Why Sleep Apnea Victims Cannot Sleep On Their Backs?

[mcpascaln]

After my diagnosis of sleep apnea, a doctor provided some instructions one of which included not sleeping on my back. Please, why sleep apnea victims are forbidden to sleep On their backs?

[Xney]

Obstructive Sleep Apnea (OSA) tends to be worse on your back - often, a LOT worse.

It's not true for everybody, though.

[PST]

The throat closes more easily in that position. Typically, higher air pressure is needed to keep one's breathing free and easy when using CPAP on your back. Higher pressure means more chance of air leaks and more discomfort. The more you can sleep on your side (especially the left side, if I remember correctly), the less air pressure necessary for effective therapy. It's now second nature for me, and I think that's true for others.

I try not to think of myself as a sleep apnea victim any more than I think of myself as a nearsightedness victim. I realize that kind of comment can make me sound like some sort of PC jerk or like criticism, but honestly I mean well. After a while everyone has some health issues. Fortunately, we now have tools to avoid most of the disadvantages. It is a medium level problem with a rational solution, made easier with the advice of others who have dealt with it already.

[Pugsy]

Supine sleeping can make OSA worse...lead to more obstructive events and/or need for greater pressure to prevent those events.
Some people will have a huge pressure difference needed with supine sleeping...some people won't have any pressure difference needed.
Some people will have a much larger number of events happen with supine sleeping and some people it doesn't make much difference in the number.

That said...I sleep in whatever position I want to sleep in because getting sleep is my primary goal and I let my machine do what it is designed to do...prevent obstructive sleep apnea events. Due to arthritis issues...staying in one position (on my side) for the entire night leads to greatly increased pain which is much worse for my sleep architecture than having a few events slip past the machine's defenses. I have done some experiments with trying to stay off my back for the entire night. No real change in pressure needs nor any changes in AHI. Just because something CAN make things worse doesn't automatically mean that it will for sure make things markedly worse.

Now if I had major pressure differences needed when sleeping supine or AHI was hugely higher at my given pressure range then I might try something different.
Back when I broke my wrist and had to have surgery to fix it I could only sleep on my back for the entire time I had the cast on for 6 weeks...my AHI wasn't one tiny bit worse nor were my pressure needs really any different than at other times. If my OSA was worse on my back...it didn't show up on my reports as my machine did what it was designed to do.

I do know of one person who needs a pressure of 19cm when supine sleeping and only 9 cm when sleeping on their side.. I don't blame them at all for doing whatever it takes to stay on their side. That's a no brainer.

I sleep in whatever position I want. It's not like I wouldn't have any events at all if I stayed on my side anyway. Since I need the machine even with side sleeping...might as well let it earn its paycheck and just do its job when supine sleeping.
Getting those hours of good sleep has always been my primary goal. However many events the machine prevents (and I never know about the prevented ones) becomes a secondary issue.

[joeyjernigan]

Body position can affect the number and severity of episodes of obstructive sleep apnea, with at least twice as many apneas occurring in people who lay on their back as in those who sleep on their side. This may be due to the effects of gravity, which cause the throat to narrow when a person lies on the back.

Source: http://www.umm.edu/patiented/articles/w ... z2GwrkQnkZ

[mcpascaln]

You all pals and gals are awesome. You bring real life experiences here.Its like gold and silver to me,

[Carmen]

Having just spent way too much time in the hospital, my advice is to learn what pressure settings work for you on your back and learn to sleep on your back. When you're trapped in a hospital bed with drains and IVs, you really don't have any other choice of position and the hospital respiratory people are not very helpful.

[PST]

I think all the posts here, and especially Pugsy's, show why people in this forum are so uniformly sold on machines with full data capabilities. They let us find out the answers to questions like whether sleeping on our backs makes our apnea worse and then we can adjust. I'm dialed in now and I just check once in a while, but for the learning period and the first year the charts and graphs meant a great deal.

[xenablue]

After my diagnosis of sleep apnea, a doctor provided some instructions one of which included not sleeping on my back. Please, why sleep apnea victims are forbidden to sleep On their backs?

Best thing you can do is get a copy of your full sleep study and results - it will surely tell you whether your OSA is worse when sleeping on your back or not.

cheers,
xena

[hopingitworks]

my advice is to learn what pressure settings work for you on your back and learn to sleep on your back.

