Throat still closing suddenly

[Hello, World?]

Hello again all, this is going to be a long one since there a lot of factors to the problem I'm having.

So I bought this used S9 Auto machine so that I can have data and try out the EPR to see if it helps with my aerophagia issue. According to the machine my AHI has ranged from 0.4 to 0.9 with a leak rate of 6 to 22 L/m each night, which is supposedly really good. However, I still wake up several times a night from my throat closing and am not sure what the problem is. There are several reasons this is getting to me, despite my AHI being less than 1.

First is that my apneas don't seem to feel like they're typically described from what I've read. Most descriptions say that your throat slowly sags closed as your muscles relax, causing the apnea or hypopnea. For me, it feels like my throat is totally open and then just closes suddenly for no reason. I can't figure out what's physically happening that's obstructing the airway. At first I thought it was because of my overbite, but I got a $2000 custom mandibular advancement device that fixes it (most people say that those don't work, but I think they're mainly thinking of the cheap generic ones your boil). This helps widen my airway a lot, but it still doesn't seem to stop my throat from closing up.

The second problem is that I seem to partially wake up and correct the problem almost immediately, which means I really don't think my machine is registering these events, since it supposedly has to last at least 10 seconds or so to count towards the AHI. I'm concerned because if it isn't registering these, then I have no idea how many of these events I'm dealing with.

The third problem is that different pressures don't seem to be helping that much at all. Higher pressures help to open my airway and make me breath easier, but it somehow just isn't stopping these throat closing events. Many will probably say that I need to increase pressure, but I've also hit a wall with that. I have my range set from 13.0 to 20.0 and I can't set it any higher without having serious aerophagia problems, plus my auto machine never goes above 13 anyway. When I first started, I kept it at it's default of 4.0 to 20.0 and the machine seemed to have kept it mostly from 8.0 to 13.0 throughout the night anyway, but I've been increasing the minimum to see if that stops these apneas to no avail. I've also tried turning on the EPR (I've only tried it on level 1), but it doesn't seem to make much of a difference.

I've looked into what else it could be, but nothing I've seen seems to exactly fit what my problem is. When I try to google my problem, the main thing that comes up is laryngospasms, but I don't think that's what's happening because they tend to happen at random times day or night while mine happen exclusively while sleeping. It also doesn't feel like I can't open my throat or anything, it just feels like it closed for no reason and I have no problem opening it again.

It's possible that it's an epiglottis problem, but I'm not sure how this would feel or how to tell if that's the problem. I could try to go to the doc again, but I'd need to know exactly what test to ask for since I don't have insurance or much disposable income to speak of at all. (I'd love to just get another sleep study done to see what the problem is, but that isn't all that possible at this point).

It's also possible that it's a sinus thing. My whole life I've always had post nasal drip and just a consistent mucus situation. My voice kind of sounds like I have a light cold from it. When I got my tonsils out, the surgeon said it was one of the worst cases he'd ever seen in his 10 years of work. I'd also love to figure out what the problem is there, but again, that takes a bunch of tests and most doctors I've talked to about it don't really give a shit. They tell me to use more nasal spray and get over it.

So overall, I'm not really sure what the problem is or where to go from here. I'm having a lot of anxiety when I start to fall asleep because I feel like I know my throat's just going to close as soon as I drift off, and not amount of pressure I can have is working. Have any of you experienced anything like this? Is there something I'm missing? Do you know of a way that I can get some kind of low cost insurance to help me fix this problem? Any advice is appreciated.

[ChicagoGranny]

The second problem is that I seem to partially wake up and correct the problem almost immediately, which means I really don't think my machine is registering these events, since it supposedly has to last at least 10 seconds or so to count towards the AHI. I'm concerned because if it isn't registering these, then I have no idea how many of these events I'm dealing with.

When you awaken from one of these "events", immediately turn your machine off. If you aren't using the highly recommended AutoStart, then turn the machine back on. The next day you will be able to find these "events" on Sleepyhead - they are at the points on the graphs where the lines are discontinuous. Find an "event" and zoom in on the waveform to look at individual breaths immediately preceding the "event". This should give you a clue about whether something is actually happening with your breathing or whether it's just "in your mind".

For me, it feels like my throat is totally open and then just closes suddenly for no reason.

How can you make an accurate judgment about this? You are sleeping when it happens. What we think is happening when we our sleeping, is often not. This is why you need to look at the waveforms - actual data.

At first I thought it was because of my overbite, but I got a $2000 custom mandibular advancement device that fixes it (most people say that those don't work, but I think they're mainly thinking of the cheap generic ones your boil).

No, we've read the medical studies which show they are not very effective for obstructive sleep apnea. Gramps and I each had $2000 MADs custom made. Worthless - even for naps they are worthless.

Many will probably say that I need to increase pressure, but I've also hit a wall with that. I have my range set from 13.0 to 20.0 and I can't set it any higher without having serious aerophagia problems, plus my auto machine never goes above 13 anyway.

Actually, many will say turn the minimum pressure down. The fact that it is not going above 13, is evidence that a lower minimum pressure might treat you well (and help with aerophagia). I would turn the minimum down to 10 tonight and see what happens. The worst would be you need 13. The AutoSet machine will get you to 13 fairly quickly if it senses partial collapse of your airway.

I've looked into what else it could be,

Let's look at some waveforms before chasing complicated or rare causes on the internet.

BTW, what position(s) do you sleep in?

[RicaLynn]

I'm glad that you have a new machine that gives you better data. However, you've only had it a couple weeks, and sometimes changing equipment can cause a brief period of readjustment. I think you're overthinking the problem a bit.

Are you using SleepyHead to check your data? If so, there are folks here more knowledgeable than myself that can look it over and help you troubleshoot. I encourage you to look over the link on the pinned posts and post a sample here.

[greatunclebill]

the throat closes itself to keep things out of it. it sounds to me like it is closing because mucous is triggering it to. the other thing is reflux from the esophagus which may be sneaking out. i have to take prilosec twice a day to keep the reflux down because prilosec only works for 12 hours. try sleeping with your head elevated.

[ChicagoGranny]

what are your pressures

He states it in his OP, Mr. Genius.

[Hello, World?]

I'll turn the min down to 10 and try it out.

I didn't realize I could sync up to anything or get a wave form set of data. I've just been looking at the minimum info the machine has on its screen. I just bought this from secondwindcpap and the manual doesn't say anything about connecting to a data site. How does that work?

[RicaLynn]

I encourage you to read up on SleepyHead here. The data from the machine is stored on an SD card at the back of your S9, but since you got it secondhand it may not have come with the card. Aalmost any SD card will work, tho.

[Pugsy]

Use available software to see the data and be able to zoom in on the flow rate.
https://sleep.tnet.com/equipment

Read this
http://www.apneaboard.com/wiki/index.ph ... d#pid73182

and my tutorial
viewtopic/t88983/Pugsys-PointersSleepyH ... Hints.html

and eventually you will learn how to look at things at this level of detail and see what is happening at the time you turn the machine off (when you experience the perceived collapse). You have to turn the machine off so that you will have a marker for when it happened.
Can't rely on memory.

Here's an example of zooming in and looking at the breathing up close where the OA gets flagged.