Stomach sleeper and mask advice?

[paul9123]

Hi all,

Newly diagnosed (AHI 120) and new to the forum.

I get my machine on Thursday. I don't know the brand name of the mask I was fitted with at my titration but it covered the nose and mouth (I'm a mouth breather) and then went up the bridge of the nose and into a t shape across my forehead. I started having panic attacks wearing this mask because the tech changed sizes on me in the night, cinched it down really tight to prevent leaks, and then hit me with the CPAP at full blast a couple of times.

Today I asked the doctor for a nasal pillow mask that covered the mouth as well. I was told that was a "Liberty" mask. Good idea, bad idea?

Also, I normally sleep on my stomach. I spent a great deal of the night at the study on my back due to the wires, and all of the night at the titration due to the mask. Am I wrong, or would stomach sleeping actually reduce the number of apneas? Am I ever going to be able to sleep on my stomach again?

Thanks all
Paul

[Pugsy]

The Liberty mask would be a good compromise for someone that has a problem with the over the nose full face mask and is also a mouth breather. It has the freedom of the nasal pillows but also covers the mouth to prevent pressure leaking out the mouth.

You can still sleep on your stomach. It takes a bit of practice to get positioned comfortably. One of the members here called Rooster has some in depth comments about doing this very thing. I just imagine he will be along later and explain it to you. He uses a mask very similar to the Liberty I believe.

Sleeping on your stomach or on your side can reduce apneas if they are worse because of position. It is common to have more events while on your back but not everyone will have markedly different positional related apnea events.
Some may have more events during REM sleep, this is also quite common. Some people will have more events when REM sleep is combined with sleeping on their back.

When you do get your equipment please add it to your user profile information and let us know how you are doing. I am sure you will have other questions pop up.
Welcome to the forum.

[roster]

It is thought that about 40% of OSA patients have Positional Sleep Apnea (PSA). The severity of their OSA is greatest when these patients sleep on their back and less severe when they sleep on their sides or tummy. Also, when using CPAP, their pressure requirements may be lower (See viewtopic/t43360/viewtopic.php?f=1&t=43 ... 79#p384179 ).

I sleep on my tummy using the Falcon position (See viewtopic.php?f=1&t=36738&st=0&sk=t&sd=a&start=15 ).

I use the Hybrid mask and have very few problems with leaks. The Liberty is a copy of the Hybrid mask. The Liberty has some differences in design to get around the patent on the Hybrid. I prefer the Hybrid but other prefer the Liberty. One very nice feature of the Hybrid is that it comes with three sizes of mouthpieces and three sizes of nasal pillows. You can try the different sizes and find the best for yourself.

I can give you some tips for sleeping with a mask in the Falcon position and some tips on using and adjusting the Hybrid mask if you decide to go that route.

BTW, do you understand the importance of getting a data-capable machine, card reader, and software?


Good luck,

[Julie]

Hi, a few years ago I ordered a 4" high slab of foam to go on my mattress. It was a good quality one (it's rated in terms of lbs (2,3,4) rather than just 'density') so it would last and be comfortable - can't remember which one I have now. Anyway, I cut out (with an electric turkey knife) a 3" wide trough starting at the top middle and extending towards the bottom by about 10 inches. It has since gotten somewhat wider and I also played with shaving the sharp edges, etc. (something you have to do on your own of course - just don't cut til you're sure!).. It's worked great so far, especially as I use an UltraMirage FF mask that vents not from the right angle of the elbow (as so many do), but from somewhere else where the vent isn't blocked by covers, or the mattress. Mostly the left side of my face is on the mattress (slab) but tilted into the trough (in other words, not straight up and down). I did it because when I tried sleeping without it, I couldn't - the mask, if it didn't break someplace, just dug into my face (beyond the usual and/or the hand I tried to use to help things, and I knew I needed a 'hole' somewhere. Anyway, that's it. Hope you find the right way for you! PS - the slab covers the whole mattress (and does slide around over time - need to rearrange it every few days, no big deal.

