apneas occur on exhale

gar729 · Post by **gar729** » Wed Oct 05, 2005 3:50 pm

Does anyone out there have their apneas occur during the exhale cycle?
I've been using a cpap @ pressure 12 for almost a year and find that I'm somewhat better, but with apneas happening on the exhale cycle, I don't think a cpap is all that effective.
I have tried an oral mask and couldn't deal with it, maybe a fullface?
Any feed back would be very welcome
Thanks Gary

Sleepless on LI · Post by **Sleepless on LI** » Wed Oct 05, 2005 4:12 pm

Gary,

The first question that comes to mind is, how do you know that they're occurring on an exhale? That is a pretty unique statement to make as it happens while you're asleep. Do you have software that lets you know that???

Guest · Post by **Guest** » Wed Oct 05, 2005 5:08 pm

Thanks Lori,
It does sound strange. I guess I assume it always happens on the exhale because if I doze without the cpap I will wake myself up gasping, taking in more and more air not being able to exhale through my nose. This would happen all the time during my pre-cpap days. This will also happen when going to the dentist. When he leans the chair way back so my head is low, I can't exhale through my nose. I've been to an ear, nose and throat Dr. and he says that the flap that closes off the nasal passage is positioned differently than normal, but surgery would be too risky.
I've also had this happen, awake, in bed reading.
The sleep study I had done originally never specified when or how the apneas occurred, or at least my Dr. never related that information to me.
The cpap definitely helps and I would be in very shape without it.
Gary

Sleepless on LI · Post by **Sleepless on LI** » Wed Oct 05, 2005 5:47 pm

Gary,

I just learned the technicalities of how CPAP works and what it is supposed to do, if you've been titrated at the correct pressure, is keep your airways constantly open by the machine having a set end pressure upon exhalation. But even though the pressure is only set for exhalation, the airways will always remain open due to the fact it's constant possitive airway pressure (CPAP). Meaning, even though it's just one pressure that is set for exhalation, it always keeps the airways open as the pressure within your airways is set to never fall below that pressure that has been determined that is needed to keep them that way.

Makes a lot of sense, no? Maybe not the way I explained it, but the concept does if you can grasp my inarticulate way of explaining it.

Guest · Post by **Guest** » Wed Oct 05, 2005 6:46 pm

Thanks Lori,
That does make perfect sense and I appreciate your research. That would also explain why I do feel better using the cpap. I guess my worry is that this is as good as I can expect. Maybe the rest is up to me. I always wake around 5:00am then go back to sleep. I feel OK at 5:00 and worse and worse the longer I try to sleep. Sometimes I take the mask off (like a small holiday) and go back to sleep. Then really feel bad. Through all this I think I have become obsessed with sleep! I think I should get up at 5:00 when I first wake up.
Thanks again
Gary

Sleepless on LI · Post by **Sleepless on LI** » Wed Oct 05, 2005 6:57 pm

Gary,

I don't know how long you've been at it, but don't give up hope. No pun intended, but where there's breath, there's hope. Your circumstances change from day to day and so can your results. Hang in there and keep using the machine. This therapy truly does work, sometimes quicker for some than others and always in different ways for each of us. Keep posted for encouragement. We're all here to help.

Boomer · Post by **Boomer** » Wed Oct 05, 2005 8:35 pm

Gary,

I've noticed the same thing, when just dozing, but only when I'm on my back. It's like the soft tissue at the back of my throat closes off TIGHT and I'm unable to exhale. The pressure would have to go way high to open that back up. I think it has to do with my jaw slipping back, when on my back.

If I move to a side or my stomach, it's not a problem. I've also noticed I seem to swallow alot of air when trying to sleep on my back. That doesn't happen either, when on my side or stomach.

Just my 2 cents.

Boomer

wading thru the muck! · Post by **wading thru the muck!** » Wed Oct 05, 2005 8:47 pm

Gary,

You are correct. Many apneas occur at the very end of the expiratory cycle. This is why when using a REMstar machine with c-flex the full pressure resumes slightly before you begin to inhale. This is also why some medical practitioners feel that when setting up a bi-level machine the expiratory pressure setting should be equal to your titrated pressure.

