Foam Collar vs Chinstrap

The OTC has three different depths as well as XS-l and 2 /12 to 3":
http://www.amazon.com/OTC-Cervical-Coll ... XM25CL9GVJ
for less than $10. After trying three collars, I realized that I had to have a collar long enough to support my chin (not the two inch one), but not riding up the chin (3") one. My thick-necked husband thinks he needs a one inch collar!

So, the $64 Question is:

Does the cervical collar actually work for keeping your mouth shut (i.e. as good or better than a chinstrap)?

I know that some of you use the Cervical collar for other reasons, but I am interested in using it to keep my mouth closed only & to no longer have to use a chinstrap.

Kitatonic wrote:The OTC has three different depths as well as XS-l and 2 /12 to 3":
http://www.amazon.com/OTC-Cervical-Coll ... XM25CL9GVJ
for less than $10. After trying three collars, I realized that I had to have a collar long enough to support my chin (not the two inch one), but not riding up the chin (3") one. My thick-necked husband thinks he needs a one inch collar!

Thanks for that link. Here is an associated link in which the reviewer claims that her doctor specifically recommended wearing a soft cervical collar during sleep:

http://www.amazon.com/review/R30KDXNHNE ... _rtr_alt_1

"As a Doctor recommended aid for night use only…"

Regards, Nate

Nate,
I've been doing some very unofficial off and on tests for the last few months. I wear my chin strap for about 3 hours and then take it off for the remainder of the night--about 3 hours.
No big conclusion on the first point--a lot more comfortable without one and far less of a headache or jaw ache in the morning.
I am pretty sure my teeth are moving and at my next checkup will verify with my dentist. Strike two for the chinstrap.
Tried the Pap-Cap, a great conceptual idea, but not for me--kept slipping down.

I've been monitoring SH leak data every day for about the last 3 or so months and have noticed a leak increase without the chinstrap--not huge, and no big increase in AHI. Big leaks with and without. I know a lot of forum members have trained themselves to keep their mouthes closed, but I'm not there yet.
I also have low pressure requirements 5-8 and know that for those of you with high pressure requirements collars and straps are required.

So in conclusion I have far less headaches without the strap, probably sleep better, and will try and go cold turkey (chin strap style) in the future.
A T

Yes, Stu, for me a properly fitted collar seems to keep my mouth shut since it opens when my jaw drops in deep sleep. My leak numbers decreased as did the pressure slightly. But the most important point for me is the mouth is not dry in the morning. I've had extensive dental restorations including implants requiring bone grafting, so having a dry mouth would jeopardize this investment.

If the chinstrap is so tight that it cuts off blood circulation ... you are obviously :

a) using the wrong type of chinstrap
b) not adjusting the PapCap correctly
c) you're some kind of non-humanoid space alien

When I use the PapCap, the strap is adjusted enough to hold my jaw in place ... not so tight that it readjusts your teeth. Unless you sleep standing up, gravity adds little to no tension to the chinstrap.

The stretchy type chinstraps (Ruby, et. al.) on the other hand by design do acts as tourniquets to some degree.

I believe Nate could be having discomfort from the different chin straps without impeding intracerebral circulation. I know I've felt like I had a bone bruise after using some hard acrylic head bands (the hair fashion kind, nothing CPAP related).

I am finding it interesting hearing from several posters that their teeth are moving. I use a bite block for my upper teeth for grinding so I think I will be safe on that though I have chewed through several of the flimsier ones in the past.

Always tired wrote:Nate,
I've been doing some very unofficial off and on tests for the last few months. I wear my chin strap for about 3 hours and then take it off for the remainder of the night--about 3 hours.
No big conclusion on the first point--a lot more comfortable without one and far less of a headache or jaw ache in the morning.
I am pretty sure my teeth are moving and at my next checkup will verify with my dentist. Strike two for the chinstrap.
Tried the Pap-Cap, a great conceptual idea, but not for me--kept slipping down.

I've been monitoring SH leak data every day for about the last 3 or so months and have noticed a leak increase without the chinstrap--not huge, and no big increase in AHI. Big leaks with and without. I know a lot of forum members have trained themselves to keep their mouthes closed, but I'm not there yet.
I also have low pressure requirements 5-8 and know that for those of you with high pressure requirements collars and straps are required.

