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Thread: Tracheotomy to treat sleep apnea?

  1. #1

    Tracheotomy to treat sleep apnea?

    Anybody have to go to this extreme to treat sleep apnea? We've tried every mask/interface made, but my jaw drops and breaks the seal - and chinstraps don't prevent it. My doc says either tracheotomy, or don't treat ("moderately severe" sleep apnea).

    RAFS, I know you have a tracheotomy and use it at night, but I don't understand how it works. Do you hook up to a ventilator? Insight appreciated.

    I'm not liking this idea.

  2. #2
    This is an extreme measure that should be limited to last resort, as this increases your risks for pulmonary infections. You do not go on a vent. Usually you keep the trach plugged during the day and then uncork it at night. Using a trach mask with humidification when unplugged is highly recommended to avoid overly dry secretions. Rarely would you need to use Bipap, as the trach usually bipasses the area of the pharyx that causes the sleep apnea. You cannot talk with the trach uncorked unless you cork it again, or place a finger over the opening, so being able to get help at night in an emergency should be a consideration.

    Has your evaluation at your SCI center resulted in this recommendation?

    (KLD)

  3. #3
    Yes, KLD, our good friends in Seattle recommend this, and taken none too lightly. I just didn't understand how it works i.e. humidification and dealing with secretions et al. Thank you for explaining. Now I'm in tears.

  4. #4
    Quadvet,
    As a fellow apnea sufferer who has had her share of CPAP problems, reading your post really blew my mind. I guess I can't believe a trach could really be suggested as a viable solution. No wonder you're in tears. I would be too.

    I'm not quite sure why the chinstrap hasn't worked for you, but couldn't there be some way of having a custom-made strap made that worked? Heck, if the "strap" ending up looking more like a ski mask, if that was needed to keep your jaws shut, I would think that even that would be better. Or just had a brilliant flash. How about some orthodontic appliance, like they would use if you broke your jaw to wire your jaw shut? Instead of wires, now they use rubberbands so that you can remove them long enough to brush your teeth. You could only wear the rubberbands at night, and only bracket some back molars to attach the bands to. There HAS to be some creative engineering type folks who can figure out a better solution.

  5. #5
    Senior Member canuck's Avatar
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    Quadvet even a tightly fitting full face mask won't work?

  6. #6
    Senior Member Jeff B's Avatar
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    I know you have tried chinstraps but this one works well for me. It pulls the chin up towards the nose instead of back towards the throat like most:

    http://www.cpap.com/productpage/prem...mouthleak.html

  7. #7
    Senior Member Jeff B's Avatar
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    I also use the Mirage Swift II nasal pillows, so I don't need a "seal" around the mouth.
    My mouth can even open a bit without the air leaking out, but the chinstrap generally keeps it closed.
    http://www.cpap.com/simple-find-cpap-products/cpap-masks/cpap-masks/nasal-pillow.html

    As Canuck asked have you tried full face masks? These ones say you can breath through your mouth:

    http://www.cpap.com/simple-find-cpap-products/cpap-masks/cpap-masks/full-face.html

  8. #8
    Sent you a PM...just fyi...

  9. #9
    Senior Member zillazangel's Avatar
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    I'm glad you asked this, because I have a related question. Chad has horrible sleep apnea and that is of course very bad for his cardiovascular system and it makes him very sleep all the time too. He has tried a number of masks but they all have two problems - the ones that just plug into the nose blow his mouth wide open within a minute or two of him falling asleep (or before usually). Is this what a chin strap is for? Secondly, we've tried the full face masks, but since he can't move at all (shoulder shrug only, and can only turn his head to one side fully and partially to the other), if it got dislodged and blocked his breathing he would not be able to summon help. And even if that weren't a concern, he uses voice activated stuff in the bedroom and he can't use it with either a full face mask nor nose prongs.

    Thoughts? The thought of a trach never occured to me ... but it sounds pretty drastic, i agree, quadvet.
    Wife of Chad (C4/5 since 1988), mom of a great teenager

  10. #10
    Quadvet, I think there are other options out there--aside from cpap or a trach. There is a dental appliance that can be used. Also there are surgical options--some seem minimal like somnoplasty (basically heats the tissue up and your body absorbs the excess tissue over a few weeks).

    I don't know how effective the above are but would be worth looking into before having a trach. These would only work with obstructive sleep apnea. I am actually going to have the somnoplasty done in my nose (nasal stuffiness), if anything it will be worth it not to have the pharmacy people look at me like I am a drug addict when I buy Claritin D

    Take care and keep us updated.

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