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Apnea and Soft Collar, End result of two months testing.

When I came across the following on the Apnea Board Wiki: , I also purchased such a soft neck collar for myself.

It takes some getting used to to sleep with it, but I like it. Of course you get more and more 'wrapped up', because I now sleep with two chin straps to keep my mouth closed. Normally this shouldn't be necessary, but because I was born with an open palate, which didn't close properly in the past, there are still gaps through which the airflow partly flows into the mouth and easily leaves it as well. With a double chinstrap this goes reasonably well. I also sleep with the Resmed Airfit P30i nasal mask, which I personally find a very nice mask. Together with a special memory foam apnea pillow with notches for the mask and two special shaped memory foam pillows that I place between my legs, I can sleep well on my right and left side.

Until recently, I slept with a Resmed Airsense 10 cpap (since September 2011), but my AHI was stuck at 1.9 per hour as an annual average. Of course you can't complain then but I still suffer from daytime fatigue when reading the newspaper and watching TV. I was able to buy a Resmed AirCurve ST second hand in January 2021 and decided to give it a try. I could still resell the device.

The device has as mode settings Cpap, S (spontaneous breathing), ST (spontaneous/time controlled) and T (time controlled)

Tried all these mode settings and I liked the S mode with Backup rate of 10 breaths per minute (only 10 or off is possible) best. Sleeping with a Bipap also took a period of getting used to and setting the device to the right (for me then) settings was a chore.

Eventually I succeeded and on 8 May 2021 I had the following settings with which I continued to sleep:

  • Ramp (Start-up time) time , Start pressure and Smart start all set to Off.
  • IPAP pressure 11 cmH2o (IPAP = inhalation pressure)
  • EPAP pressure 5 cmH2o (EPAP = exhalation pressure)
  • Pressure support 6 cmH2o (PS = respiratory pressure support)
  • Backup Rate 10 (breaths per minute)
  • Ti-Min 0.1 seconds (could not be lower)
  • Ti-Max 4.0 seconds (could not go higher)
  • Climate Control on Auto Setting
  • Hose Temperature on Auto Position
  • Mask: Resmed Airfit P30i nasal mask
Deviation 2 through 6 May IPAP 10.8 other IPAP 11.0 and EPAP 4.8 other EPAP 5.0 PS standard 6.0 cmh2o
Deviation 3 to 7 May 3 - 4 - 6 - 7 May rise time 600 msec and May 5 rise time 700 msec Leakage 2 to May 6 19118 sec

Because I had not set up the device to my satisfaction until May 8, 2021, for the first week, this slightly affected my test over two months (May and June) of the soft Neck Collar. Mainly, I suffered from leakage.

I split the test as follows:
  • May 1 - 15 with neck collar
  • May 16 - 31 without cervical collar
  • June 1 - 15 without cervical collar
  • June 16 - 30 with cervical collar
I excluded three days from the test.

Excluded from measurement Reason
14-May (with) AHI too different from all other days.
10-Jun (without) No backup rate used, therefore Deviating data.
29-Jun (with) Forgot to put on neck collar.

Because of this the month of May has 30 days ( 2 x 15) and the month of June has 28 days (2 x 14)

To keep the comparison of the dates the same, I made two periods of both 29 days with and without a neck collar.

I have placed this in a table which is attached here.

The result of my AHI is of course now also determined by the setting of the Bipap mode S compared to the Cpap.

You can see my monthly AHI in the overview and you can see that the AHI over the month of May has decreased to 0.4 per hour and over the month of June to 0.42 per hour. The AHI over the month of July, now 10 days old, is currently 0.26 per hour.

My Central apnea 41 days out of 61 days = 67% (period 01 - 03 / 30-04)
My Hypopnea 59 days out of 61 days = 97% (period 01 - 03 / 30-04)

has decreased to

Central apnea 16 days out of 61 days = 26% (period 01-05 / 30-06)
Hypopnea 44 days out of 61 days = 72% (period 01-05 / 30-06)

In days, this is already a significant decrease as can be seen in the overview of all months. It is difficult to see how much the neck collar contributed to this.

The AHI decreased only slightly from 0.35 to 0.26 per hour, The number of Unclassified Apnea decreased from 15 to 7 with only a gain of 88 seconds less in time without breath.

The number of hypopneas decreased from 56 to 44 and that is a time gain of at least 12 *10 sec = 120 sec or at least 2 minutes, but in time very marginal over 29 days.

Compared to all the months before, there is definitely a big gain, but whether this is due to the neck collar is questionable, I think rather due to the use of the Bipap.

So what do I experience of the neck collar myself? I think I sleep better with it and I feel better.

I do notice that without a neck collar, I have my head bent more often in the side position towards the chest and that I notice that sometimes problems arise in the throat. The neck collar also supports my chin better, which means that I now experience less leakage.

Other users who now also sleep with a neck collar tell me that it helps them very well and that they are glad they tried it. I also hear that it does help, but that it is too hot or that they don't really like it. Of course, this is a different experience for everyone. There will also be a difference in the softness of the collar which again depends on the material used.

The final conclusion is that wearing a neck collar possibly contributes to reducing an obstructive (partial) airway obstruction and that it can always be useful to give it a chance.

Not a shot is always a miss.
Groet RuudJ
Medewerker AV-Kenniscentrum
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