Sleeping on Back w/BiPAP (Central Sleep Apnea)
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Sleeping on Back w/BiPAP (Central Sleep Apnea)
I had a sleep study done recently, was diagnosed with central sleep apnea, and prescribed to get a BiPAP machine. After months of fiddling around with it with my doctor, we finally got it to the point where it seems to work. The mask is comfortable, the air pressure is comfortable, and according to the data from the machine, it is completely eliminating my sleep apnea. The problem is, I still feel terrible.
I think the problem is that in order to use the machine, I have to sleep on my back, which is intolerable to me. I don't think it's a physical problem, like my tongue blocking the airways. If anything, the discomfort is in my back. In any case, I think the problem is really in my head with my sleeping habits. As long as I can remember, I've always slept on my stomach or side. I just can't get remotely comfortable sleeping on my back. However, I can't use the machine that way, because the mask will slip off enough to leak, rendering it useless. After months of trying, I just can't get used to sleeping on my back. The only way I can see that being possible is to actually see tangible results in how I feel, not just numbers from a machine, which isn't happening for now.
Are there any other options? I see three possibilities. First, find a way to get used to sleeping on my back. Second, find a way to make it impossible for the mask to slip off, even sleeping on my stomach. Third, find a way of treating my central sleep apnea with a means other than BiPAP. However, from what everyone has told me so far, BiPAP is the only known treatment for central sleep apnea. Every other potential treatment that I've heard of is for obstructive sleep apnea, so that doesn't help me. Regardless, neither my doctor nor I have been able to find a means of utilizing any of the three options, so I'm stuck in limbo right now.
On a side note, my doctor did say that since a lot of my symptoms are depression-related, it may take some combination of the BiPAP and medications to solve the overall problem. However, since I've had doctors tinker with various antidepressants on me for most of my adult life, to no avail at all, I tend to discount that as a possibility. Not to mention, they usually made me feel immensely worse. Neither antidepressants nor any CPAP/BiPAP machine has made a dent in the problem for me.
Thanks for your help.
I think the problem is that in order to use the machine, I have to sleep on my back, which is intolerable to me. I don't think it's a physical problem, like my tongue blocking the airways. If anything, the discomfort is in my back. In any case, I think the problem is really in my head with my sleeping habits. As long as I can remember, I've always slept on my stomach or side. I just can't get remotely comfortable sleeping on my back. However, I can't use the machine that way, because the mask will slip off enough to leak, rendering it useless. After months of trying, I just can't get used to sleeping on my back. The only way I can see that being possible is to actually see tangible results in how I feel, not just numbers from a machine, which isn't happening for now.
Are there any other options? I see three possibilities. First, find a way to get used to sleeping on my back. Second, find a way to make it impossible for the mask to slip off, even sleeping on my stomach. Third, find a way of treating my central sleep apnea with a means other than BiPAP. However, from what everyone has told me so far, BiPAP is the only known treatment for central sleep apnea. Every other potential treatment that I've heard of is for obstructive sleep apnea, so that doesn't help me. Regardless, neither my doctor nor I have been able to find a means of utilizing any of the three options, so I'm stuck in limbo right now.
On a side note, my doctor did say that since a lot of my symptoms are depression-related, it may take some combination of the BiPAP and medications to solve the overall problem. However, since I've had doctors tinker with various antidepressants on me for most of my adult life, to no avail at all, I tend to discount that as a possibility. Not to mention, they usually made me feel immensely worse. Neither antidepressants nor any CPAP/BiPAP machine has made a dent in the problem for me.
Thanks for your help.
_________________
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
Welcome to CpapTalk.
Why do you feel that you have to sleep on your back? I've always slept on my stomach (mostly) or side (occasionally). Sleeping on your back can increase your obstructive apnea.
If you would add your equipment to your profile it would help others to answer. wiki/index.php/Registering_Equipment_in_User_Profile
Why do you feel that you have to sleep on your back? I've always slept on my stomach (mostly) or side (occasionally). Sleeping on your back can increase your obstructive apnea.
