"please keep me updated about oximeters "
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Cervical collar replaces CPAP
Today was a special day for me.
A few months ago I decided to see if wearing an inexpensive foam cervical collar (see typical example at http://bit.ly/h6YsBj) during sleep would help mitigate my severe sleep apnea. I got the idea because I noticed that my airway would begin to be constricted when I allowed my head to drop forward as it naturally does during sleep. Conversely, straightening my neck out would unkink the airway and allow for unobstructed breathing. My theory was that the collar would gently keep my neck in place, allowing my breathing to proceed normally and thereby reducing the number of apneas I would experience. It seemed to work pretty well, but of course I was hesitant to quit using the CPAP without knowing for sure just how effective the collar was in practice.
By way of background, in 2007 a sleep study revealed that I was experiencing 33 apneas per hour, and so I was diagnosed with severe sleep apnea and outfitted with a CPAP.
Like many people, I have always found the CPAP to be uncomfortable. In addition to the discomfort, I was unhappy about having to carry it along on trips, and I despaired of the prospect of never being able to go backpacking or river rafting again. So when I came up with the idea of using the cervical collar to keep my neck straight while sleeping, I had a fantasy that it just might replace the CPAP.
A week ago, I had a sleep study done while wearing the collar, and today I received the results from my doctor. He and I were both stunned to learn that I had only ONE apnea while wearing the collar. He advised me to put my CPAP in its case and not worry about using it anymore, as long as I slept with the collar on. As far as I know, this is the first time the efficacy of a cervical collar has been tested in a sleep study. Needless to say, I'm overwhelmed with delight at the outcome, which is much more than I had hoped for.
Tonight I will sleep without the discomfort of the CPAP mask for the first time in over 3 years. I can't wait to go to bed, but first I wanted to share this news with the sleep apnea community. While it should be clear that this approach won't necessarily work for everyone, and while of course I am NOT recommending that you try this without first talking with your doctor, I do suggest that others consider the possibility that a cervical collar will work for them too, and perhaps try a sleep study to see if that is the case.
There is almost nothing in the medical literature about the use of collars for apnea, and I have heard of only a couple of other people who have independently come up with this solution. So I believe there is a bit of medical history in the works here, and I am happy to report a good result in my case. I would be even happier to find that this works for others. I'd love to hear any news about this development, and I wish you all the best of luck with your management of your apnea.
Owen Dell
Views: 10693
Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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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. This is also the principle behind how the contour pillow works—by keeping your head extended somewhat, you're less likely to obstruct, especially when you're in deep sleep (when your muscles relax). Unfortunately, this option works for only some people, since there are so many other variables, including how stuffy your nose is, your sleep position, weather changes, what you just ate, and how extended your neck becomes with the device in place.
Here's a picture of the airway in someone on his back with the head in a relatively neutral position.
Here's the same person with the head bent forward a bit (flexed)
And with the head bent back (extended).
Notice a big difference in the space behind the tongue between all these positions.
Different people with have different levels of responses even with the same maneuvers. This is why some people can benefit from neck collars, but not all. Hope this answers your question.
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Permalink Reply by gordon on
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interesting. I might have too many pillows, i'll use one tonight, flatter, see what happens. My oximetry came out abnormal, I see a new sleep doc on Wed.
Steven Y. Park, MD said:
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. This is also the principle behind how the contour pillow works—by keeping your head extended somewhat, you're less likely to obstruct, especially when you're in deep sleep (when your muscles relax). Unfortunately, this option works for only some people, since there are so many other variables, including how stuffy your nose is, your sleep position, weather changes, what you just ate, and how extended your neck becomes with the device in place.
Here's a picture of the airway in someone on his back with the head in a relatively neutral position.
Here's the same person with the head bent forward a bit (flexed)
And with the head bent back (extended).
Notice a big difference in the space behind the tongue between all these positions.
Different people with have different levels of responses even with the same maneuvers. This is why some people can benefit from neck collars, but not all. Hope this answers your question.
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Dr. Park,
Does this hold for side sleepers too, or is this relevant only for people who sleep on their back?
And I am fascinated by your comment about the weather! I assume you are talking humidity, or are there other factors too?
Thanks, Irma
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Permalink Reply by sleepycarol on
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I wonder what kind of results you would have with the collar and a dental device?
Any thoughts about that combination Dr. Park?
I wouldn't be interested it the combo, but if it could help others it might be worth a shot. Hmm does make me wonder though about such a set up for power outages now that I think about it.
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