So in conclusion I have far less headaches without the strap, probably sleep better, and will try and go cold turkey (chin strap style) in the future.
A T

We seem to be having a lot in common on this mouth breathing challenge. I'm at least glad to know that I am not the only one.

Nate

DreamStalker wrote:If the chinstrap is so tight that it cuts off blood circulation ... you are obviously :

a) using the wrong type of chinstrap
b) not adjusting the PapCap correctly
c) you're some kind of non-humanoid space alien

When I use the PapCap, the strap is adjusted enough to hold my jaw in place ... not so tight that it readjusts your teeth. Unless you sleep standing up, gravity adds little to no tension to the chinstrap.

The stretchy type chinstraps (Ruby, et. al.) on the other hand by design do acts as tourniquets to some degree.

I guess you blew my cover - I am obviously (c).

Regards, Nate

NateS wrote:I was still curious about the question as to whether or not the use of cpap chinstraps on infants is relevant to my concerns about the potential effects of tightness of chinstraps sufficient to keep the adult mouth closed.

Here's what I found regarding infant chinstraps at: http://www.neotechproducts.com/product- ... /chinstrap

The use of the Neotech ChinStrap is not to restrain the mouth from opening, it is to simply provide support to the patient to help maintain the pressure of CPAP. The ChinStrap should not be placed tightly, the infant should still be able to use a pacifier and if needed, cry, open their mouth, and if emesis occurs it will be expelled through the mouth.

I suggest that this supports my more tentative first impression, to-wit: that these are not comparable applications, since the purpose of an adult cpap chinstrap is in fact to keep the mouth closed in order to prevent the adult patient from breathing through the mouth.

Respectfully,

Nate

The description of the child chinstrap sounds just like an adult chinstrap. It doesn't make it impossible to open the mouth, it just keeps it closed in the relaxed position and provides some "bias" to keep it closed despite air pressure. With mine, I can still cry, open my mouth, talk, eat, or even use a pacifier.

archangle wrote:

NateS wrote:I was still curious about the question as to whether or not the use of cpap chinstraps on infants is relevant to my concerns about the potential effects of tightness of chinstraps sufficient to keep the adult mouth closed.

Here's what I found regarding infant chinstraps at: http://www.neotechproducts.com/product- ... /chinstrap

The use of the Neotech ChinStrap is not to restrain the mouth from opening, it is to simply provide support to the patient to help maintain the pressure of CPAP. The ChinStrap should not be placed tightly, the infant should still be able to use a pacifier and if needed, cry, open their mouth, and if emesis occurs it will be expelled through the mouth.

I suggest that this supports my more tentative first impression, to-wit: that these are not comparable applications, since the purpose of an adult cpap chinstrap is in fact to keep the mouth closed in order to prevent the adult patient from breathing through the mouth.

Respectfully,

Nate

The description of the child chinstrap sounds just like an adult chinstrap. It doesn't make it impossible to open the mouth, it just keeps it closed in the relaxed position and provides some "bias" to keep it closed despite air pressure. With mine, I can still cry, open my mouth, talk, eat, or even use a pacifier.

With all due respect, archangle, if that is a correct definition of the design objective for an adult cpap chinstrap, then how would you account for all the mouth-tapers here on cpaptalk, and what is your opinion of their efforts?

Respectfully, Nate

The one thing I find I missed by giving up chinstraps is that they were apparently providing friction at the back of my head which kept the rear headband on my Aloha mask from slipping up and forward. Without the chinstraps, the rear band started slipping forward over my head, causing the nasal pillows to become displaced during the night, setting off my leak alarm.

Then it occurred to me - why not use the foam cervical collar to keep the Aloha rear headband in place? Instead of friction keeping it down, I took a couple of narrow velcro strips and attached the rear handband to the rear velcro strap on the foam collar so that it stays just above the collar and voila! - it keeps the headband in place even better than the friction from any chinstrap!

So, as an additional benefit, the foam collar seems to be improving the performance of the Aloha mask. I assume this might work with other masks which also rely on a rear headband to stay in place.