If you would add your equipment to your profile it would help others to answer. wiki/index.php/Registering_Equipment_in_User_Profile
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- Uncle Flapp
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
I have Complex Sleep Apnea (obstructive and centrals), use a full face mask (FFM), and sleep on my side. You should be able to also. I have a CPAP pillow and it makes a big difference. As far as sleeping on your stomach, that may be a bit of a challenge with a FFM - others may chime in.
Edit: I use this pillow.
It would help if you added your machine in your signature line and provided some screenshots of your data. There are folks here that can help.
- Flappy
Edit: I use this pillow.
It would help if you added your machine in your signature line and provided some screenshots of your data. There are folks here that can help.
- Flappy
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Last edited by Uncle Flapp on Tue Mar 24, 2015 6:44 pm, edited 1 time in total.
Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
How about another option...find a mask that you can sleep on your side or stomach? Or maybe change your bed pillow to something that won't push on the mask so much.
What mask are you currently using?
Why can't you sleep on your side or stomach with the current mask? Is it the bed pillow pushing on it causing it to move and lose its seal.
People sleep on their sides and stomachs all the time with all sorts of masks. It can be done.
What mask are you currently using?
Why can't you sleep on your side or stomach with the current mask? Is it the bed pillow pushing on it causing it to move and lose its seal.
People sleep on their sides and stomachs all the time with all sorts of masks. It can be done.
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
Wow, thanks for the quick responses!
The reason I have to sleep on my back is because if I sleep on my stomach or side, the mask slips off my face enough to create an air leak. This is not only extremely uncomfortable with air going into my eyes, but also renders the machine useless, since the air is escaping. The only way I've found to completely prevent air from leaking is to sleep on my back, which is incredibly uncomfortable. Also, I've added my machine to my profile.
I currently use a full face mask, which made a huge difference for me, or rather less of a difference in pressure between my nose and my mouth. It made wearing the mask completely tolerable. The machine works. The data shows that I don't have apneic episodes while using it. However, I still wake up feeling terrible every single day, and I have no numbers that suggest why. The only logical conclusion I can come up with is that the discomfort from sleeping my back is preventing me from really falling asleep, even with the BiPAP.
There's two problems with sleeping on my stomach with the mask. First, my pillow is pushing the mask, breaking the seal. Moving the pillow around so the mask is off the pillow is extremely uncomfortable, since there's less support on the edge of the pillow than in the middle. Second, I toss and turn my head a lot when I sleep, so even if I do somehow get comfortable with the position of the pillow, I have to move everything around again, every time I turn my head.
I've also been prescribed various drugs to help with my sleep, to no avail. They'll get me asleep, but I still don't feel well rested at all, even with the BiPAP.
The reason I have to sleep on my back is because if I sleep on my stomach or side, the mask slips off my face enough to create an air leak. This is not only extremely uncomfortable with air going into my eyes, but also renders the machine useless, since the air is escaping. The only way I've found to completely prevent air from leaking is to sleep on my back, which is incredibly uncomfortable. Also, I've added my machine to my profile.
I currently use a full face mask, which made a huge difference for me, or rather less of a difference in pressure between my nose and my mouth. It made wearing the mask completely tolerable. The machine works. The data shows that I don't have apneic episodes while using it. However, I still wake up feeling terrible every single day, and I have no numbers that suggest why. The only logical conclusion I can come up with is that the discomfort from sleeping my back is preventing me from really falling asleep, even with the BiPAP.
There's two problems with sleeping on my stomach with the mask. First, my pillow is pushing the mask, breaking the seal. Moving the pillow around so the mask is off the pillow is extremely uncomfortable, since there's less support on the edge of the pillow than in the middle. Second, I toss and turn my head a lot when I sleep, so even if I do somehow get comfortable with the position of the pillow, I have to move everything around again, every time I turn my head.
I've also been prescribed various drugs to help with my sleep, to no avail. They'll get me asleep, but I still don't feel well rested at all, even with the BiPAP.
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
What full face mask are you using? Others using that mask may be able to help you. Have you tried a nasal or pillow mask?
Are you using software to see your data?
Are you using software to see your data?
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
Have you looked at one of the special cpap pillows with the cutouts on the sides to accommodate the mask without putting extra pressure on it?
