Expiratory palatal obstruction

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Expiratory palatal obstruction

Post by Pugsy » Wed Jun 10, 2020 8:25 am

Okaythen wrote:
Wed Jun 10, 2020 7:51 am
Nothing of the pain meds works for you, huh? At least you have a target, though. You’ve tried CBD oil and the like?
Long story there which I won't go into and it's complicated. I can't take any NSAIDs due to GI distress for one thing so that's a complicating factor. Pain meds help some but they wear off after about 4 hours so what I see when I look at my flow rate is usually a decent sleep quality for 3 or 4 hours and then things go to hell. I have a good friend who tells me that I need to have a pill by my bedside and when I first wake up I need to take it. Unfortunately I am the worst patient in the world (that happens when people work in the medical field) and I can't seem to get to that point. I actually take 2 different pain meds because the one I take during the day causes insomnia. There's that baggage thing again. Plus I have more going on than just plain old osteoarthritis...there's scoliosis as well as some non union fractures and we are now going through the process of ruling out systemic inflammatory factors. I need to stay off my back when I sleep but that's sometimes easier said than done because now my shoulders are complaining about my being on them all the time. :lol:
Damned if you do and damned if you don't.

Brief trial with CBD oil but I suspect that I didn't take a high enough dose but what I did take didn't help at all and it seemed to cause fast pulse rate which was annoying and messed with sleep.
I even tried some marijuana when I was visiting my daughter in Vegas where it is legal but the lowest dose possible caused again the pulse rate issues plus I didn't like the way it made me feel.

So I am still working on things but as you know it's a slow process but I haven't given up.
A surgery that would likely help some of my issues is considered experimental and not covered by insurance and I simply don't have the money to pay for it out of pocket.

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khauser
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Re: Expiratory palatal obstruction

Post by khauser » Wed Jun 10, 2020 8:36 am

Pugsy wrote:
Wed Jun 10, 2020 8:25 am
Brief trial with CBD oil but I suspect that I didn't take a high enough dose but what I did take didn't help at all and it seemed to cause fast pulse rate which was annoying and messed with sleep.
I even tried some marijuana when I was visiting my daughter in Vegas where it is legal but the lowest dose possible caused again the pulse rate issues plus I didn't like the way it made me feel.

So I am still working on things but as you know it's a slow process but I haven't given up.
A surgery that would likely help some of my issues is considered experimental and not covered by insurance and I simply don't have the money to pay for it out of pocket.
Marijuana is known to raise the pulse rate, and it wouldn't surprise me if CBD did the same, which is a shame, really (it would cause severe anxiety for me). When I was a youngin, some number of lives ago, I used marijuana for awhile. One day the escalated pulse caused a full-on anxiety attack. I was sure I was going to die. Not a pleasant experience at all. So that was quite literally the last day I used marijuana, no trouble quitting cold turkey. After all, it didn't help me relax any more!

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Pugsy
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Re: Expiratory palatal obstruction

Post by Pugsy » Wed Jun 10, 2020 8:50 am

khauser wrote:
Wed Jun 10, 2020 8:36 am
Marijuana is known to raise the pulse rate, and it wouldn't surprise me if CBD did the same, which is a shame, really (it would cause severe anxiety for me). When I was a youngin, some number of lives ago, I used marijuana for awhile. One day the escalated pulse caused a full-on anxiety attack. I was sure I was going to die. Not a pleasant experience at all. So that was quite literally the last day I used marijuana, no trouble quitting cold turkey. After all, it didn't help me relax any more!
I have never really used the recreational drugs of any sort. A half a weed some 35 years ago was a horrible experience and I figured if it didn't make me feel good then I had zero use for it. :lol: That was the extent of my recreational drug experiments in my mid 30s. Just never wanted to.

The pulse rate thing for me was highly annoying. Since I knew the cause I didn't panic but it was annoying to have my pulse rate actually double. Not a good feeling. Sure didn't help my sleep quality which was the whole idea of the experiment. I just traded one messing with sleep factor for a different messing with sleep factor. I see no sense in swapping problems with any sort of drugs.

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Okaythen
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Re: Expiratory palatal obstruction

Post by Okaythen » Wed Jun 10, 2020 8:51 am

Khauser, thanks for your advice, but, alas, I tried Gabapentin and it did not help me. Be careful — it’s an awful drug to come off of, when you do. I tapered off very slowly and still had severe withdrawal effects. I’ve tried 23 different meds in an effort to fix my poor sleep!

