A member on SleepGuide commented about his experience using a soft cervical collar to effectively treat his sleep apnea. Here’s a copy of my response to him:
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. The bottom line is, it can’t hurt to try. Hope this answers your question.
Hi Dr. Park!
Part of my go to bed ritual is to place my lower CPAP mask strap high enough on the back of my skull that it does not pull my neck when I tilt my head back. I start sleep on my back with my head tilted back. It makes breathing much easier.
I monitor my pulse oximetery and record the audio and hope in the near future to include peripheral arterial tonometry (PAT) (I guess I will have to build this myself – some things are hard to obtain). If I find too many awakenings I will probably pursue a soft neck brace – thanks for the tip – I may well need it.
Sincerely,
Tod
I thought I’d understood from my spinal surgeon that wearing a cervical collar daily for extended periods could cause permanent stiffness in the neck, especially as we are all prone to arthritic conditions as we get older. Perhaps I’m wrong, but it seems to me that doing this for years could result in some fusing in the cervical spine and I can’t imagine this would be an option for anyone that has any type of degenerative disease of the cervical spine already. This sounds like a good temporary option but I’d consult with an orthopedic or spinal surgeon before implementing this long term just to be safe.
I would like to comment, I used to wear CPAPs but it never worked for me. After a few days I end up having severe sinus reactions. There is one alternative that worked hopefully it will work for others. Buy a cheap Futuro neck brace and wear it as normal. Pick a pillow that is about the same height as the distance from your ear to the bed when you sleep on your side and with the pillow compressed. Put one hand between that same ear and the pillow and the other hand between your knees. This will stabilize your side sleep position. Later in the night you will reposition during sleep, which is expected, but try to go back to this position when you have the chance and if it feels comfortable to do again on the other side. You will find breathing a lot easier and feel much better in the morning.
After a few nights of doing this you will notice having a stiff neck in the morning. Do a few neck rotations and neck side-to-side exercises during the day to relieve this, in time the neck pain will go away and you will get used to the technique. There is an unexpected benefit to this method, your posture will improve during the day and you will get used to having your head tilted backward during sleep preventing airway restriction.
One more advise, losing weight has helped a lot too. Best of luck to other CPAP users.
On my own idea, probably influenced by my profession, I went to my Hospital Brace Shop and asked them for a “Philadelphia” neck collar fitted to keep my jaw firmly closed. When you sleep on your back and use a pillow that tends to flex your head forwards- then your airway is narrower,as in the pictures above. In addition almost in everybody, when fully asleep, the jaw drops open. In the majority of people this dramatically increases the tendency of the tongue, drawn by gravity, to move backwards often completely closing the airway. By using the neck collar to keep your jaw closed helped me at least a lot. In addition,many people find benefit from a custom moulded mouthpiece, made by certain dentist specialists. These hold the lower jaw further forwards by 3-5 mm or more. The better models you can adjust so your lower jaw is moved mm by mm forwards until you get the optimal benefit.
Then, after I retired, and lost forty pounds, (215 to 175) then using just the mouthpiece and the neck collar I had a completely normal sleep study,all night on my back-.so after ttwenty years of using the CPAP mask, For the last five years I have been mask free and free of any sleep apnea. When I have experimented and went to sleep with just the mouth piece, my wife says that things are fine lying on my side (as they were even at 215 lbs); but when Turn during my sleep onto my back she says my jaw drops open and my airway obstructs about every 1 and 1/2 minutes to two minutes. The next day I would feel rather washed out. So that little experiment was done only four times. Now I never go to sleep without the collar and the mouth piece.
My expert MD trained in Sleep medicine, working a large sleep center with three other specialists had never heard of using a sleep collar to keep your jaw closed and tongue from falling back. They had also never seen anybody 70 years old (at retirement) get rid of their mask and sleep apnea with a twenty year history. Since my normal sleep study three and one half years ago they have bee suggesting a Brace Shop fitted Philadelphia neck collar to not a few of their patients. Now I hear they have a number of patients thrilled as I am to enjoy the very special blessing of freedom – without a CPAP mask. If you have any thoughts or questions my email is chaspol@aol.com and telephone number 860 678-8176 or 518-873-2262. the collars are relatively inexpensive and I would very strongly recommend that everyone with sleep apnea give them a try. Perhaps they will just allow you to lower the pressure of your CPAP, which happened in my case until I no longer needed the mask.