Like this one (there are tons out there available just google "cpap pillow" to see what's available)
https://www.cpap.com/productpage/breath ... illow.html
If you want to try something like this I usually tell people to go to WalMart and get one of those cheap memory foam pillows and just cut out the holes on the side. Electric knife works great but I think a box/utility knife would also work.
Like this one (there are tons out there available just google "cpap pillow" to see what's available)
https://www.cpap.com/productpage/breath ... illow.html
If you want to try something like this I usually tell people to go to WalMart and get one of those cheap memory foam pillows and just cut out the holes on the side. Electric knife works great but I think a box/utility knife would also work.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
There seems to be an inconsistency between the diagnosis of Central Sleep Apnea and the prescription of an auto bi-level machine.
Do you have a copy of your sleep study so you can see what it actually says?
Do you have a copy of SleepyHead software or ResScan software so you can look at what is really going on while you sleep?
Either of these will allow you to get your own data reports so you can what is going on.
It doesn't take many fairly lengthy central events to make your night's sleep really crappy to coin a phrase.
I was on a bi-level machine for three years and had pretty good AHI numbers and still felt tired during the day. It wasn't until I switched to an ASV machine that my days finally got better.
Your machine is an excellent CPAP machine but it won't do anything at all to respond to central apnea events, only an ASV machine will do that (with the exception of some very unusual RT machines that most folks don't get.)
Sometimes insurance companies require a "failure" on a bi-level machine before they will approve the more expensive ASV type machine. Perhaps that is a part of what is going on.
Do you have a copy of your sleep study so you can see what it actually says?
Do you have a copy of SleepyHead software or ResScan software so you can look at what is really going on while you sleep?
Either of these will allow you to get your own data reports so you can what is going on.
It doesn't take many fairly lengthy central events to make your night's sleep really crappy to coin a phrase.
I was on a bi-level machine for three years and had pretty good AHI numbers and still felt tired during the day. It wasn't until I switched to an ASV machine that my days finally got better.
Your machine is an excellent CPAP machine but it won't do anything at all to respond to central apnea events, only an ASV machine will do that (with the exception of some very unusual RT machines that most folks don't get.)
Sometimes insurance companies require a "failure" on a bi-level machine before they will approve the more expensive ASV type machine. Perhaps that is a part of what is going on.
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DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
I've added the face mask to my profile there. I've tried quite a few of them, and this is the only one that I've found remotely tolerable. I haven't tried a CPAP pillow, but I suppose I could look into it. Still, every time I toss and turn my head, the hose gets caught, which I don't see how a pillow would help. As for my data, I just bring the SD card from the machine and give it to my doctor. I don't have direct access to the information from my own computer at home here.
As for my sleep study, I know it said there was some obstructive, but mostly central sleep apnea. From some cursory research, some seem to call it "complex" sleep apnea, though none of my doctors even called it that. I always just thought it was a laymen's term. At first, we tried a machine designed for obstructive sleep apnea, which didn't work at all. I think they said they tried it first, because it was cheaper, and sometimes removing the obstructive sleep apnea can help the central sleep apnea, but it did not. So, I switched to a machine specifically for central sleep apnea. I also use a breathing strip and antihistamine to help, since I know I have a post nasal drip. The doctor said that the new machine was supposedly working, but I don't feel any difference.
I've never heard of ASV before. Is that the auto-titration? I know my machine has that. Maybe I selected the wrong model in my profile. They all look the same to me. I don't see anything on the website about ASV.
As for my sleep study, I know it said there was some obstructive, but mostly central sleep apnea. From some cursory research, some seem to call it "complex" sleep apnea, though none of my doctors even called it that. I always just thought it was a laymen's term. At first, we tried a machine designed for obstructive sleep apnea, which didn't work at all. I think they said they tried it first, because it was cheaper, and sometimes removing the obstructive sleep apnea can help the central sleep apnea, but it did not. So, I switched to a machine specifically for central sleep apnea. I also use a breathing strip and antihistamine to help, since I know I have a post nasal drip. The doctor said that the new machine was supposedly working, but I don't feel any difference.
I've never heard of ASV before. Is that the auto-titration? I know my machine has that. Maybe I selected the wrong model in my profile. They all look the same to me. I don't see anything on the website about ASV.
