Obstructive Sleep Apnea and many years of SCUBA diving

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welshmike

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Location
Winchester, UK
# of dives
500 - 999
I'm a newbie to this forum and apologise if I have posted in an inappropriate place.
I have Obstructive Sleep Apnea, OSA, and am being treated with overnight use of an Automatic Positive Airway Pressure, APAP, device and a full face mask.
When I roll onto my back while asleep the muscles and soft tissues in my throat relax and collapse sufficiently to cause a total blockage of the airway.
The APAP device that had been producing air at 4 cms of water pressure (4 millibars?) then increases the pressure of the air it pumps up to 20 cms of water pressure (20 millibars) and I believe that instead of the blockage in my airway being forced open I resist the pressure by keeping my throat closed. This negates the purpose for using an APAP device and wakes my up several times.
I am wondering if my reaction is a result of SCUBA diving regularly over more than 30 years especially having started when the only regulators available were back mounted twin hose types with no non-return valves in the hoses.
Such regulators provided comfortable breathing pressure while swimming face down but over-pressurised the air by approximately 20 millibars.
My condition reaction was then to close my throat.
Furthermore as a diving instructor the many practices and demonstrations to students of ditch and retrieve where there was a tendency to start breathing from single hose regulators while they were free-flowing may have “conditioned” my throat closing reaction.

I've very much appreciate the opinion of diving doctors on this issue please.

Mike
 
I see your logic and muscle memory is definitely active in the sleep rem cycle

Is is posible to detune your apap to a lower setting that may not trigger the reflex
 
There's a diving medicine section on SB where you might get an MD to respond. You could ask one of the Mods to move it there for you. Sounds logical, but I'm no MD.
 
Been diving and using cpap for many years. You need to have your machine recalibrated. Call your doctor that prescribed the unit and have it corrected.
 
My lay opinion is that your scuba experience has nothing to do with your APAP experience. I am a CPAP/APAP user, and I have been treated by the Stanford Sleep Medicine, which is headed by Dr. Guilleminault, who is one of the fathers of sleep medicine.

http://en.wikipedia.org/wiki/Christian_Guilleminault

The physicians at Stanford do not allow APAPs to determine what pressure to use. The CPAP makers won't disclose their proprietary algorithms so it's a black box as far as the physicians are concerned. They will prescribe a min/max setting and allow the machine to adjust the pressure within the prescribed range, but they will not allow the machine free range to do what it wants.

You may be correct that the pressure is too high. That was a problem for one of my friends who has OSA (and has never scuba dived), which was solved by lowering the pressure (also treated at Stanford). According to my friend, the too-high pressure was triggering CSA (central sleep apnea).

You need to have a sleep study to titrate the machine. Otherwise it's just guesswork. Have you had such a sleep study?

If your physician is relying on the machine to determine what pressure to use, you need a new physician.

If you sometimes need 20 cm H20 of pressure, then there is no way you should be using 4 cm to begin with (other than as the start of a ramp time). And if the machine is going from 4 to 20 in seconds, it's no wonder that it disrupts your sleep.

My advice: Forget the scuba connection and focus on getting a physician to get the right settings on your APAP.

Good luck with this.
 
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Have you thought about surgery to remove the excess soft tissues at the back of your throat/mouth area? I did and that ended having to use a CPAP. Also, no more snoring either. B.
 
Sounds to me like your settings are incorrect. It's very difficult, maybe impossible, to voluntarily close the trachea. You could protect the airway involuntarily, which is what normally happens when you eat or drink but you can't make it happen. I think your idea about scuba has no validity whatsoever.
 
I've also been facing the sort of same problem...i'm a patient of Sleep Apnea and using CPAP supplies and that stuff to get a nice sleep... i've been also doing scuba diving for almost 5 years... so , i share the same vision as you.

Thanks

APu
 
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