usually harder then because of what the surgery did.

Not recommended!

Do a forum search on it and see what the hits say.

PS - next time start a new thread... this one's old and really about a different issue entirely.