Apnea on *exhalation*

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
DarthTater1234

Apnea on *exhalation*

Post by DarthTater1234 » Wed May 12, 2010 4:22 pm

Hello. I am new here. Been having trouble with sleeping a long time.

I have not had a sleep study but I am sure I have sleep apnea. I don't have insurance right now, but I know I have to get a sleep study. However, I was wondering if a Bi/C/PAP Machine would help if I have apnea on **exhalation**.

I have been semi-awake several times where I cannot exhale due to blockage of what I assume is the soft palette. I also snore loudly. Also, when I am tired I can feel my soft palette muscles tired and sort of go flaccid. If I sort of relax my muscles I can duplicate this exhalation blockage when I am awake. Anyway my point is I am *positive* that the blockage occurs on *exhalation*.

If that's the case will I probably need surgery? Or perhaps a mouth guard? In other words a BiPap machines are for **inhalation** right? Although I do snore on inhalation too. Any info would be appreciated.[/b]

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Julie
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Re: Apnea on *exhalation*

Post by Julie » Wed May 12, 2010 4:25 pm

Hi, I really don't think you can diagnose yourself that way, especially not when you're conscious. You need to be asleep and breathing differently from when you're awake, for some time, to get any kind of accurate assessment of what's going on. There's an organization that helps people with financial problems - if you search the site here for "Awake in America" you should find references and links about it.

gar729
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Re: Apnea on *exhalation*

Post by gar729 » Wed May 12, 2010 4:59 pm

Hey Darth- I haven't been to this site in a long, long time. I'm glad I happened onto you post. I'm like you, all my apneas are on the exhale. I even have trouble in the dentist's chair when it's tipped way back. I just can't exhale. I've been using a cpap for 6 years and it works just fine although I have to sleep on my side / stomach or the exhale is labored, even with the cpap.
In the past I've had a somnoplasty (sp) which did nothing and was very painful. Also my dentist fit my with a devise that pushed the lower jaw forward. This did work, but was so uncomfortable I couldn't use it. All that said, you need to get a sleep study done and find out for sure what is going on. Most Dr.s will work with you if you have no insurance.
There is hope and you will feel better.
Gary

Country4ever
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Re: Apnea on *exhalation*

Post by Country4ever » Wed May 12, 2010 5:32 pm

Hi Darthtater,
I have the same problem, from a lax soft palate and uvula.
I have read that there are soft palate exercises you can do to strengthen that area. Just google "soft palate exercises". I'm afraid I haven't done them much, so I can't say if they work or not.
good luck to you.

DarthTater1234

Re: Apnea on *exhalation*

Post by DarthTater1234 » Wed May 12, 2010 6:40 pm

Thanks for all the info. I will google all the stuff you guys mentioned. Gar729, so the PAP machine does help even though the apnea is on the exhale? The sleep test confirmed that it was on the exhale? I guess the airflow keeps the palette from collapsing or something and so you can exhale. A mouth guard works for me somewhat. The kind I have is the one that is shown on TV btw. It's adjustable so you can bring it back some. I was able to get used to it. But I still snore with it! Thanks again for your replies. If anyone else has any thoughts, chime in.

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Julie
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Re: Apnea on *exhalation*

Post by Julie » Wed May 12, 2010 9:31 pm

Sleep apnea has deeper 'roots' or causes beyond problems that can be fixed with mouth guards or nasal tweaks. It seems to have neurological or pulmonary connections, so apneas won't stop just by working on mechanical mouth or nose issues, though they may help. The reasons you stop breathing at night are more complex.

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Goofproof
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Re: Apnea on *exhalation*

Post by Goofproof » Wed May 12, 2010 10:16 pm

Sleep Apnea is called that for a reason, you are asleep when you have it. even the data from the machines is incorrect if you are not sleeping. XPAPs keep the airway open for intake, exhaust is on you, unless you are on a vent. Jim
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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Big Daddy RRT,RPSGT
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Re: Apnea on *exhalation*

Post by Big Daddy RRT,RPSGT » Thu May 13, 2010 5:12 am

In the sleep lab we a have very specific way to refer to your condition......Obstructive Sleep Apnea.
I am on a life quest for the perfect night's sleep...Keep trying...Good sleep can blow!

jnk
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Re: Apnea on *exhalation*

Post by jnk » Thu May 13, 2010 6:30 am

Pressurizing the airway at the right pressure generally prevents obstructions during sleep on exhale just as well as it does on inhale, as I understand it. If it does not, adding in a little positional therapy and a mandibular advancement device may do the trick. If those combinations don't do it, then, and only then, would I consider any form of surgery, myself. But hey, that's just me.