Just thought I might pass that suggestion along, in case it helps anyone else.

Regards, Nate

Is it safe?

Although personally I would never consider relying on the foam collar exclusively, especially since I am prone to central apneas, the following references seem to support the position that a foam neck collar is not only safe for the sleep apnea patient to wear during the night, but may actually contribute to treating the apnea condition itself:

Snoring and Sleep Apnea

Whip your snore. Wearing a neck brace or whiplash collar to bed will keep your chin extended, so your throat may stay open, says Dr. Fairbanks. To guard against a stiff neck the next morning, Dr. Fairbanks suggests using a foam collar rather than a plastic one. Foam cushions the neck better and is less restraining. But if you do have some morning kinks, gently stretching your neck muscles, giving yourself a gentle massage or taking a warm shower will help, he says.

http://www.guidetohealth.com/library/ag ... eep-apnea/

System and Method for Treating Sleep Apnea and Snoring
US Patent 20120234330 A1

System and method for the treatment of sleep apnea and snoring having a removable collar with a tubular sleeve inside made of foam rubber, which is applied around the neck and forces the head to remain upright or extended and the muscle tissues of the throat stay tight.

http://www.google.com/patents/US20120234330

Cervical collar replaces CPAP

Reply by Steven Y. Park, MD on February 5, 2011 at 10:31am
Owen, I'm glad to hear that the collar worked for you. I've had a handful of patients that have reported similar results using soft and hard neck braces. You're right in that it does keep your airway open.

http://www.sleepguide.com/forum/topics/ ... laces-cpap

Again, just to clarify and for emphasis, I would never give up my VPAP for using a foam neck collar alone, but information like that above would seem to lend support to the reasoning that it is safe to wear a foam neck collar while sleeping, and that it perhaps may even contribute to or enhance the treatment provided by your cpap or vpap machine.

And so far, I certainly prefer it over the chinstraps I formerly wore in my efforts to keep my mouth shut while sleeping.

Regards, Nate

Hi Nate,

I have posted on this forum about needing to wear a collar in addition to my full face mask to keep my pressure at 9.5 with a sub 5 AHI. Unfortunately, I have been unable to stay sleep on the machine for more than 2.5 to 3 hours and wonder if collar discomfort is an issue. I am trying out some various remedies and hopefully, something will help.

By the way, about a month ago, I had one of those "you will never believe it" moments that involved a neck collar. Because I was extremely frustrated with my cpap, I decided to take a nap wearing my neck collar and using my leak strap in the role of a chin strap just to see what would happen although frankly, I wasn't expecting much of anything.

Well, after napping for 5 minutes, it was like I had entered another world. I had energy I hadn't had in months and was able to take care of tasks in my apartment that had been left undone for a long time. I ran multiple errands when usually, I was lucky if I could get one thing done.

Unfortunately, I have been unable to replicate what happened that day. I think I must have hit my pillow at exactly the right angle to open up the airway and I guess the odds of doing that again, were slim and none.

Therefore, I definitely agree with Dr. Park about how using the neck collar successfully without a pap machine depends on so many variable. My once in a lifetime moment is living proof of that.

49er

Nate, in my case I can be treated adequately WITOUT a chinstrap or more adequatly WITH it.

Giving up my chinstrapnow I account for using one for a year and getting used to keeping my mouth shut.

I am a plain OSA sufferer who had about a 42 for AHI before CPAPing, three years ago.

Here are my results from last night with NO chinsrap. Notice the one time leak above the redline:










The following are typical results WITH using my chin strap:







My opinion about Nate's post:

=> headaches in the mornings are from other reasons than chinstraps
=> air force pilot's usually don't complain of headaches from their helmets
=> that chinstraps are constricting blood flow inside the brain is most likely absord
=> having dry mouth could come from other sources such as Rx, getting old, etc.
also, having drymouth indicates that the chinstrap IS working and it does not depend on the humidifier setting, just accumulation of Bacteria. use mouthwash
=> shave off your messy beard and maustage and then try again. Even if you're a sort of a Rabbi or just a Bolshevik
=> Since you're using nasal pillows mask try this mask without a chinstrap:
(I plan to try adding such a chinstrap support to my present mask)