_________________
Mask: Simplus Full Face CPAP Mask with Headgear |
Additional Comments: Machine: https://www.cpap.com/productpage/pr-system-one-60-series-bipap-auto-machine.html |
Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
you'd be surprised how much extra leaking can occur and the machine not be useless.Sleeplessintulsa wrote:Wow, thanks for the quick responses!
The reason I have to sleep on my back is because if I sleep on my stomach or side, the mask slips off my face enough to create an air leak. This is not only extremely uncomfortable with air going into my eyes, but also renders the machine useless, since the air is escaping.
mask liners (search on the forum or in google) were what allowed me to tame the leaks and keep them from bothering me when I wore a full face mask. and I never sleep on my back.
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
Many of us have the concurrent disease of Diabetes, which can have as a side effect depression, which does not mean that one can treat the Diabetes only and not the depression. After a while, folks tend to develop what Zig Ziglar called stinking thinking. I know I enjoy feeling sorry for myself. Like my friend said, I had a pity party and nobody came, I got bored, so I left.
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Additional Comments: |
Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
A hose manage system to route the hose over your head might help. You can buy them or make them.
Something like this
https://www.cpap.com/productpage/HoseBu ... ystem.html
or this which is a little taller
https://www.cpap.com/productpage/hosebu ... ystem.html
or this which is a little cheaper
https://www.cpap.com/productpage/arden- ... ystem.html
or various DIY projects discussed here
viewtopic.php?t=10640
or this one which is ultra simple
http://pur-sleep.com/shop/hose-manageme ... ystem.html
About your model machine...tell us exactly what it says on the top of the machine up by the LCD screen and/or look on the side for a sticker that has a model REF number.
While it wouldn't be impossible for your doctor to be using the VPAP Auto for the centrals...highly unusual as it normally isn't used when centrals are in large numbers.
Normally the Adapt or maybe one of the higher end VPAPs (like S/T model) but if you had obstructives as well as central the Adapt would be my first thought.
In the equipment selection for profiles there is no option for the Adapt...and when that is what people are using we just tell them to add it in the comments section and leave the machine blank and just put the humidifier in the menu along with mask.
The Adapt is the S9 model name and you may not see the letters ASV but the Adapt is an ASV machine. We sort of use it interchangeably.
Your complaints aren't anything new that we haven't heard before and people have been able to sort through those issues. It may take some trial and error to find what suits you but it can be done.
Something like this
https://www.cpap.com/productpage/HoseBu ... ystem.html
or this which is a little taller
https://www.cpap.com/productpage/hosebu ... ystem.html
or this which is a little cheaper
https://www.cpap.com/productpage/arden- ... ystem.html
or various DIY projects discussed here
viewtopic.php?t=10640
or this one which is ultra simple
http://pur-sleep.com/shop/hose-manageme ... ystem.html
About your model machine...tell us exactly what it says on the top of the machine up by the LCD screen and/or look on the side for a sticker that has a model REF number.
While it wouldn't be impossible for your doctor to be using the VPAP Auto for the centrals...highly unusual as it normally isn't used when centrals are in large numbers.
Normally the Adapt or maybe one of the higher end VPAPs (like S/T model) but if you had obstructives as well as central the Adapt would be my first thought.
In the equipment selection for profiles there is no option for the Adapt...and when that is what people are using we just tell them to add it in the comments section and leave the machine blank and just put the humidifier in the menu along with mask.
The Adapt is the S9 model name and you may not see the letters ASV but the Adapt is an ASV machine. We sort of use it interchangeably.
Your complaints aren't anything new that we haven't heard before and people have been able to sort through those issues. It may take some trial and error to find what suits you but it can be done.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
You can get Sleepyhead software for your computer where you can read your SD card and see your own data to find out if your therapy is optimal. Here is a link with information and if you have questions ask here and someone will help you. https://sleep.tnet.com/resources/sleepyhead
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Sleepyhead Software |
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
There is another related issue that I wanted to bring up. Might be worth a separate topic, but I figured I don't want to clutter up the forum, especially being so new here. I saw the topic on the importance of having a support team, which is something that I greatly lack, and could use some help with that. Probably my biggest problem is that my support group is so disjointed, often making it difficult to get them to communicate with each other, and get the job done. I hope this doesn't come off as whining and complaining, so I'll start with the positives.