Sleepless on LI · Post by **Sleepless on LI** » Thu Oct 06, 2005 4:58 am

Boomer wrote:Gary,

I've noticed the same thing, when just dozing, but only when I'm on my back. It's like the soft tissue at the back of my throat closes off TIGHT and I'm unable to exhale. The pressure would have to go way high to open that back up. I think it has to do with my jaw slipping back, when on my back.

If I move to a side or my stomach, it's not a problem. I've also noticed I seem to swallow alot of air when trying to sleep on my back. That doesn't happen either, when on my side or stomach.

Just my 2 cents.

Boomer

I think what you're describing, Boomer, is the cause for MANY people's apnea. And that's also why they suggest not sleeping on your back, because it forces the throat to be closed off in the manner you described.

wading thru the muck! · Post by **wading thru the muck!** » Thu Oct 06, 2005 6:06 am

FYI,

An earlier "cure" for apnea was to sew a tennis ball into the back of your PJs

Reminds me of some of the pharmaceutical "cures" that just prevent you from getting any REM sleep (where most apneas occur). Why not just stay awake?... that would cure apnea for sure.

Sleepless on LI · Post by **Sleepless on LI** » Thu Oct 06, 2005 6:07 am

wading thru the muck! wrote: Why not just stay awake?... that would cure apnea for sure.

I think, subconsciously, that's what I've been doing lately. So much for my hero melatonin.

wading thru the muck! · Post by **wading thru the muck!** » Thu Oct 06, 2005 6:28 am

Sleepless on LI wrote:
wading thru the muck! wrote: Why not just stay awake?... that would cure apnea for sure.
I think, subconsciously, that's what I've been doing lately. So much for my hero melatonin.

Is that why you've posted 100+ times in the last three days? LOL

Sleepless on LI · Post by **Sleepless on LI** » Thu Oct 06, 2005 6:34 am

Is that why you've posted 100+ times in the last three days? LOL

Okay, Wader, keeping track of the competition, eh? LOL.

No, I have been home from work due to this nasty head cold, so I've been around all the time with nothing to do...when you start seeing posts from me at 2 AM and 4 AM, then you'll know that is the reason.

LoneRider · Post by **LoneRider** » Thu Oct 06, 2005 8:21 am

wading thru the muck! wrote:An earlier "cure" for apnea was to sew a tennis ball into the back of your PJs

I would not need that, my wife has gotten pretty good a kicking me whenever I try to sleep on my back

wading thru the muck! wrote:Reminds me of some of the pharmaceutical "cures" that just prevent you from getting any REM sleep (where most apneas occur). Why not just stay awake?... that would cure apnea for sure.

You know, I've been wondering why I feel worse the longer I sleep. When ever I let myself sleep longer than about 7 hours I really feel bad. My GP was not completely sure if theory is correct or not, so I will ask y'all.

During the sleep lap my O2 sat got down to 88%, but I was never unconsious for longer than 3 to 3 1/2 hours. Where would my O2 sats go if I was unconsious for 6, 7 maybe 10 hours. Is it possible that when I "sleep" for 10 hours my O2 sat gets down to the point where I am causing physiological damage? Anyway, GP thought it was plausible, but did not know.

By the way, yesterday, when I was at the GP's, again BP check, I rang it at about 140 over 102, we joked, another 3 on the lower number and I get a free set of steak knives , but my O2 was 99% at 11am.

cheers,
Tom

Sleepless on LI · Post by **Sleepless on LI** » Thu Oct 06, 2005 8:47 am

Tom,

I, too, suffered from about 88% oxygen desats at my study and just last week asked my doctor if she thought I should have my levels tested again overnight with a home pulse oximeter from the DME, even though they do a finger pulse oximeter test every time I go in.

Her answer was, as long as I am on the machine, those levels will be perfect. Hope she's right, although she usually is. I know my titration night, the report said that while on CPAP, my levels never went below 92%. That's a good thing.

Mask	Humidifier