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khauser
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Re: Expiratory palatal obstruction

Post by khauser » Wed Jun 10, 2020 9:08 am

Okaythen wrote:
Wed Jun 10, 2020 8:51 am
Khauser, thanks for your advice, but, alas, I tried Gabapentin and it did not help me. Be careful — it’s an awful drug to come off of, when you do. I tapered off very slowly and still had severe withdrawal effects. I’ve tried 23 different meds in an effort to fix my poor sleep!
Yeah, I know it is hard to stop. My daughter took Lyrica (pregabilin) for a week, and had to stop because her (no ex-) doctor went incommunicado. So she stopped cold turkey. I never want to see that happen again.

I'm on a low-ish dose right now (600mg a night). I've cut back to 300 without problem, and I think I can cut to nothing from there (as in I've done that before).

MS Contin and oxycodone (ESPECIALLY oxycodone) ... now those are not fun to taper off of.

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Janknitz
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Re: Expiratory palatal obstruction

Post by Janknitz » Wed Jun 10, 2020 3:43 pm

Expiratory palatal obstruction” is when the soft palate flaps back into the nose upon mid-nasal expiration, preventing CPAP from being effective
Curious about a few things. If the soft palate was obstructing CPAP expiratory airflow and requiring you to open you mouth to breathe out, wouldn’t it show as a leak and wouldn’t your AHI be higher?

And wouldn’t a FF mask bypass the entire issue?
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Okaythen
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Re: Expiratory palatal obstruction

Post by Okaythen » Thu Jun 11, 2020 6:14 am

Janknitz, that’s a solid point. It sounds logical. I’m thinking that something would be amiss. Perhaps it is not, in fact, affecting the breathing pattern.

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EPOpillars
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Re: Expiratory palatal obstruction

Post by EPOpillars » Wed Aug 19, 2020 1:01 pm

Hi Everyone! I was so glad to see this thread on EPO.
Here is my experience with this.
*When i was 170lbs super fit and in my 20's my sister used to tell me that i snore or exhale loud and forcefully/ stop breathing when i try to breath out. (also my cat used to take 1 claw and poke me under my neck to wake me up during those episodes, prob saved my life, though i used to get really PO'ed when Furball would wake me up like that :-P )

So eventually i got a cpap and it seemed to help, though never helped with weight as i put on a lot of weight after my 30's (now i know it was ADHD related, which now at 39 i am getting treatment for and hoping i will lose weight)
Anyway I only discovered that EPO thing about two years ago when i got a new CPAP(APAP) with Expiatory relief option. and noticed that suddenly I had very poor sleep.
I messed with the settings, and finally tried 1 night with Expiatory Relief turned OFF. Wow, total difference like 1000%, I was getting great sleep again!
--So I found Dr. Park's article on this:
https://doctorstevenpark.com/epo
https://doctorstevenpark.com/2things
https://doctorstevenpark.com/expiratory ... ral-apneas

And his paper (link below), and brought this printout to my ENT and also asked him consult with Dr Park directly. (BTW the ENT professional community in USA is small and all the Doctors know each other, so its always worth to ask if your doctor would consult with a colleague)
--Expiratory-apneas-with-or-without-catathrenia:
https://www.dropbox.com/s/w6bjzbjqobij2 ... S.pdf?dl=0

--another paper here: https://erj.ersjournals.com/content/51/2/1701419

*anyway it had me think back to when I started this Sleep Apnea journey and remembered that my sister would say i can inhale but would stop breathing on the exhale.
*also when I used my APAP with the Auto Start / Stop feature, it would just shutoff the APAP in the middle of the night (once i turned that OFF, the treatment was working again)

--NEXT STEPS as recommended by my doctor:
lose weight until neck = 17"
soft palate implants (not covered by insurance) (done in-office)
I also need treatment for allergies so my turbinates dont come back (this is a mostly at home treatment over the course of two years to lower my sensitivity to my major allergens)
turbinate reduction (done in office)
and nose sidewall implants to prevent collapse during inhalation (in office)

the goal is to try to reinforce the entire passage of air between neck and nose opening.
I will prob still need my cpap but this should help a lot




Looks like word is getting out on this since now there are conversations around EPO in many threads:
http://cpaptalk.com/viewtopic/t171982/M ... ticle.html
https://www.reddit.com/r/SleepApnea/com ... struction/
http://www.apneaboard.com/forums/Thread ... oft-Palate

Hope this helps!
:D