I, too, had a serious problem with blockages that prevented exhale when on my back. I found that using a full-face mask and getting my PAP therapy through my mouth caused my nose to be taken completely out of the loop once my soft palate got pushed up, in my case. But now that I get my therapy nasally, my condition is treated very well with PAP therapy. My home-machine-estimated AI has been 0.1 to 0.3 lately (ResMed S8).

Hopefully, PAP will do its thing just as well for you.

jeff

wil
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Re: Apnea on *exhalation*

Post by wil » Thu May 13, 2010 7:19 am

I, too, had a serious problem with blockages that prevented exhale when on my back. I found that using a full-face mask and getting my PAP therapy through my mouth caused my nose to be taken completely out of the loop once my soft palate got pushed up, in my case.
Ditto, but I had to stick with a FF (Liberty, actually). Even with high pressure nasal only therapy my soft palate collapses on exhale when on my back. Obviously I try not to sleep on my back, but it does happen. I notice when I wake up on my back my mouth is dry, but when I wake up on my side I don't have that problem...

Either way, it is best not to attempt to solve the problem yourself. I understand the burdens of not having insurance, and I know my sleep study would have cost around $3,500 without it (cost me $1000 with it), not counting any hardware you need to correct the problem. Just be aware that there is much more to this than feeling tired throughout the day.

Sleep problems are deeply tied to so many of your body's systems. We know of neurological and cardiac links, and I would guess that we're going to find many, many more links in the future. It's worth looking for a way to have this diagnosed.

gar729
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Re: Apnea on *exhalation*

Post by gar729 » Thu May 13, 2010 2:43 pm

Garth- Yes, the cpap takes care of apneas on both inhale and exhale, providing you have the correct air pressure, and that is determined by your sleep study. It keeps the throat open through pressurized air. I have no insurance either, but I realized I had to take care of this or live a miserable life. You can buy a cpap and equipment from cpap.com with a prescription.
Good Luck!
Gary

FMR

Re: Apnea on *exhalation*

Post by FMR » Tue Jul 23, 2013 7:03 pm

Join the club. A lot of ENTs still don't realize what's going on with exhalation blockages.

After two or three sleep studies over the years -- none of which picked up the blockage upon exhalation -- I figured out what was going on just from being aware of my body, and described my symptoms to an ENT at a major academic medical center, just as the rest of you have: cannot exhale through my nose when relaxed and on my back -- and too often, even when on my side. In the middle or beginning of the exhalation, my soft palate pops shut and I must complete the exhalation through my mouth -- which reliably wakes me up or causes an arousal. This ENT told me that I had some sort of breathing disturbance but it wasn't OSA. And left it at that. Thanks!

More than a year later, I decided to go to a sleep clinic at the same center and describe the problem. After listening to my description and examining my abnormally long, swooping soft palate descending down the back of my throat, this MD agreed to prescribe, without a sleep study, an autotitrating CPAP machine. Bingo. With a nasal mask, the problem is gone, but only if I sleep on my side. Evidently, the machine holds my airway open even when I am exhaling. A BIPAP machine will not do this, of course. I use a ResMed S9 with humidifier.

Interestingly, the CPAP's computer chip recording shows that the machine needs to put out almost 11 cm of H2O pressure to eliminate 95 percent of my hypopneas and apneas. So that means I had two things going on: the mousetrapping soft palate blocking the exhalation through the nose, plus some form of upper airway resistance, like the usual OSA.

I'm disappointed that I still cannot sleep on my back, but at least I get through the night without being tortured with repeated exhalation blockage arousals.

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Stormynights
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Re: Apnea on *exhalation*

Post by Stormynights » Tue Jul 23, 2013 7:32 pm

Do you check your data? I was just wondering how these events are flagged.

sellarsftcd@

Re: Apnea on *exhalation*

Post by sellarsftcd@ » Wed Aug 02, 2017 8:49 am

I totally relate to the EXTREME frustration. I am sick of Drs. telling me "oh i'm sorry" with no apparent interest to look further. Same DR. gave me the same response when I explained that the sleep study was innacurate. I only got 2 hrs of sleep(documented) because the bed made me feel like i was going to roll off. Given this information, both the sleep study provider still say "oh I'm sorry". I guess I need a new Dr.(YA THINK!?). So to all who havent gone further because of insurance,we're at the same frustrating point and I'm getting better info here.(not that wer'e in the same boat elsewhere, god help you).

CarJon

Re: Apnea on *exhalation*

Post by CarJon » Fri Nov 03, 2017 7:37 am

What you see is that during mid-nasal exhalation, the redundant uvula flaps back up into the nasopharnx, blocking nasal exhalation completely. During this event, you can either hold your breath, like straining lightly during a bowel movement, or vocalize continuously, leading to moans.

Google Palatal Obstruction APSS

Hope this helps.....