[paul9123]

Thank you all for the advice and making me feel welcome! I am eager to get started and get healthy.

Rooster, I would like a data capable machine, but unfortunately I had not heard of them until AFTER I left the doctor's office yesterday otherwise I would have specified that up front like I did with the mask. I don't know what I am going to get on Thursday. I will push back and pitch a fit until I get data capable. I would also like CF, that sounds like something that might help me.

Will keep you posted!

[DarkSideOfTheMoon]

Hi Paul,
I am a faithful and committed stomach sleeper. I think it saved my life while waiting 2 decades for a diagnosis. I used to need 3 pillows to prop me up and it was probably to lessen the apneas. I use a petite nasal mask with a small profile. I find that if it just fits over my nose (I call it a nose cozy then I can sleep on my stomach. I have to maneuver my pillows just right (one boomerang pillow, one small neck roll one and one normal pillow with the corner folded under) but when I get in my sweet spot....AHHH!!!

My first night on CPAP I tried sleeping on my back and had pillows under my knees. I woke up sobbing like I had just had the wind knocked out of me. I was not used to remaining in one position for so long and my back was KILLING ME. I knew this crap was NOT going to work and I'd better start working on a solution. My husband knows to wait 10 minutes after I get in bed to join me because of my mask fixing, pillow fixing, hose whipping to get comfy.

I am working on nasal pillow masks next with my NEW DME provider. firing my current one. I have a relatively high pressure of 15 and small nostrils. I think it might be the ticket though.

Cathy

[roster]

..... I will push back and pitch a fit until I get data capable. I would also like CF, that sounds like something that might help me.

........

Good for you. I advise people to say, "I will not use CPAP unless I get a machine that is fully data capable so I can monitor my therapy. I will not use CPAP unless I have data to show it is effective."

Sometimes insurance companies rent your machine for an initial period to make sure you are going to stick with CPAP. Then after that, they purchase it. If your machine is still "rental", then you need to bring this issue to a head before your insurance company buys the machine. At that point you would be stuck.

I don't know what you mean by "CF".

[Guest]

I don't know what you mean by "CF".

I butchered that with all the new terminology I am learning. I meant "C-Flex". From what I can gather some machines take a little pause to help you exhale?

I had a bad time the night of my titration because the three or four times the technician came in to adjust the mask, he forgot to ramp up the CPAP again and instead hit me full blast with the pressure. I could not exhale. After this happened once or twice I started to get panicked when he put the mask on. Very concerned about adjusting to CPAP but it's that or die early, so I guess I'll adjust.

Anyway the idea of a little exhale pause sounded good to me.

[samofny]

I sleep flat on my stomach with a low pilow. The ComfortLite 2 has been great for me; http://comfortlite2.respironics.com/

[old64mb]

Newly diagnosed (AHI 120)...Am I wrong, or would stomach sleeping actually reduce the number of apneas?

Maybe.

I'm not sure where Rooster has come up with his 40% number for overall positional apnea - there are several journal articles starting in 1985 that suggest 50-55% - but the standard reference is a Chest journal article from 2005 which came up with split numbers depending on how severe your case is. Mild apnea (AHI < 15) runs about 50%, moderate (15-30) 20%, and severe (30+) about 5% positional. Another study in 1997 suggested that if someone is obese they are a lot more likely to be non-positional, and in fact losing weight helped a lot. Those who did saw their AHI drop during side sleeping long before any help on their back, and several eventually dropped enough weight to turned into positional patients.

This corresponds with what the Stanford people prescribe, which is that if you're mild and positional they'll generally try tennis balls in a tshirt to force you away from your back along with a dental device or surgery, but anything over 15 and it's xPAP.

The only way to really tell is to look at your sleep study and see the breakdown of AHI by position. In my case, I wasn't aware that I was positional until I looked at my side sleeping and saw an AHI of 0.0 on my right and <2 on my left side, but my back was a disaster. (It also explains how I was functional and remained undiagnosed for so many years, and why I was so picky about beds when I was traveling so much for work - my hate for hard beds had a very good source, which is that after a full night on my back I'd be a zombie on top of the normal issues with traveling.)

