Thought I had back sleeping problem but turns out it's rem sleep disorder

Edit: My thread started out originally as a possible supine/back sleeping problem, but it turn out the major culprit was a serious rem sleep problem so that's where the discussion has turned. The first few pages are about supine sleeping and starting the last post of page 3 it turns to rem sleep problems. I'm no longer focused on supine sleeping since I need to figure out the rem problem first. Then possibly the supine sleeping won't be an issue at all, I hope. Decided to change the title and continue on with this thread so everything is contained here and shows the progression, discovery and hopefully treatment then recovery.





I've been on cpap for several years and still struggle with sleeping. My pressure is good and ahi is real low. From looking at my breathing waveforms I still struggle to breath when sleeping on my back. Breathing waveforms are erratic and I can remember waking up like 5-12 times a night. Most nights are like 7-8 times that I can remember. So the nights are pretty restless still. I've never seen the machine go above 14cm pressure even though the max is set higher.

In the past one of my sleep docs said I probably could go without the machine if I sleep on my side. My waveforms are perfect when I'm side sleeping.

My whole life I've been a back sleeper, but having apnea for several years I've trained myself to side sleep. The problem is that apparently I've become an active sleeper and move around a lot in bed. Back when I slept great before apnea I barely moved all night and slept like I was in a coma, nothing would wake me. Every time I go to sleep or go back to sleep, I do it on my side. While I'm completely asleep I somehow end up on my back, struggle with breathing and wake up because of it. I might wake up 8 times in a night, always waking up on my back. I'll go back to sleep on my side and somehow end up on my back. I can't believe I move around that much.

Has anyone had to deal with this problem and what can be done? I have read about the tennis ball trick, but I suspect it would cause a person to wake up which is what I need to avoid. I've seen electronic devises that will vibrate when you move to your back. That doesn't solve my problem if it wakes me up. Maybe deep v shaped mattress would keep me from rolling. lol

I also have had a lot of years of hard labor and many aches and pains when I sleep. I can't sleep all night on one side or in one position anymore so I need to be able to change positions during the night when I wake up. The main thing is to figure out how to stop the back sleeping position if possible.

Don't know if it would work for you, but what about (temp of course) a backpack stuffed with e.g. towels?

OR, viewtopic/t70205/-Mars-Given-OK-On-Posi ... rapy-.html

From 2011 - he's long gone from the forum and won't be looking at it any more, nor waiting for e.g. PMs, etc, but... it's an interesting story you might want to read.

There's a lot of stuff you can ignore - doesn't meaningfully pertain to you or even the subject really, so ignore, but what does apply, applies.

With age, I get pain. I accept that, but I don't have to bear what I can relieve.
Ibuprofen helps, but my cpap lets me sleep in whatever configuration that feels best.
Enough sleep helps with pain, immunity, etc.
After my breast surgery, I could not sleep on either side for several weeks to ensure symmetry.
My shoulders bedevil me fairly often--
OMG--this machine makes my life worth living.

Most of my efforts to not back sleep were futile. I could lay on something REAL uncomfortable and sleep right through it. Making my space narrow didn't help. If you seriously want to stop, I'd say something that would cause pain if rolled on would probably stop you but makes it hard to roll over to change sides. I became able to back sleep without repercussions by mastering the technique of keeping my tongue sealed to the roof of my mouth. Guess that helps keep my tongue out of the back of my throat.

I use a tennis ball with a pocket on the back my wife sewed on..... I cut the ball in half and it's not as painful when you roll on your back.

How is it that some of you can sleep on your back and not have to worry about it? That doesn't seem to be the case for me. My machine doesn't seem to take care of it. My breathing is pretty messed up still and I wake a bunch when I'm on my back. AHI is below one most every night. The machine is set to auto with a maximum pressure of 15cm. Not once have I ever seen it go above 14cm. Most of the time it is less.

I've been studying my breathing with Oscar. I get 1/2-1hr long periods where things look bad and that is where I'm waking quite a bit. The breathing kind of looks like I'm awake the whole time, but I'm not. I wake up long enough to turn over and adjust things and go back to sleep. Whenever I wake it's on my back and during one of the periods with poor breathing. I'm at a loss to figure out what's going on so figured I'd ask for help.

Here's a sample of what things are looking like. Chart 1 shows those blocks of time with poor breathing and clusters of events. Sometime those blocks of time are shorter and more frequent. I suspect I'm on my back a lot more during those nights. Chart 2 is zoomed in more and shows that things are not looking good. Chart 3 more zoomed in. Breathing varies a great deal.

Julie, thanks for the link on positional therapy. I'm going study up on it more now that I'm seeing there are more options than just side sleeping. One thing that I figured out on my own and that I do all the time is curl the bottom of my pillow up between my shoulder and neck when I lay on my side. It seems to give better support and head position. I supposed that is what the dedicated cpap pillows do.

