Discussion on positional sleep apnea?

[beyondtired]

I wanted to talk a little about positional sleep apnea. On my sleep lab test, it was shown that I had mild sleep apnea with an AHI index of 12.9. This was all from hypopneas and no apneas. The supine AHI was 10.2. This means that my
non-supine AHI was only 2.7. So that basically means if I don't sleep on my back at all, I wouldn't have sleep apnea right?

During the study, I moved around to my sides and my back. I wasn't really able to sleep on my stomach with all those wires and everything. At home, I believe that I normally sleep on my sides and stomach more so than I do on my back. Maybe I move to my back at times during the night, it can be hard to tell while sleeping. I only had 3 minutes total of REM sleep during the sleep test though, so if I would have slept more in the REM stage, maybe my AHI would have possibly been higher?

[Pugsy]

I only had 3 minutes total of REM sleep during the sleep test though, so if I would have slept more in the REM stage, maybe my AHI would have possibly been higher?

Yes it is possible.

Some people are much worse in REM sleep. Others not much difference.

I scored 11 AHI in non REM sleep and 53 AHI in REM and I didn't have much REM either but I had more than 3 minutes. There is a way that the sleep doctors take the amount of sleep in REM and extrapolate it to get an hourly index. Example 30 minutes of REM with 20 AHI would multiply out to be 40 AHI because we multiply 30 times 2 to get the 60 minutes. It's a rough estimate but sometimes the best we can do when we are worse in REM and the events keep coming and waking us up out of REM.
If you had any events in REM at all during that 3 minutes you can multiply it out and see what it might have been. It isn't exact but would maybe give an idea.

[beyondtired]

Thanks for the reply. It said that I didn't have any AHI in those 3 minutes of REM sleep. It would have been nice if I would have slept a little longer in REM to get a better idea though. Cause normally at home I can remember dreaming a lot everytime I sleep. But the atmosphere of the sleep lab and all must have caused me to have less REM sleep than normal.

I thought that my sleep test would have mentioned something about having positional sleep apnea though? Are some people able to not sleep on their backs at all anymore by using different techniques?

[beyondtired]

Is this pretty common to have?

[Otter]

I wanted to talk a little about positional sleep apnea. On my sleep lab test, it was shown that I had mild sleep apnea with an AHI index of 12.9. This was all from hypopneas and no apneas. The supine AHI was 10.2. This means that my
non-supine AHI was only 2.7. So that basically means if I don't sleep on my back at all, I wouldn't have sleep apnea right?

I muddled along for years by sleeping only on my side. Not only was I not aware that I had OSA or UARS, I'd never heard of them when I trained myself to sleep on my side. I just didn't want to keep my girlfriend awake. But it worked very well. In hindsight, though, I waited much longer than I should have to do something about my OSA. If you find that even in REM sleep you don't have OSA unless you're on your back, and you opt for positional therapy instead of PAP, be alert for changes. Just because you don't have apnea on your side now doesn't mean you never will.

It said that I didn't have any AHI in those 3 minutes of REM sleep. It would have been nice if I would have slept a little longer in REM to get a better idea though. Cause normally at home I can remember dreaming a lot everytime I sleep.

I wonder how much you actually dream. I thought my OSA couldn't be very bad because I remembered dreams. Obviously I was getting REM sleep, right? But now I'm fairly sure that for at least the last few years, I remembered my dreams because my OSA woke me up shortly after I went into REM. You may dream often, but how far into your dreams do you usually get?

[BryanC]

I questioned my doctor on sleep positions. Actually, my WHOLE REASON for going in for my last test was for me to find out if I was better or worse on my side/stomach or back. The doc didn't really seem to care about my request for that information. BUT, when I sleep on my side or stomach, I get much better sleep, my CPAP shows a lot less OA's happening, and I've started dreaming again, almost every night...

Now, the thing about Dreams is, they don't happen in real time. We can have a seemly week long dream in a matter of minutes, kinda like it happens on TV and at the movies, our mind just 'fills in'... At my sleep study, I got 0 REM sleep. heck, i think I only slept 2 MAYBE 3 hours during the study, which they insisted was long enough. but I had to readjust my pressure when i got home, cause the pressure they picked wasn't working good enough.

anyways, with all that aside, whether it means anything or not, I definitely sleep in longer 'chucks' sleeping on my side or stomach. (did this answer any of your questions? it's late, and I need to be headed for my machine )

[DavidCarolina]

I may fall into the rare category, but sleeping on my back is the absolute worst thing I can do.