The risk of using one I believe is very low- perhaps a stiff neck at first that you can easily free up in the morning. Over fifty years of Neurosurgery we treated certain types of neck fractures with Philadelphia neck collars, worn almost twenty for hours a day some times for twelve weeks. Never have I seen or heard from my colleagues at Massachusetts General Hospital in Boston or at the Hartford Hospital, Ct, of any cervical fusings resulting from prolonged use of the collar. In some people with severe cervical osteoarthritis, or other cervical diseases, I suspect it might encourage self-fusion. But I suspect the probability is Very very low. If you do have a neck condition then see a cervical spine specialist — Neurosurgeon or Orthopedist.
Hope this diatribe and my own experience mighty inspire, motivate, and help some more people. It really is a blessing to get rid of that mask!
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Thank you
This is really very promising. I hope that this will work to most of the people who has sleep apnea problem. I know that it was stated above that it does not work to all but I am just hoping that this can of great help to them.
I have had sleep apnea for at least 20 years and was diagnosed and put on CPAP but had problems with condensation and compliance. I then had throat and nose surgery to open my airways. I started to have severe drowsiness last year and was put back on CPAP. I also have some central apneas. I realized that even though my AHI was under 5, I still wasn’t getting rest. I also had flow graphs from the CPAP smart card that showed my rate of breathing would drop so low that the graph showed it as if I had taken the mask off or turned the machine off. With the cervical collar, my rate graph almost looks as good when I am asleep as when I am awake. I still used the CPAP too. I found that if my chin is too high my stomach fills with air, but if it is level, it works really well. Less fatigued, less pain, less dizziness!!!
I use a CPAP. I bought a soft cervical collar to support my neck while sleeping because I have terrible neck problems – and it does help that problem – but it makes my apnea worse! when I am not wearing it, my Auto CPAP which is set to 8-15 cmh2o has a median pressure of 9 and a max of 12 to 13. While wearing the collar, the Flow limitation graph gets crazy, and the pressure stays in the 13 to 15 range all night. Thinking that the height of the collar under my chin might be pushing the chin back and dumping the tongue into the airway, I tried turning the collar backwards so that it is very short in front but still high on the sides (I am a side sleeper) but this had the same result. I am not wearing it tight.
I have had a thyroidectomy for benign multinodular goiter 7 years ago, and the surgeon mentioned that the goiter had pushed the trachea off center…. I have no idea if it has stayed off center though. I am puzzled by the result!
This is very interesting.
These pictures are indecipherable .. to me at least.
I’ve got severe obstructive sleep apnea, and a collar helps lower my AHI using a CPAP, but it’s quite uncomfortable. I need to try a “shorter” one. Needless to say, it was an online form rather than my sleep doctor who suggested it.
Four months of CPAP usage averaging over 8 hrs a night, and I’m just as tired as ever. Starting a BiPAP tonight to see if that helps.
I’ve been worn out for several years now. My business has suffered greatly as a result of my limited “schedule.” Too many docs over the years that haven’t helped at all .. my lab tests were “normal” so they dropped it. Literally. Finally one suggested a sleep study last year. Hoping this will help me get better soon.
05/27/2018 I have also been wearing a soft collar for a few months now and I now sleep continuously for about six hours which is good for me as I have never slept for eight hours, I am now 69 years old, now I awake totally rested (instead of exhausted after problems of awakeing 45 minutes to 90 minutes after going to bed and having trouble going back to sleep) I do not know why my sleep pattern changed but I needed a solution. My sister and brother have CPAP machines which helped my brother tremendouly but my sister quit using hers after a short while, I have not been evaluated for sleep apnea. I still snore but not nearly as loud nor as much but bottom line I breathe and sleep much better (just laying in bed I could feel the difference). Note: I adjust the collar to keep my bottom jaw firmly to keep my mouth from opening and it works great….only problem is if my head tilts backwards then the pressure on my jaw is relieved but by arranging the pillow correctly it keeps my head in a position for a good nights rest. NOTE: I do not stretch my neck the collar is there to keep the jaw from dropping. Leo
I tried it and all I got was a sore neck.
I tried using a coft collar in desperation a few nights ago and I think it is helping. I was diagnosed with sleep apnoea nearly 4 weeks ago (in addition to a stress-related inability to sleep) and have been using CPAP since then with limited success. I looked up the subject of neck support today and found this site so decided to add my short trial for the benefit of others. In my layman’s opinion it is worth trying a soft collar. Compared to CPAP it is easy to get used to wearing the collar and I find that I have not been woken up by sudden increases in air pressure from the CPAP, suggesting I have reduced the severity of obstructions during the night. Clearly, it does not work for everyone but I think it is helping me.