Poll: What Is The Cause Of Your Obstructive Sleep Apnea ?

Hi Everybody

I just read an interesting post at -

viewtopic/t52172/New-better-than-CPAP-treatment.html

I found more information at -

http://www.imtheramedical.com/index.php
and an interesting video at -
https://www.youtube.com/watch?v=RSTKSt5hxgU

I am pretty sure my obstructive sleep apnea is caused in my pharynx, so this implant would be of no use to me. So I will have to stick to my vocal fold exercises, when I can remember to do them

http://www.medicalnewstoday.com/articles/149238.php

the throat exercises come near the end of this long paper -

http://www.nature.com/gimo/contents/pt1 ... imo50.html

I also found this interesting post from ericlhyman -

viewtopic/t39630/Singing-for-Snorers-Exercises.html

I wonder how many of us know if our obstructive sleep apnea is caused by our tongue, our pharynx, or both, or something else entirely. So I thought we could have a poll, and see if we can find out more about this.

My purpose is to distinguish between the tongue causing the apnea and the soft tissues in the throat causing the apnea. This is necessary to know if non-cpap methods are envisaged in the future.

cheers

Mars

PS If anyone has the "Singing CD's", it would be great to have feedback

Mars,

When I saw this poll I thought - might be a lost cause - but when I read the questions I realized I just don't truly know what causes my OSA. I always imagined it was my tongue but mainly after a friday night drink. But, I had to answer that I don't really know.

You have now got me thinking - thanks

DSM

Are you sure you're not getting "pharynx" mixed up with "palate"? I've never heard of a pharynx blocking anything, only being blocked itself. Also, while the upshot of one's apnea may be their tongue blocking their airway (pharynx), the root cause may be different entirely.

Julie wrote:Are you sure you're not getting "pharynx" mixed up with "palate"? I've never heard of a pharynx blocking anything, only being blocked itself. Also, while the upshot of one's apnea may be their tongue blocking their airway (pharynx), the root cause may be different entirely.

Hi Julie

Thank you for your help.

Some talk about the pharynx, some talk about soft tissue, some talk about the throat, and some talk about the palate etc.

Medicine.Net says at http://www.medicinenet.com/sleep_apnea/page3.htm#toce

* airflow can become diminished if a person has a deviated septum (the middle wall of the nose that separates the two nostrils). A septum can be deviated to one or both sides narrowing the air passages;

* there are filters in the nose called turbinates that can obstruct airflow when they become swollen;

* if the palate and uvula (the part of soft palate that hangs down in the back of the throat) are long or floppy, they can fall backwards and close the area through which air flows;

* the back of the tongue can also fall backwards and obstruct breathing especially when individuals lay flat on their backs; or

* the side walls of the throat can fall together to narrow or close the airway.

Here are some more links -

http://linkinghub.elsevier.com/retrieve ... 6505700980

PHARYNGEAL AIRWAY OBSTRUCTION IN OBSTRUCTIVE SLEEP APNEA ...
by AR Schwartz - 1998 - Cited by 23 - Related articles
It is well recognized that airflow obstruction in obstructive sleep apnea is caused by collapse of the pharynx. Although the precise anatomic and structural ...
linkinghub.elsevier.com/retrieve/pii/S0030666505700980

http://www.sma.org.sg/smj/4204/4204a3.pdf

A further reading would indicate that the words have been used interchangeably, but my reading is that the pharynx (and the palate) would include the soft tissue of the throat, including the vocal chords (vocal folds).

My purpose is to distinguish between the tongue causing the apnea and the soft tissues in the throat causing the apnea.
This is necessary to know if non-cpap methods are envisaged in the future.

I have changed the wording in the poll, and will include clarification regarding the what and why of the poll.

Thanks, Julie

cheers

Mars

I believe that it would be impossible for any one patient or doc to know with certainty the precise location that an obstruction first started in that one patient at that one instant unless the patient happened to be imaged DURING THAT ONE OBSTRUCTION during sleep.

I believe it is thought that negative pressure collapses the airway first at whatever location a particular patient happens to be most susceptible to collapse at that particular moment, but that if collapse is prevented at that location, then it would very likely simply then begin to occur at another location in the airway. That is why location-specific surgery so rarely actually solves the problem well and for all time.

For those, and other, reasons, I'm not so sure that the problem can be approached merely in terms of location of obstruction for a patient when all the variables may be constantly on the move during the night, and night-to-night, therefore making the question mostly academic in the context of PAP therapy, which is designed to prevent collapse at all locations at all times and is highly effective at accomplishing that.

In other words, I'm too dumb and confused to figure out how to answer your poll. But, hey, that's my fault, not yours.

I apologize for my confusion causing me to refrain from voting. I would very much like to vote, though, since, as you know, I LOVE polls!!

Can there be a choice for "I do not know, since I consider it unknowable, and do not care in the sense that PAP prevents obstructions in all locations, but I do care in the sense of having an academic interest in questions with no real relevance to how I choose to live my life"?

jeff

ps-please excuse me for being myself today.

jnk wrote:I believe that it would be impossible for any one patient or doc to know with certainty specifically where an obstruction first started in that one patient at that one instant unless the patient happened to be scoped or imaged DURING SLEEP DURING THAT ONE OBSTRUCTION.

I believe it is thought that negative pressure collapses the airway first at whatever location a particular patient happens to be most susceptible to collapse at that particular moment, but that if collapse is prevented at that location, then it would very likely simply then occur at another location in the airway.