Im a natural back sleeper, so I rig up ties to my belt loops so that I cant roll over in sleep!!!

Apparently my soft tissues are so soft that ......even with cpap, I will snore and have APNEAS WITH
the mask on.

I do everything i can to sleep on my stomach, even though it causes mask leakage consistently.

[greg-g]

From your sleep test how were your SpO2 results.
Hypopneas can cause significant reductions in blood oxygen which aren't good.
I convinced myself of my Sleep Apnea by making an Infra Red video of my sleep while using a recording SpO2 meter.

[roster]

I wanted to talk a little about positional sleep apnea. On my sleep lab test, it was shown that I had mild sleep apnea with an AHI index of 12.9. This was all from hypopneas and no apneas. The supine AHI was 10.2. This means that my
non-supine AHI was only 2.7. So that basically means if I don't sleep on my back at all, I wouldn't have sleep apnea right?

During the study, I moved around to my sides and my back. I wasn't really able to sleep on my stomach with all those wires and everything. At home, I believe that I normally sleep on my sides and stomach more so than I do on my back. Maybe I move to my back at times during the night, it can be hard to tell while sleeping. I only had 3 minutes total of REM sleep during the sleep test though, so if I would have slept more in the REM stage, maybe my AHI would have possibly been higher?

Subtracting the supine AHI from the total AHI will not correctly calculate the non-supine AHI, so 2.7 is not necessarily the correct number. However, it is likely that your non-supine AHI under normal sleeping conditions is much lower than your supine AHI.

You could get a copy of your sleep study and check how many minutes you slept in non-supine positions, how many of these minutes were in which sleep stages, and what the AHI was. It sounds like this would be a small sample and therefore inconclusive about the severity of your condition while sleeping in non-supine positions.

There are tactics to force non-supine sleeping only:

Some use a tennis ball sewn into the back of a shirt. I can sleep on a tennis ball so instead went to the more extreme measure of wearing a small backpack. It is actually a CamelBak with a large rigid plastic bottle inserted. I sleep the first half of the night in the Falcon position, http://www.uarsrelief.com/sleeppositions.html, and highly recommend it.

Except for the issue of cost, it would be good to have another sleep study where you take a sleep drug to ensure sufficient sleep and sleep exclusively in non-supine positions.

At home you might want to try sleeping exclusively in non-supine positions and see if your symptoms go away.

Your experience in the sleep lab shows how poorly prepared sleep labs are for making a thorough diagnosis in one night.

[Lizistired]

Now that my therapy is effective, I sleep on my back more and get better rest. My joint pain has lessened noticeably. I hadn't slept on my back in years and never realized it was because I couldn't breathe. Duh.

[roster]

I hadn't slept on my back in years and never realized it was because I couldn't breathe. Duh.

Most doctors don't know this. Many of the post-surgery deaths are because the patient is stuck in a hospital bed and forced to sleep on their backs for the first time in years. The stress of this and the surgery kills them.

Same is true with broken hips in nursing homes. The patients have to sleep on their backs for a long recovery period and the stress of old age and sleep-disordered breathing does them in.

[beyondtired]

I wanted to talk a little about positional sleep apnea. On my sleep lab test, it was shown that I had mild sleep apnea with an AHI index of 12.9. This was all from hypopneas and no apneas. The supine AHI was 10.2. This means that my
non-supine AHI was only 2.7. So that basically means if I don't sleep on my back at all, I wouldn't have sleep apnea right?

I muddled along for years by sleeping only on my side. Not only was I not aware that I had OSA or UARS, I'd never heard of them when I trained myself to sleep on my side. I just didn't want to keep my girlfriend awake. But it worked very well. In hindsight, though, I waited much longer than I should have to do something about my OSA. If you find that even in REM sleep you don't have OSA unless you're on your back, and you opt for positional therapy instead of PAP, be alert for changes. Just because you don't have apnea on your side now doesn't mean you never will.

It said that I didn't have any AHI in those 3 minutes of REM sleep. It would have been nice if I would have slept a little longer in REM to get a better idea though. Cause normally at home I can remember dreaming a lot everytime I sleep.

I wonder how much you actually dream. I thought my OSA couldn't be very bad because I remembered dreams. Obviously I was getting REM sleep, right? But now I'm fairly sure that for at least the last few years, I remembered my dreams because my OSA woke me up shortly after I went into REM. You may dream often, but how far into your dreams do you usually get?