It's also why I tape/denture cream and use nasal pillows, because with a full face mask or hybrid I'll either wake up several times during the night from it cutting into my face as I'm moving back and forth between side or stomach sleeping, or even worse when I'm really out of it will spend the entire night on my back. Since my goal is to spend as much time as possible on my sides and stomach with uninterrupted sleep, while I have a hybrid for traveling and naps and colds and such, for full nights I'm usually far better off taping. Repeated posts here indicate nasal pillows are an awful lot easier for stomach sleepers to tolerate than any other mask, and my experience bears that out in a big way.

In your case, it's probably a good thing to try to sleep on your stomach, but with your extreme score it's probably most important to get a good mask fit to deal with your mouth breathing and get the pressure right to keep the airway open in all positions. Then you can get a specialized pillow with cutouts if there's a problem sleeping on your side or stomach and worry about what position you should be going for...in that order.

[paul9123]

I think I did good. I got a Mirage Liberty mask and a S8 Elite II. I was told this was a high end machine -- it certainly had all the features I wanted. Didn't have to argue over anything, it was there waiting for me when I met the technician. Just tried on the mask, no panic attacks on ramping up, so I turned it full blast. No problems. Will need a little practice getting the nose pillows just right, I think.

[roster]

I think I did good. I got a Mirage Liberty mask and a S8 Elite II. I was told this was a high end machine -- it certainly had all the features I wanted. Didn't have to argue over anything, it was there waiting for me when I met the technician. Just tried on the mask, no panic attacks on ramping up, so I turned it full blast. No problems. Will need a little practice getting the nose pillows just right, I think.

Paul,

You did very well on the first try. Now I would ask the ResMed users here how to get the software and necessary hardware to thoroughly monitor your therapy.

Regards,

[paul9123]

First night was fantastic...my wife woke me up at 5:30 am because the mask was making all sorts of noise and she thought I was leaking, plus I was lying on the hose and she was afraid I'd strangle myself. In fiddling with the mask I got the left pillow out of whack and could not get it back, so I just got up.

I don't think I have EVER felt as good as I felt Friday. Full of energy, alert, ready to take on the world. Weird feeling in my upper body as if I had been inflated. No swelling or gas or anything.

Last night was the opposite--disaster. Created a hose hanger out of a elastic headband tied to the headboard, that seemed to work ok. I don't know if it was related to the hose hanger or maybe I'm just over my fear of the pressure or something but it just felt like I was not getting enough pressure.

Woke up at one point with my face buried in the pillow, oops.

Woke up again later to pee.

Woke up again at 5am with the mask making all sorts of noise and started looking for leaks. Started wondering if maybe after all night at the pressure (12) the mask just gets really leaky and loud. Couldn't get things sorted out, did as best as I could, slept a couple more hours, and I feel miserable today. Actually, I feel just like I've felt every other day of my life before being diagnosed, but now that I know how good a good night's sleep feels it's depressing. Absolutely crabby today.

The tech at the sleep clinic started me out on the small nose pillows, I'm going to try medium tonight and see if it makes a difference. Also read the manual on the machine and found out how to work the mask test, will try that.

Is there a way to see your leak rate on the CPAP? I know how to get into the clinical menu, saw a leak rate option in there, chose it but it said NO DATA. Said NO DATA for all of the options. I had unplugged the machine briefly this morning, I don't know if that's why. I would like to get the ResScan 3.7 software but the $200 isn't going to happen right now.

[twokatmew]

Unfortunately some nights are like that, Paul. I have one or two good nights and think I'm starting to get the hang of this, and then I have one or more horrendous nights and start feeling blue again. Only three months in, though, so there's hope. In fact, there's always hope, right?

Welcome to the forum!

BTW, for software and card reader, see:

http://www.cpapaustralia.com.au/shoppin ... 31305.html

https://www.cpap.com/productpage/resmed ... -cpap.html

ResMed has stopped the sale of ResScan to patients in the US, thus we've been buying it from Australia -- at half the price!