For those, and other, reasons, I'm not so sure that the problem can be approached merely in terms of location of obstruction for a patient when all the variables may be constantly on the move during the night, and night-to-night, and may therefore be mostly academic in the context of PAP therapy that is designed to prevent collapse at all locations at all times.

In other words, I'm too dumb and confused to figure out how to answer your poll. But, hey, that's my fault, not yours.

I apologize for my confusion causing me to refrain from voting. I would very much like to vote, though, since, as you know, I LOVE polls!!

jeff

Hi Jeff

You are trying to put one over on me

You make an assertion - without any backing evidence - and then use that assertion as proof of your following assertions - which also lacks backing evidence.

Your statement

then it would very likely simply then occur at another location in the airway.

begs the question - why would it be "very likely".

You also say

and may therefore be mostly academic in the context of PAP therapy that is designed to prevent collapse at all locations at all times.

Now you know this poll was started because of the post - viewtopic/t52172/New-better-than-CPAP-treatment.html
which was about non-cpap treatment. There are now companies researching, and testing, electrical pulse equipment on the tongue, and on the throat. As far as I know no one is suggesting that the location of the apneas in an individual is not knowable.

I hate to see you disappointed again with one of my polls, especially as you can vote for both locations together, either as certain, or as a guess. This was put in specially for you, so as not to be left out

How can I go wrong with so much help, first from Julie, and now from you. What a helpful place this Forum is

cheers

Mars

I was merely stating what I believe.

(Please note that the above statement is merely an assertion. I assume that I know what I believe, although I have no direct evidence that I actually do understand what I believe, and I am unaware of any scientific method of documenting my assertion of my supposed certainty of what my beliefs truly are.)

When a pollster asks what people "think" then berates them with demands for proof and attacks their statements as mere groundless assertions, does that make the pollster abusive? Nah. He's just pulling your leg!

My doctor was able to have me close my throat to simulate an apnea event. My throat is narrow to begin with, and it closes very easily. I have copies of the x-rays showing it closing.

jnk wrote:I was merely stating what I believe.

(Please note that the above statement is merely an assertion. I assume that I know what I believe, although I have no direct evidence that I actually do understand what I believe, and I am unaware of any scientific method of documenting my assertion of my supposed certainty of what my beliefs truly are.)

When a pollster asks what people "think" then berates them with demands for proof and attacks their statements as mere groundless assertions, does that make the pollster abusive? Nah. He's just pulling your leg!

It used to be that when all else failed I would say to myself "a bottle of rum often helps".

Now I say it's time to go to bed, wish you all a pleasant day, especially JNK, and go to sleep.

But I must say that the post by bearded_two was interesting.

Goodnight

Mars

bearded_two wrote:My doctor was able to have me close my throat to simulate an apnea event. My throat is narrow to begin with, and it closes very easily. I have copies of the x-rays showing it closing.

Key word being "simulate." You weren't asleep having a spontaneous apnea.

I got no trouble with ENT scoping. Some info is better than none. But what they are doing, according to my groundless assertion, is making educated guesses about what may be happening (as far as exact location) when you are asleep based on how your airway looks when you are awake.

The whole basis of the often quoted wet-straw theory of OSA and the airway is that if you merely stiffen one section of the straw or selectively widen one location, the straw can still collapse at another section since the negative pressure remains.

Hey, it's all theory anyway. Kinda like electricity. And I'm not sure I believe in that either.

All I know about mine was in the OR it took them twenty minutes to get a tube in my airway. Must be kind of tight in there. Jim

INTERESTING QUESTION!

I dont really know what causes mine..

all I know is that my pulmanolgist said when looking around my head..

"Oh you have a backwards set jaw... ..this is a cranial facial abnormality.. Oh, I see you have tiny ear canals, OH, and
large adenoids, and very large tonsils..and a very large, tongue.. and OH MY, your throat opening is so, very, very tiny!"

I replied, yes, I guess that is why I always choke on water!"

Anyway, she said. "I would HIGHLY RECOMMEND YOU DO A SLEEP STUDY.. " you have all the classic signs for sleep apnea.. a perfect storm of them!

(all the classic signs except daytime sleepiness.. a big ZERO on the epworth sleep scale..)

So, what causes mine? I have no idea! one, or two, or three, or all of the above? I had some centrals too, so maybe a little bit of everything.

Mine started when I was pregnant - 22 years ago. At the same time that i lost my fine motor control for my hands, got really clumsy. There are apparently hormones that relax the muscles so the baby can grow and come out without doing too much damage. It took me 3 years to get the drawing back and the snoring only got worse.

If my sleep doc & cardiologist are right...the cause of mine is fat. I know that high up behind my sinuses, I can easily sniff hard and shut off my airway...30 yrs chronic sinusitis-allergies-rhinitis likely have damaged tissues/nerves. As I lost weight my pressure requirements were lowered and with my recent gain my median pressure has gone up. But as to whether I will be OSA-free when I finally lose all this excess wt...I'm not making bets.

If doctors knew what caused someone's apnea, wouldn't that make surgery success rates much higher than they are? My understanding is that it is not so easy to determine the site(s) of obstruction, and that it's a combination of anatomy and collapsibility. I'm told my nose is a "big problem" (or did they say my big nose is a problem?), but I don't think a nose can be the sole cause of apnea. Who knows.