Back sleeping vs. side sleeping

[StevenJ]

I get best results (apnea control) when sleeping on my side so that's where I spend most (aiming for all) of my sleep time. Side sleeping comes natural for me, so it's generally not a problem. But sometimes during the middle of the night I find myself on my back, or intentionally start out on my back because nasal breathing is often easier at the beginning of a session. So here's the question: shouldn't my treatment control the apnea whether I'm on my back or on my side? Isn't that what APAP is for? (I'm on CPAP). Or should CPAP pressure be set high enough to prevent apnea while back sleeping? I'm really not wanting to sew a tennis ball into the back of my sleep shirt.

[roster]

I need 19 cm on my back and 8.5 cm works well on my side. I tried setting of 8.5 - 20. Fine as long as sleeping on my side, but as soon as I rolled to my back apneas would start hitting me hard. The machine would very gradually get up to 13 or 14 cm and in the meantime I had many long apneas. It would never get to the required 19 cm.

The solution for me was to wear a small backpack. I use a CamelBak hydration pack and stuff in it an empty 20-ounce water bottle. Now I cannot roll to my back and 8.5 cm controls my apnea. When I travel the CamelBak goes along with the cpap equipment.

[Hawthorne]

Cpap therapy should be effective no matter your sleeping position. Most often people are titrated on their backs so that the titrated pressure will be high enough so that you get good therapy even sleeping on your back.

If a person has to sleep on their back for long (or short) periods of time because of a medical problem, either temporary or chronic, and that person has sleep apnea and is using cpap it should be set to work in case these circumstances arise, from the beginning. That is what is usually done at titration.

I, for one, have Rheumatoid Arthritis and the only pain free position for me to sleep is on my back. Other positions cause pain in the hips, shoulders, knees, etc and I can't sleep! My body seems to know that other positions cause pain so, while I sleep, I hardly move at all.

So, while it is not the preferred sleeping position for someone with sleep apnea, I sleep on my back, and my Auto is set at a very narrow range. I get a good rest and my numbers are great. My AHI is almost always below 1. Because I have the software and reader, I know that things are going well with my sleep therapy (in spite of my situation) because I see the data every day.

[WNJ]

I think it is not unusual for folks to need a higher pressure if they are sleeping on their back as compared to on their side. That is certainly true for me.

I was titrated at 13 cm, which I found to be a bit uncomfortable. According to the report from the sleep study, this reduced my AHI to 7.5.

I bought an APAP and, after some experimentation, settled on a range of 10 cm to 14 cm. I do my best to sleep on my side and I have pretty good success without help from tennis balls, etc.

It seems that if I can stay on my side, the APAP rarely goes above 10 cm. OTOH, if I roll over on my back, the pressure goes up, and often the higher pressure often wakes me. I do pretty well at staying on my side and I spend over 70% if my time at 10 cm.

For me, the nice thing about the APAP is that I can keep the pressure at a more comfortable level most of the time, yet it will respond when I need more pressure. With APAP (and perhaps with sleeping on my side), my AHI is usually below 3.

I would expect that your CPAP is already set at a pressure that will cover what you need while sleeping on your back. With a single pressure machine, the normal thing is to prescribe a pressure that will cover the patient’s needs 90 or 95% of the time.

Wayne

[jnk]

I need 19 cm on my back and 8.5 cm works well on my side. I tried setting of 8.5 - 20. Fine as long as sleeping on my side, but as soon as I rolled to my back apneas would start hitting me hard. The machine would very gradually get up to 13 or 14 cm and in the meantime I had many long apneas. It would never get to the required 19 cm.

The solution for me was to wear a small backpack. I use a CamelBak hydration pack and stuff in it an empty 20-ounce water bottle. Now I cannot roll to my back and 8.5 cm controls my apnea. When I travel the CamelBak goes along with the cpap equipment.

That solution (backpack, sewn tennis balls, etc) may work for some. (I am glad it works for you, rooster.) I've heard and read of its being suggested by good doctors. BUT, depending on the person, it can destroy normal sleep architecture, according to my understanding.

If your body keeps trying to roll over on its back and keeps getting sleep arousals from the makeshift "solution," you may end up winning the no-back-sleep battle but losing the good-sleep-architecture war. I guess it can be tried as a way of training your body, if it doesn't mess up how you feel the next day. But I would not consider wearing something on the back every night to be a longterm solution, myself. In fact, it might be better for someone to just sleep on his or her back and raise CPAP pressure than to keep getting awakened throughout the night by a suped-up-anti-supine contraption for sleeping on one's side.

If someone has very mild OSA and is sleeping without PAP therapy, that may be a different colored horse. But if you're gonna wear the hose anyway, why not just get your pressure to where you can sleep how your body likes to sleep?

Only one man's opinion--what forums are for!

[roster]

....... BUT, depending on the person, it can destroy normal sleep architecture, according to my understanding.

If your body keeps trying to roll over on its back and keeps getting sleep arousals from the makeshift "solution," you may end up winning the no-back-sleep battle but losing the good-sleep-architecture war. I guess it can be tried as a way of training your body, ...!

There is a training effect. The first three weeks or so were hell. As the months have gone on I find myself trying to roll onto my back less and less.

[jnk]

There is a training effect. The first three weeks or so were hell. As the months have gone on I find myself trying to roll onto my back less and less.

That's good to know. Thanks, rooster.

jeff

[ca_hosehead]

After viewing a lot of videotape I discovered that sleeping on my back was quite a bit worse than other positions.

I have an auto, but it seems to be entirely clueless. I have a very low AHI but still feel tired. My theory is that the apnea events wake me up and wreck my sleep architecture. I'll have an apnea event and then the auto will raise the pressure. Of course by then it's too late. After a short period the auto will drop the pressure back down. Then along comes the next event to wake me up.

I tried raising my floor pressure to better respond to apneas. My 90% pressure was always a point or so above where I had the floor pressure right now, so kept raising it. Once I got to to 15 I started to have some other problems so I stopped at 14.

I trained myself using a variant of the "tennis ball" technique. And it does wreck your sleep until you get used to it, but it doesn't take that long. After a few weeks your sleep habits are retrained and it's not a problem.

Judging the from the tape, I didn't try to roll onto to my back over and over again. You try once or twice, it doesn't work and then you try some other position. That works and you go back to sleep.

They say that after you are trained into it you can wear the back thing only once a week. I haven't tried that.

It lowered my AHI significantly to get away from back sleeping.