Hybrid Sleep Position by Sir Noddin Off

[mars]

Hi Everyone

As this thread no longer is about the original subject, I have re-titled it to reflect what it is now about, and to make sure that those interested in the Hybrid Sleep Position do not confuse it with anything else, and those interested in positional therapy for sleep apnea do not confuse that with the hybrid sleep position.

Happy New Year to all

mars

[nanwilson]

Welcome back Mars... hope you stick around for awhile. Happy New Year to you too.

[ChicagoGranny]

mars

How is your PLMD?

[Sir NoddinOff]

Here's something called hybrid sleep position which I wrote quite awhile ago, maybe it's useful to this discussion? I use it almost every night because I need a lot of positions to keep me comfortable:

I used to have trouble sleeping flat on my back, but I managed to learn how to gradually achieve it by following this method (this is a cut and paste of a post I wrote in July) :

Here's something I came up with last summer and I post it a lot when positional sleeping comes up. The info below isn't intended to be a pitch for back sleeping per se - it's more of an attempt to familiarize sleeping on one's side while rotated over by about 45 degrees... I call it 'Hybrid Supine Position'. (Later Edit: Julie calls this the 'HALFWAY ROLLED OVER TECHNIQUE' which probably makes more sense.) See a couple of post down fro her explanation.

First a caveat tho - For some people their AHI may go up either a little bit or a lot (or possibly down). If you basically have your AHI under control and can tolerate a slight increase then it may be worth your time to try supine sleeping, some of the benefits of which I mention in the last paragraph. In other words, get a good data based machine, use your sleep software and pay attention to how you feel in the morning!
------ original post ------
I'm one of the biggest proponents of supine sleeping on this site (usually getting a fair amount of umbrage from the devoted side sleepers ) First off I realize some people are never going to be able to back sleep due to bad backs, joint pain, breathing problems etc... I wish them good luck sidesleeping.

Anyway, that said, I've been able to train myself to sleep on my back using what I call the Hybrid Supine Position . First get some throw pillows from a couch or roll up a blanket to make a support system to place in your bed; it should be about 3' long and a thick as you feel comfortable with. Rather than start out sleeping flat on your back, start on your favorite side. After a reasonable amount of time and after adjusting your covers, mask etc,reach back and slide the rolled up blanket or the throw pillows into contact with your butt and back areas. You may have to lift up your body a bit to get the contact really firm. Next roll your torso and hips back a bit, letting the supports take the weight of your body... the object is to have your torso at a 45 degree angle to the bed. Note, I'm NOT saying put the pillows etc under your back and shoulders, like you are reading in bed!!! Adjust your pillow so you are comfortable and don't worry about your legs, they seem to take care of themselves. I find this hybrid position really comfortable and eventually after a week or two started pushing the supports out of the way after an hour or so, thusly ending up flat on my back while sleeping soundly. It took a couple of months using this method, but now I sleep easily flat on my back or in the 45 degree position.

BENEFITS OF SUPINE SLEEPING, IMO: Before CPAP I hadn't slept on my back for over thirty years but now with my 95% pressure around 9.5cmH20 my airways stay open and my snoring is totally gone. Therefore I now love to sleep on my back. I've found that supine sleeping is better for me because my mask leaks are usually minimal; it lets the large muscle groups relax evenly and naturally; my joints and cartilage heal more efficiently with my bodys weight evenly distributed; plus it takes pressure off the brainstem, especially if your head is slightly elevated. Hey, what can I say, I found I love supine... nobody was more shocked than me, because I was a habitual side sleeper.

[Stormynights]

I am so dense. I had to read this about 15 times to figure it out. So you put a little pillow behind your lower back just above your butt? Did I get that correct? I will try this.

[ems]

Just had a few seconds to read SNO's post... but... if one has back issues I can't see how this could be done. Had back surgery in 1996 and it was successful; still have to baby it tho. I can't stay on my back for more than a few minutes before I have to turn on my side.

[mckooi]

I went for a body massage years ago and was sleeping with face down. There was a hole fit right on your face so you can stretch out your body. After 45mins of full zzz i woke up feeling i was fully 100% slept rested. No snoring no headach no ssweeting after woke up feeling so fresh that like i had not been zzz for years. This position with face facing can be used if there is a power outage and cpap not working. Hope it help by sharing with you all. Gid bless.

