Problems breathing out; mouth dryness
Question:
Also, just a side note, a sign of emphysema or pulmonary fibrosis is difficult or inefficient exhalation. In a collapsable upper airway, an impaired or belabored exhalation may easier facilitate collapse, thereby giving the impression of notable apnea on exhalation. Just an interjection. Doug
Response:
Hi, Reed, About your exhaling problem, I have a couple of questions. You wrote: < What I notice is that I <have an obstruction on Exhalation–my guess is it is the uvula flapping <shut. Is that different from normal OSA? This happens when I am just <dropping off. I can even do it "consciously" by relaxing my muscles <completely while lying down. <If I adjust the pressure up quite a bit, I can exhale "normally" through my <nose, but then after I fall asleep, I start exhaling through my mouth and <the whole back of my throat and mouth get totally dried out and I wake up. Question 1: Did you get your sleep study done at an accredited sleep disorders center (accred. by the American Sleep Disorders Assoc. — a list of accredited centers is at <www.asda.org>. Question 2: Was your CPAP pressure properly custom set ("titrated") for you during a sleep-over in the sleep lab? The reasons for my questions are that it sounds as if you might have nasal or palatal obstructions (uvula, as you mention) that might be interfering with your CPAP use. If, for example, you have a badly deviated nasal septum, or a huge uvula or tonsils, and you can’t breathe WITH the CPAP, then some of the obstructions may need to be removed. And if these problems exist, why weren’t they detected during your sleep evaluation? It’s fairly common, in cases of nasal or pharyngeal obstruction, for the sleep specialist to recommend minor surgery to open the passages, so that CPAP can then be effective. I suggest you talk with your sleep center (if it’s accredited) or the next closest board certified sleep specialist about the obstruction problems that you describe, and ask what they suggest as solutions. (I’m not a sleep expert, by the way, but a medical writer who has written quite a lot about sleep apnea — including the book mentioned in my signature line. So don’t take this as gospel.) Best wishes, Sally in Seattle (JSo…@aol.com) Coauthor, with Dr. Ralph Pascualy, of Snoring and Sleep Apnea: Personal and Family Guide to Diagnosis and Treatment, published in 1996 by Demos Vermande, NY. Available through bookstores, ISBN # 0-939957-82-5.
Response:
- Hide quoted text — Show quoted text -"Reed Jacobson" <u…@msn.com> wrote: > I’ve been using CPAP for about 2 months, with mostly bad experiences so > far. I am now on a Healthdyne bipap and just got a Mirage mask. Those seem > to be good, but I am still not sleeping well. > Most everything I have read (or had the dr tell me) talks about obstruction > on Inhilation (and that only after deep asleep). What I notice is that I > have an obstruction on Exhalation–my guess is it is the uvula flapping > shut. Is that different from normal OSA? This happens when I am just > dropping off. I can even do it "consciously" by relaxing my muscles > completely while lying down. > If I adjust the pressure up quite a bit, I can exhale "normally" through my > nose, but then after I fall asleep, I start exhaling through my mouth and > the whole back of my throat and mouth get totally dried out and I wake up. > I don’t have a heated humidifier–just a Respironics Oasis. Is a heated > humidifier what I need or is this exhale problem something different? > Any suggestions, > Thanks, > Reed J
Dear Reed: Though I haven’t personally read the interpretation of my sleep study, I too believe that my obstruction is upon exhalation, by my soft palate closing off my throat. I can do this consciously, too. From what I have read, there are multiple mechanisms of obstruction, which is one big reason OSA is so hard to develop a cure for. Some people’s tongue falls back into the throat, some have a flopply soft palate that closes off like a boat sail, some both, etc. I would also be interested in knowing what all known obstructive mechanisms are, along with their prevalence. Bob
Response:
I’ve been using CPAP for about 2 months, with mostly bad experiences so far. I am now on a Healthdyne bipap and just got a Mirage mask. Those seem to be good, but I am still not sleeping well. Most everything I have read (or had the dr tell me) talks about obstruction on Inhilation (and that only after deep asleep). What I notice is that I have an obstruction on Exhalation–my guess is it is the uvula flapping shut. Is that different from normal OSA? This happens when I am just dropping off. I can even do it "consciously" by relaxing my muscles completely while lying down. If I adjust the pressure up quite a bit, I can exhale "normally" through my nose, but then after I fall asleep, I start exhaling through my mouth and the whole back of my throat and mouth get totally dried out and I wake up. I don’t have a heated humidifier–just a Respironics Oasis. Is a heated humidifier what I need or is this exhale problem something different? Any suggestions, Thanks, Reed J