I believe that I do get pretty far into some of my dreams. Or at least it seems like I do. I also thought that my sleep apnea could be causing me to wake up during some of my dreams, and then I'd remember them. Though since being on CPAP now since March 22, I'm still waking up a lot during dreams and I'm not feeling any less exhausted than before CPAP. I think the excessive dreaming might be contributing to my excessive daytime sleepiness, but I'm not sure. I also dream during naps. I can wake up and fall back asleep, and go right into another dream. It feels like I'm dreaming even before I'm asleep, like when I'm getting close to drifting off.

[beyondtired]

I questioned my doctor on sleep positions. Actually, my WHOLE REASON for going in for my last test was for me to find out if I was better or worse on my side/stomach or back. The doc didn't really seem to care about my request for that information. BUT, when I sleep on my side or stomach, I get much better sleep, my CPAP shows a lot less OA's happening, and I've started dreaming again, almost every night...

Now, the thing about Dreams is, they don't happen in real time. We can have a seemly week long dream in a matter of minutes, kinda like it happens on TV and at the movies, our mind just 'fills in'... At my sleep study, I got 0 REM sleep. heck, i think I only slept 2 MAYBE 3 hours during the study, which they insisted was long enough. but I had to readjust my pressure when i got home, cause the pressure they picked wasn't working good enough.

anyways, with all that aside, whether it means anything or not, I definitely sleep in longer 'chucks' sleeping on my side or stomach. (did this answer any of your questions? it's late, and I need to be headed for my machine )

I had been wondering about this before. Do you have some links to some articles or studies that I could look at concerning that dreams don't happen in real time?

[beyondtired]

From your sleep test how were your SpO2 results.
Hypopneas can cause significant reductions in blood oxygen which aren't good.
I convinced myself of my Sleep Apnea by making an Infra Red video of my sleep while using a recording SpO2 meter.

Well my baseline SpO2 was 98.3 % and it only went down to 90.0 % during the sleep study. So that doesn't sound too bad right?

[beyondtired]

I wanted to talk a little about positional sleep apnea. On my sleep lab test, it was shown that I had mild sleep apnea with an AHI index of 12.9. This was all from hypopneas and no apneas. The supine AHI was 10.2. This means that my
non-supine AHI was only 2.7. So that basically means if I don't sleep on my back at all, I wouldn't have sleep apnea right?

During the study, I moved around to my sides and my back. I wasn't really able to sleep on my stomach with all those wires and everything. At home, I believe that I normally sleep on my sides and stomach more so than I do on my back. Maybe I move to my back at times during the night, it can be hard to tell while sleeping. I only had 3 minutes total of REM sleep during the sleep test though, so if I would have slept more in the REM stage, maybe my AHI would have possibly been higher?

Subtracting the supine AHI from the total AHI will not correctly calculate the non-supine AHI, so 2.7 is not necessarily the correct number. However, it is likely that your non-supine AHI under normal sleeping conditions is much lower than your supine AHI.

You could get a copy of your sleep study and check how many minutes you slept in non-supine positions, how many of these minutes were in which sleep stages, and what the AHI was. It sounds like this would be a small sample and therefore inconclusive about the severity of your condition while sleeping in non-supine positions.

There are tactics to force non-supine sleeping only:

Some use a tennis ball sewn into the back of a shirt. I can sleep on a tennis ball so instead went to the more extreme measure of wearing a small backpack. It is actually a CamelBak with a large rigid plastic bottle inserted. I sleep the first half of the night in the Falcon position, http://www.uarsrelief.com/sleeppositions.html, and highly recommend it.

Except for the issue of cost, it would be good to have another sleep study where you take a sleep drug to ensure sufficient sleep and sleep exclusively in non-supine positions.

At home you might want to try sleeping exclusively in non-supine positions and see if your symptoms go away.

Your experience in the sleep lab shows how poorly prepared sleep labs are for making a thorough diagnosis in one night.

I do have copies of my sleep studies, but it's not the full and complete results. So I'm not able to see on my sleep study which sleep positions I was in, during which part of the night, and what were my AHI during those times. On the copy of my titration, they did include a graph that shows the various sleep positions I was in throughout the night. So I'm not sure why they didn't include that info with the copy of my first sleep study. I should ask my sleep doctor for a copy of the full and complete detailed results.