Tailoring sleep position to keep it on, annoying. Solutions?

[CAsleep]

In writing my long post earlier....I realized the main problem I experience is that to fall asleep, (without CPAP), I like to somehow be touching my husband (spooning, or one hand on his arm or leg, etc)....then, about 30 minutes into that, I will roll over onto my tummy, or my side, or alternate between the two until I"m realllllly comfy, then knock out. That is heaven to me. That's how I sleep.

When wearing the mask, I can't and don't do any of that. Those side positions, or moving, knock my mask too far off (using the swift nasal pillows). And, because of that, I can't fall asleep. I *was* using Lunesta as the only way I could knock out, without doing my above routine. But, even WITH Lunesta, not being able to figit myself comfortable while wearing the mask, and toss and get comfy......impacted my sleep, greatly. I would arouse myself, because I knew I wasn't comfortable. But I was tailoring my sleep position to my mask.

That's just it....tailoring my sleep position to the mask. Positioning my head a certain way on the pillow, a way that feels unnatural to me. Positioning my body a certain way. All so the dang mask doesn't fall off. Anyone else? And that keeps you up??? It's like you can' never fully relax, because you are always aware of this "thing" that you "may" (and probably will) knock out of place, if you don't sleep in a certain unnatural-feeling position.

THAT is my problem.

What should I do about it???

I have tried different masks, and given it "time." I think I am just very particular in general, when it comes to getting comfortable before falling asleep.

Right now, the only solution I see is to try the surgery. I am young, in decent shape, 30 years old, if any of that matters.

[jamiswolf]

CAsleep,
I think I understand your situation. Having long time sleep habits that you now can't follow. CPAP induced insomnia. You're definitely not alone and other then mask fit, it's probably the biggest issue faced by cpappers. Search through the archives and I know you'll find many threads on the topic.

I've been doing this for several years with a little break during moving. I can only tell you what I do, and hope some of it helps. I've never tried nasal pillows but early on, I tried at lease 6 different masks before I settled in with the Quattro. It's a full face mask with an air cushion seal that doesn't require lots of pressure. I keep it especially loose and count on a little side pressure from the pillow to hold it in place. This keeps me on my side where my apnea is the least. If I flop over to my back (which I've trained myself not to do much), the mask leaks wake me up and I turn to my side again. I also learned that using a double layer of Tee shirt material provides a nice soft good sealing surface on my face. I use new ones each night for sanitary reasons.

I've also had to make accommodations in my life habits. Too much alcohol or too much caffeine or even eating too late in the day messes with my sleep so I'm strict about that. And if I err in that regard I pay for it with poor sleep.

I also started taking 50 mg Benadryl (the antihistamine) for just enough drowsiness to aide in inducing sleep.

It's sort of a holistic effort but a comfortable leak-free mask is the number one issue. If my memory serves me...Robysue wrote a lot about her struggle with insomnia. Please correct me people if I'm wrong here.

Each situation is unique so you have to learn enough to be your own therapist. Far as surgery goes, I don't read too many success stories. I personally would not resort to that. but please research it carefully before making that decision.
Good luck,
J

PS Do you use some sort of hose hanger? Being able to turn from side to side is so much easier when you don't have the hose all over you.

[chunkyfrog]

I'm guessing you've not been using the machine full time for a while.
Bear in mind that the silicone parts degrade with time and use; and you may need new nasal pillows or a new cushion.
Many new masks have come up since you were here before.
Perhaps a new one will offer what the old one has failed to.
Check out our host site, cpap.com, and maybe something new will get you rolling.
(retail therapy?)

[Julie]

You can get something called a Hose Buddy (do a forum search for more info) that looks like a small IV pole with a hook for the hose (you'll probably want a slightly longer one), or you could rig something to attach the hose over the back of the bed to a headboard (leaving enough slack to turn, etc.), or a hook on the ceiling (again, more hose length needed, but it's cheap). Lots of ways to deal with it.

[robysue]

IBut, even WITH Lunesta, not being able to figit myself comfortable while wearing the mask, and toss and get comfy......impacted my sleep, greatly. I would arouse myself, because I knew I wasn't comfortable. But I was tailoring my sleep position to my mask.

That's just it....tailoring my sleep position to the mask. Positioning my head a certain way on the pillow, a way that feels unnatural to me. Positioning my body a certain way. All so the dang mask doesn't fall off.

The best fix for "I can't get comfortable because I have to accommodate the mask" is to simply allow yourself to snuggle into your favorite position (as best you can) and once you're there, tug on the nasal pillows slightly so they reseat against your nostrils and then DO NOT WORRY about whether the mask is going to get knocked off during the night. And if you do wake up to a massive leak because the mask has fallen off, it's simple enough to put a Swift FX nasal mask back on.

Let me tell you about my own struggle to learn this lesson:

Pre-CPAP I'd settle down with my nose nestled into my hubby's armpit most nights and talk to him (long after he'd fallen asleep) until I fell asleep.

When I first started PAPing, I could not get my nose into hubby armpit. I felt like the HOSE was forcing me to sleep on my back, which I really don't like doing unless I'm super, super congested. And I worried tremendously about how moving around in the bed might trigger leaks or cause the mask to fall off. And I had to work hard on arranging my head and neck "just so" so that the exhaust flow was not too annoying and that the position of the head and neck might help prevent the aerophagia I was fighting. And yes, it was annoying, and it did keep me from sleeping well, and I would wake up with a neck ache on most mornings from the attempt to not move around too much for fear the mask would fall off or that I'd get tangled in the hose or that I'd wake up with a basketball of air in my stomach. In short, I was "tailoring my sleep position to the mask" and not sleeping very well at all.

