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Your apnea could be undertreated, or it could be a symptom of a bigger problem. Epiglottic collapse is not uncommon in apnea patinets (10-15% of cases), and is not treatable by positive pressure, as it is an inspiratory valve.

CPAP only works on the expiratory valve - which is your soft palate.

If you are having a large number of arousals, despite optimal CPAP pressure, and your respiratory waveform is jagged in certain ways (hard to describe in text) - you are very likely having epiglottic collapses.

However, epiglottic collapse can only be definitively diagnosed by sleep endoscopy.

Epiglottic collapse can only be treated surgicially.



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