Mckooi

[DoriC]

Hi Mars, Happy New Year and good to see you again! Stick around, this is going to be an interesting thread!!

[pbriggs]

Hello Mars,

Most interesting read - I used to be a side sleeper and trained myself to sleep on my back a few years ago - not sure why I did it other than at the time I thought I would sleep better and my back would feel better.

The article that you link to is a study that was performed to understand positional therapy to CPAP. The results are very interesting and the study clearly was done with patients positional OSA, nonsupine AHI < 5 events/h. Nonsupine means that they don't sleep on their backs. Further in the summary they state they the average went from 11 events per hour to 0 with CPAP and 2 with positional therapy. Most impressive if you ask me.

The Sir NoddinOff has an interesting post on training yourself to sleep on your back - supine position. Of course his statement is to sleep on the back with treatment and lists several benefits.

The two are polar opposite - the research on positional therapy looks very sound is stating that nonsupine position is best. Since my BiPAP treatment started, I have tried getting out of the habit of sleeping on my back as a way to minimize any events. From my own data I see that my event numbers are lower when I sleep on my side "most" of the time. There are times where I get some high leaks that I am working on and on those nights I get higher events.

I think it is necessary to contrast the two posts, thus I posted, to be sure that they two are not saying the same thing. - at least that is how I read it.

[Julie]

I think Sir NO is an exception - he's chosen to sleep like that because it works for him while on Cpap, though very likely knows it's not recommended. Most of us do our best to side sleep.

[Sir NoddinOff]

Stormynights, EMS and everybody else: My bad. I now realize my post is more confusing than it needed to be, ie. photos are in order cuz this is really a simple idea and not rocket science. Also, I'm not suggesting that by using my method of hybrid supine positioning that everybody needs to transition to full supine position or that it is necessarily desirable... stop at halfway rolled over if it works for you. Also, I only tried to make a case for sort of a half and half version where one's torso is half supine and half rolled over, ie. the torso is at 45 degrees. ALSO AS NOTED ABOVE: DON'T STICK ANY PILLOWS OR BLANKETS UNDER THE SMALL OF YOUR BACK THEN LAY SUPINE... THAT IS COUNTERPRODUCTIVE TO MY IDEA!!!!!!! REPEAT: THAT IS A NO-NO

In my case, and only my case,I was able to transition to full supine sleeping using my method. I however I realize (as I stated in my above reply) that that is not an option for some people. I've heard these criticisms before and now realize words aren't going to describe what I am attempting to outline. So here's my new offer. I'll take some photos showing exactly what I am suggesting, including the rolled up blanket that I use. I'll get my wife on the case with my Nikon camera and we'll post some photos tomorrow. Full disclosure: Yes, as rumored, I do have red sheets and I wear Star Wars jammies.

[Sir NoddinOff]

I am so dense. I had to read this about 15 times to figure it out. So you put a little pillow behind your lower back just above your butt? Did I get that correct? I will try this.

Yeah, but I didn't lay flat on my back with a pillow under the small of my back. I just used the pillow or rolled up blanket in the middle of my back and up to my shoulders to keep my torso at a 45 degree position. Words fail in this case... Look for my photos coming tomorrow, as mentioned above.

[Julie]

Think I'm getting it... the blanket is like a wedge under your upper half (or quarter?) so you end up sort of leaning against it as if you were going to lie flat, but don't... kind of halfway between supine and sideways?

[Sir NoddinOff]

Think I'm getting it... the blanket is like a wedge under your upper half (or quarter?) so you end up sort of leaning against it as if you were going to lie flat, but don't... kind of halfway between supine and sideways?

Yes, very good Julie. You said what it took me a few hundred words to attempt to explain BTW, I don't sleep totally supine that much anymore since I've been using my Quattro FX FFM. I find that my halfway rolled over technique helps keep my tongue from sliding back. There's no great expense in trying my "half rolled over tip", so give it a shot. I think you'll find it useful to have another sleep position in your quiver, plus it's totally adjustable to your needs.

Does this mean I don't have to have my wife take a picture of me in my jammies

[kteague]

Hi Mars. Good to hear your efforts are still yielding good results. You have been diligent in determining that it is indeed working working for you. Certainly there are others out there with strictly positional OSA who could also be successful with your methods. Bit jealous here, as my events on my side were just a few less than supine. Thanks for updating us.