The ones I'm most pleased with are my therapist and psychiatrist, who I mostly see about my depression, perhaps caused by or causes my sleep apnea. My therapist keeps her appointments on time, but still takes the time to make sure that we get to everything I want to talk about. She's not an expert in sleep at all, but she is helpful for her support. I'm also reasonably satisfied with my psychiatrist, in that, I'm satisfied with the service she provides. However, I'm not certain as to her competence, but I find that having a good relationship with any doctor is FAR more difficult to come by than that, so I stick with her. Still, she's just not getting the job done, for whatever reason. Maybe we just need to find the right balance of meds, but our current theory is that either I have treatment-resistant depression and/or the sleep apnea is preventing anything from working. I'm not sure if a psychiatrist really needs to be a part of my support team in treating my sleep, but I just thought I'd bring it up.
I'm quite displeased with my sleep specialist, DME, and primary care physician. For example, regarding the original problem in this topic, my sleep specialist was saying that I was just going to have to get used to sleeping in a different position. He never even mentioned ASV, a special pillow, or any means of coping with the transition, but I tolerate him, because at this point, I'm unaware of any other options. Still, when there are other options out there that he's not telling me about, I'm strongly concerned about that, especially when I'm at the mercy of what information he chooses to disclose to me. My DME and primary care physician are about on the same level.
How would you suggest upgrading my support team? It's so disorganized and disjointed that I don't even know where to begin. It feels like I have to do their job for them, following up with them, making sure they're doing the job I told them to do, like getting the referral to go through to make an appointment with a neurologist. If that's the way it is, then I'll keep doing the best I can to stay on top of things. It just strikes me as very unusual when I'm so impaired that I need a doctor to help me, I need to maintain constant vigil to make sure they do, yet if I had the judgment and lucidity to do so, I wouldn't have needed their help in the first place. It seems like a catch-22.
Any advice you can give about upgrading my support team would be appreciated. Thanks a lot.
The ones I'm most pleased with are my therapist and psychiatrist, who I mostly see about my depression, perhaps caused by or causes my sleep apnea. My therapist keeps her appointments on time, but still takes the time to make sure that we get to everything I want to talk about. She's not an expert in sleep at all, but she is helpful for her support. I'm also reasonably satisfied with my psychiatrist, in that, I'm satisfied with the service she provides. However, I'm not certain as to her competence, but I find that having a good relationship with any doctor is FAR more difficult to come by than that, so I stick with her. Still, she's just not getting the job done, for whatever reason. Maybe we just need to find the right balance of meds, but our current theory is that either I have treatment-resistant depression and/or the sleep apnea is preventing anything from working. I'm not sure if a psychiatrist really needs to be a part of my support team in treating my sleep, but I just thought I'd bring it up.
I'm quite displeased with my sleep specialist, DME, and primary care physician. For example, regarding the original problem in this topic, my sleep specialist was saying that I was just going to have to get used to sleeping in a different position. He never even mentioned ASV, a special pillow, or any means of coping with the transition, but I tolerate him, because at this point, I'm unaware of any other options. Still, when there are other options out there that he's not telling me about, I'm strongly concerned about that, especially when I'm at the mercy of what information he chooses to disclose to me. My DME and primary care physician are about on the same level.
How would you suggest upgrading my support team? It's so disorganized and disjointed that I don't even know where to begin. It feels like I have to do their job for them, following up with them, making sure they're doing the job I told them to do, like getting the referral to go through to make an appointment with a neurologist. If that's the way it is, then I'll keep doing the best I can to stay on top of things. It just strikes me as very unusual when I'm so impaired that I need a doctor to help me, I need to maintain constant vigil to make sure they do, yet if I had the judgment and lucidity to do so, I wouldn't have needed their help in the first place. It seems like a catch-22.
Any advice you can give about upgrading my support team would be appreciated. Thanks a lot.
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Re: Sleeping on Back w/BiPAP (Central Sleep Apnea)
As an employer, your job is to evaluate your team. If they don't meet up to the "job description" and expected activities it is time to send them on their way and hire new positions to complete your support team.
I will add that sometimes it is difficult to find good help...
I will add that sometimes it is difficult to find good help...
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SpO2 96+% and holding...