It took me months of trying to sleep in a position that would "accommodate" the mask before I simply was tired enough to just sleep the way I wanted to one night: That night I simply fell asleep with my head under the covers (like I used to do pre-CPAP) and with my head butted up against my husband's hip (because I couldn't get the masked nose into his armpit, but his hip was easy.) I woke up the next morning realizing two things: (1) Unlike pre-CPAP days, I didn't have to wake up to "come up for air" by getting my head out from under the covers since Kaa gave me a fresh supply of air all night long and (2) I didn't have the damn CPAP-induced neckache I'd been dealing with for months.

I now am able to consistently nestle into my hubby's side just above his hip (my head is under the covers when I do this) and fall asleep that way. On most nights, I have no real problems getting to sleep---if I'm sleepy enough. (Staying asleep is another issue, but I don't think it's related to the BiPAP.) On "bad" nights, hubby will tell me "rat astronaut" stories where "robysue the baby rat astronaut" is the star of the story. (He's always said that I somehow resemble a cute baby rat in my sleep and with the hose on my nose, I now look like a "baby rat astronaut" to him.)

And I can move around---a lot---in bed without having any serious problems with my nasal pillows dislodging. And while I'm not much of a tummy sleeper, when I want to be on my stomach, it's not that hard---if my head is near the edge of my bed pillow.

Like others, I'm wondering if the nasal pillows are simply too old and degraded. One of the sure signs that my nasal pillows need to be replaced is that I have to start fiddling with them over and over to get them to seat properly at the beginning of the night and worn pillows are much more prone to spring leaks when I move around.

I'm also wondering if you have the headgear adjusted too tightly. Or perhaps the problem is that you are using pillows that are either too large or too small. With the Swift FX nasal pillows mask, I have the headgear adjusted so loose that it threatens to fall off if I sit up in bed and the machine is not on. I can get several fingers under the top silicon trap without even trying and I can easily get a finger or two under the side strap without much stretching of the strap. And yet, once the machine is on, the nasal pillows fully inflate and settle against my nose in a way that is actually quite robust when it comes to staying put while I'm moving around.

[Iowamv]

Those side positions, or moving, knock my mask too far off (using the swift nasal pillows). And, because of that, I can't fall asleep.

Take a look at this: https://www.cpap.com/productpage/cpapma ... oduct.html

It made a WORLD of difference to me immediately. I can sleep on my side, and the hose just hangs off the side of the pillow in one of the cut out sections of the pillow. I sleep on my side almost all night long with the Swift FX mask.

[Babette]

I was using a memory foam contour pillow before I got the mask, so I one one step up to those fancy cut out pillows. I looked at the cutout and thought "Why not just position your face on the edge of the pillow so the mask swings free?"

Did that. Still doing it 6 years later.

But if the cutout works for you, by all means use the cutout. Or make your own with an electric knife and a cheap memory foam pillow. Of course, then you need to tailor a pillowcase, and that may be too much effort. Certainly is for me.

RobySue has a really great post and I can't agree with her more. Just get into the position you like and try to quit worrying about the mask.
B.

[caffeinatedcfo]

I switched from belly to supine and was fine after a couple of days doing the "new normal." I hear a hose buddy works for your situation.

[Sir NoddinOff]

Some excellent posts on people's methods of adaptation. I don't have any big insights to add other than to say this is a fairly typical experimentation cycle of success/failure. To my way of thinking, your efforts are pretty typical for most people in this neck of the woods. You do seem to show a lot of determination, which is good.

About ten years ago, my mother-in-law was Rx'd a very common machine and mask. It's been lovely for her every since. Sadly, in my experience, that's an unusually fast adaptation to CPAP. A newbie is lucky if they can pull that off, but most people at CPAPtalk are tweakers, survivors and stubborn sons of a guns (edited for politeness) ... IMO, that's really the reason this forum exists. It celebrates the human spirit as it strives to transmute something bad into something one can endure. You can't beat Mother Nature, however sometimes you can parlay with her.

[Shore Snorer]

I'm sleeping well enough, and keeping my mask on, but I miss spooning. At 11 cmH2O, the exhaust from my (full face) mask is pretty noticeable. I need to face away from Shore Spouse.

[newsnore]

I see you are using nasal pillows. Have you considered trying the Tap Pap nasal pillows? I tried all manner of masks, and being a restless sleeper they all leaked and disturbed my sleep for many months of CPAP therapy until I tried the Tap Pap (seven months ago now) and virtually from day one (actually night one) I went from an average of 3 1/2 hours usage each night to an average of 7 1/2 hours - it has made CPAP work for me. Because of the stabilizing affect of the mouthpiece fitted to the upper teeth, the pillows just don't move once in place. On the occasional night I have dislodged a pillow when scratching my nose, but otherwise they are immoveable, so leaks are not an issue. As far as I am aware all other masks rely on the head gear to help hold it all in place and stop the leaks - so they are all prone to developing leaks when you move your head against the pillow or when the hose drags while tossing and turning. Initially I wondered how I would possibly cope with the mouthpiece, but it was a non issue and I don't even notice it - there is no discomfort. It could be worth you looking into this mask - maybe even look at other threads on this forum relating to the Tap Pap.