Others know more about this than me, but it may be that you chin tuck while laying on you back and/or your side. Lots of folks here find that using a soft cervical collar is a great help. Here's a nice example:

https://www.amazon.com/gp/product/B07MY ... UTF8&psc=1

I was able to borrow an old iphone from a friend and I installed the Somnopose sleep position app. I used it for two nights now. I'm moving around a lot during those blocks for time when my breathing is all over the place. Somnopose shows that I'm sleeping on my side but end up on my back due to a lot of movement, breathing continues to get worse until I completely wake up which by then I'm on my back. This made me think that back sleeping was causing the wake ups, but possibly it's something else. The movement is always accompanied by a lot of irregular breathing and flagged events.

I've read that if one struggles to breath that it can cause jerky body movements which appears to be happening based on the Somnopose graphs.

I also wonder if this is a REM sleep problem since things seem to start going bad when I'm on my side. I was told my apnea is worse during REM sleep. There's no way for me to accurately track my sleep stages. A lot of do it yourself devices claim to but obviously they do it with little accuracy.

I was also reading about rem sleep disorder. Your body doesn't produce the proper chemicals to paralyze you during the rem stage and keep you from acting out your dreams.

Will continue to monitor sleep position and it's affects for a while. Is something causing irregular breathing, movement and wake ups? Is the irregular breathing causing the movement and wake ups? What direction should I go with this information?

I kind of feel like the next thing I should be trying to figure out is what do to about REM stage breathing problems since there is a good chance that is what's really happening.

I was just reviewing my sleep lab charts and apnea is worse on my back. Somnopose would suggest that also. So my guess is I go into REM while on my side, poor breathing during rem is causing me to move a lot and end up on my back for the double whammy. Some of this is speculation so if anyone has any suggestions or insight I sure could use it.

Rob K wrote: ↑

Tue May 12, 2020 8:16 am

I was just reviewing my sleep lab charts and apnea is worse on my back. Somnopose would suggest that also. So my guess is I go into REM while on my side, poor breathing during rem is causing me to move a lot and end up on my back for the double whammy. Some of this is speculation so if anyone has any suggestions or insight I sure could use it.

I'm seeing an AHI of 0.51. You're dialed in. So I think you're on the right track that this is less about machine settings and more about other things that lead to better sleep.

If you are currently at this low an AHI on a regular basis (well managed), I'm not sure positional sleeping is the answer. By all means, give it a shot, but REM happens regardless of position. I wonder if it wouldn't be worth exploring causes of chronic pain and attempting to evaluate, eliminate and/or treat those aspects of chronic pain as a wake trigger.

Also, a question for those who know -- UF1 and UF2 on Vauto are apparently for Flow Restriction 20% and Flow Restriction 50%. If these flags are about flow limitation, why are they not seemingly creating a rise in pressure?

Apnea is always higher on your back (anyone's), so didn't realize you didn't apparently know that up front, but in any case, look again at suggestions made earlier in this post.

I've heard that apnea is worse on one's back but never actually seen the evidence until now. Now that I can track my sleep position and since I just reviewed my sleep lab graphs from several years ago that also shows sleep position.

DreamDiver wrote: ↑

Tue May 12, 2020 9:21 am

Also, a question for those who know -- UF1 and UF2 on Vauto are apparently for Flow Restriction 20% and Flow Restriction 50%. If these flags are about flow limitation, why are they not seemingly creating a rise in pressure?

UF1 & UF2 are generated by Oscar when I upload the sd card data. That was a setting in the preferences. It's a way to show events that are less than 10 seconds that supposedly the machine ignores. UF1 & UF2 have nothing to do with the Vauto. I have UF1 set to 20% flow restriction and only shows a flag between 8-10 seconds. UF2 is 50% flow restriction and I also set to only show a flag between 8-10 seconds. I don't know much about it but I'm guessing the machine doesn't ramp up the pressure until the event is 10 seconds or more.

I just read that breathing can be erratic during rem sleep. So maybe the breathing is not to unusual but possibly the amount I move around in my sleep is. The docs did say I had some limb movement during the sleep studies but not bad. It's been several years so possibly it has gotten worse. I have read it can get worse with age.

I'm struggling to get the Somnopose .csv files from the iphone to my Windows 10 computer. I'm fairly computer savvy since I built my own computer. I'd really like to show you all how much I move around in bed when I'm sleeping. Sometime the phone will shift as much as 20-30 degrees while strapped tight to my chest. I seem to be getting a good workout at night. lol This is possibly the root of the poor sleep and frequent wake ups. Maybe I'm getting somewhere with this finally. Maybe should be looking at getting a video camera next since I live alone. Or a partner, then I can kick her in my sleep. That would go over real well I'm sure. lol