When I was diagnosed with OSA 4 months ago I could still sleep on one of my shoulders and my back. Soon thereafter I could only sleep on my back because of issues with both shoulders. For many years I had only slept on my stomach, which was my preferred way to sleep.

I had a home testing kit to diagnose my OSA when I could still sleep on one shoulder without pain. The night of the test I propped up pillows to prevent myself from rolling onto my back where I felt, for sure, that my numbers would be higher. I was diagnosed with 31 events/hr and prescribed a machine with 7.8 cm/H20 while sleeping on that shoulder. Since then I have been confined to sleeping on my back (problems with both shoulders now) and that same pressure seems to control my AHI (no increase in pressure was required).

[archangle]

Many people get more apnea when sleeping on their back. Part of this is that gravity pulls your tongue and other tissues back and tend to make your airway collapse.

Learn how to monitor your results that your machine records every night. That's a good thing to do anyway, but it will help tell you whether your CPAP is preventing your apnea whether you sleep on your back or not.

Many of us sleep on our backs anyway and check our results to make sure the CPAP is still preventing apneas.

I forget how you can monitor your results with the F&P machine you have, but you can get at least some info out of it.

[mcpascaln]

Many people get more apnea when sleeping on their back.

In effect, you are stating that sleeping on the back can cause sleep apnea in non-sleep apnea people? Sorry for misunderstanding, are you meaning that people already with sleep apnea register increased incidents of sleep apnea when they sleep on their backs compared to those who have sleep apnea but sleep on their shoulders?

[wm_hess]

Many people get more apnea when sleeping on their back.

In effect, you are stating that sleeping on the back can cause sleep apnea in non-sleep apnea people? Sorry for misunderstanding, are you meaning that people already with sleep apnea register increased incidents of sleep apnea when they sleep on their backs compared to those who have sleep apnea but sleep on their shoulders?

Hi

By diagnosis (OSA), we're already in a group of people whose soft tissues in the throat collapse when we sleep and our muscles relax.

Sleeping on your back makes it easier for your soft tissues to collapse, and because you belong to a group of people who already have problems, the chances of you having increased problems are already increased.

Think of it this way, imagine a recovering alcoholic, and a social drinker in a bar. Who's more likely to get in trouble if they have some booze? The chances are the recovering alcoholic is going to have more problems with drinking than a social drinker. Same for us, and sleeping on our backs. We're already more likely to have issues with our breathing, and sleeping on your back, you're making it more likely to have additional problems.

Having said that, I also sleep on my back most of the time due to hip bursitis on one side, and shoulder on the other. I've yet to figure out how to sleep on my head, so I'm running out of positions to sleep in. I let my machine do it's thing, and my average AHI is under 1. My sleep study pegged me at 26 AHI supine (on my back), and 17 on my side.

-Bill

[zoocrewphoto]

Like many others, my sleep apnea is worse on my back. My average ahi at the sleep study was 79. On my back, it was 99. Because of this, I was prescribed an apap machine with a range of pressures. If I sleep on my side, a pressure of 11-13 pretty much takes care of all my apneas. But if I sleep on my back, it sometimes goes up to 17. So, my pressure range is 11-17. This works really well for me as I only have to use the higher pressure when i am on my back. It takes care of me when I put myself into less than ideal situations. I do tend to sleep on my side more with my machine than before. I think my brain knows that my jaw falls open further than normal, and that causes my cheeks to flap in the higher pressure. So, I tend to turn back onto my side when that happens.

[kteague]

Many people get more apnea when sleeping on their back.

In effect, you are stating that sleeping on the back can cause sleep apnea in non-sleep apnea people? Sorry for misunderstanding, are you meaning that people already with sleep apnea register increased incidents of sleep apnea when they sleep on their backs compared to those who have sleep apnea but sleep on their shoulders?

The person who has apneas only when supine still has sleep apnea, but it is called positional sleep apnea. A person who truly only experiences events when on their back can take steps to assure they never roll onto their back while asleep. I have more events when supine, but not many more. My side sleeping events are still in the severe range. Everyone is different. For one whose testing has indicated positional sleep apnea, I would suggest they do some temporary monitoring at home to be sure that night in the sleep lab was really representative of their usual sleep. One could get a loaner autopap for a week or two and see if the pressure rises during the night, or use an oxygen monitor overnight to see if there's any drops. It's just about being sure before deciding to forego using a CPAP when their apnea appears to be positional.