sleep position and mask for gastric insufflation

[insufflated]

Because of gastric insufflation I began to sleep on my back with my chin as far away from my chest as possible. It is quite unnatural, uncomfortable and often leaves me with a sore neck in the morning, but it works and a sore neck is less painful than a stomach stuffed with air.

In this position, my Wisp mask does not fit very well and I wake up and readjust it often because the headgear slides up and then I get leaks.

Is there a better sleeping position for gastric insufflation?

Is there a mask/headgear better than the Wisp for this sleeping position?

I've been using the CPAP for 14 months now. I will be using a BiPap for the first time tonight. The CPAP pressure was at 18, the BiPAP is set for 16 in / 12 out. If anyone has tips on BiPAP pressures, particularly for gastric insufflation, I'd like to hear about that too. The gap of 4 seems odd because it is really not much different than the flex which gives a gap of 3 if I understood it correctly.

I asked the doctor for Auto, but he said insurance likes to see a set pressure and gave me BiPAP instead. My gastric insufflation was a lot better when I turned the APAP trial on using the CPAP machine. He also wasn't thrilled with me self-adjusting the pressures, but, he didn't make it any easier to get an appointment with him either (usually takes 3 months to get on the schedule). I didn't see an Auto setting on this new machine. It is a RemStar BiPAP Pro with Bi-Flex (660P).

Thanks in advance for the tips!

[mrog]

I used to sleep with one or two pillows. Recently, I got a 3" gel memory foam mattress topper from Costco. Now I can sleep on my back without any pillows, which has helped my apnea quite a bit. I can't promise it will work for everyone, but it's worth considering. Costco has a great return policy, so you can take it back if you don't like it. (Just don't expect to fit it back into the box it came in. That's not going to work.)

[insufflated]

I used to sleep with one or two pillows. Recently, I got a 3" gel memory foam mattress topper from Costco[/url]. Now I can sleep on my back without any pillows, which has helped my apnea quite a bit. I can't promise it will work for everyone, but it's worth considering. Costco has a great return policy, so you can take it back if you don't like it. (Just don't expect to fit it back into the box it came in. That's not going to work.)

I sleep on my back with no pillows now. A new mattress sounds nice though

[insufflated]

I used to sleep with one or two pillows. Recently, I got a 3" gel memory foam mattress topper from Costco[/url]. Now I can sleep on my back without any pillows, which has helped my apnea quite a bit. I can't promise it will work for everyone, but it's worth considering. Costco has a great return policy, so you can take it back if you don't like it. (Just don't expect to fit it back into the box it came in. That's not going to work.)

I do not use a pillow any more either. I have a pillow-top mattress that I do not much care for, but am not planning on replacing because of the cost. I wonder if that foam top would rest well on top of a pillow top?

[Pugsy]

The gap of 4 seems odd because it is really not much different than the flex which gives a gap of 3 if I understood it correctly.

Was your other machine a Respironics or a ResMed?
If it was Respironics the setting of 3 for Flex exhale relief doesn't do a straight 3 cm reduction. The actual amount of reduction is flow based and the maximum available is 2 cm on a setting of 3. I know it's weird but that is how they do it and you may not have even attained the maximum available if your breathing is not particularly forceful.
If it was a ResMed machine then yes..the setting of EPR 3 equals 3 cm reduction.

Actually a setting of 4 cm difference between inhale and exhale when using a bilevel pressure machine is probably what is most commonly used and a good starting point. You may see substantial difference (hopefully) at that setting. The difference along with the minimum used means not so much time at the higher pressure and there is a real good chance it will help you out.

I asked the doctor for Auto, but he said insurance likes to see a set pressure and gave me BiPAP instead.

Oh...you might like a memory foam topper. I used one on a pillow top mattress with success until I bought a different mattress totally.

Hogwash. Insurance doesn't care. Sounds like the doctor doesn't like auto adjusting pressures since he got upset when you went to APAP trial mode.
But instead of just telling you that is what he prefers he wants to blame insurance.
The billing code for fixed bilevel and auto adjusting bilevel is the same just like it is for cpap and auto cpap (apap) machines.
He's doing you a disservice with this mindset because auto would enable you to maybe use less pressure for part of the night and only do higher pressures when needed...and thus lessen the chance for the air in the belly thing to rear its ugly head.
You are unlikely to get him to change his mind though...but they could have just as easily given you a RX for auto bilevel machine because those machines have fixed bilevel modes available. Insurance wouldn't have cared and you could then have used or tried either fixed bilevel or auto adjusting bilevel.

[palerider]

The gap of 4 seems odd because it is really not much different than the flex which gives a gap of 3 if I understood it correctly.

Was your other machine a Respironics or a ResMed?
If it was Respironics the setting of 3 for Flex exhale relief doesn't do a straight 3 cm reduction. The actual amount of reduction is flow based and the maximum available is 2 cm on a setting of 3.

editing:
every reference I've been able to find says that bi-flex is "up to 1/2 cm per level", or up to 1.5cm relief, depending on how hard you're breathing, at a setting of 3. which of course, may not be applicable to the aflex the OP seems to be talking about. but 1.5 or 2, as pugsy says, either way it's much less than the 4 on the bilevel machine.

[ChicagoGranny]

Because of gastric insufflation I began to sleep on my back with my chin as far away from my chest as possible. It is quite unnatural, uncomfortable and often leaves me with a sore neck in the morning, but it works and a sore neck is less painful than a stomach stuffed with air.

.....

Is there a better sleeping position for gastric insufflation?

Try a soft cervical collar. Very inexpensive and works well to keep your head in the right position to open your airway. See viewtopic.php?f=1&t=103756&p=976755#p976755

Backsleeping is the best position for those with gastric insufflation assuming they have no other health problems that interfere with backsleeping.

[Sheffey]

That picture that ChicagoGranny always posts may look uncomfortable to some. But the soft collar is not uncomfortable and does help maintain your head and chin in a good position.

I live in a subtropical climate and the collar is not uncomfortable even during our hottest/most humid months.

[Pugsy]

every reference I've been able to find says that *flex is "up to 1/2 cm per level", or up to 1.5cm relief, depending on how hard you're breathing, at a setting of 3.

and since it's flow dependent, that 1.5 would only be when breathing hard.

I found a reference that says no more than 2 cm. I forget where I got this but it was from one of the manuals.

[palerider]

every reference I've been able to find says that *flex is "up to 1/2 cm per level", or up to 1.5cm relief, depending on how hard you're breathing, at a setting of 3.

and since it's flow dependent, that 1.5 would only be when breathing hard.

I found a reference that says no more than 2 cm. I forget where I got this but it was from one of the manuals.

interesting, I found the 1.5 in several places on the net... nice and confusing

well, at any rate, it absolutely is less than 1 per step, like bilevel or EPR....

sorry, didn't mean to take away from your original point, which is completely correct.

[Wulfman...]

Because of gastric insufflation I began to sleep on my back with my chin as far away from my chest as possible. It is quite unnatural, uncomfortable and often leaves me with a sore neck in the morning, but it works and a sore neck is less painful than a stomach stuffed with air.

In this position, my Wisp mask does not fit very well and I wake up and readjust it often because the headgear slides up and then I get leaks.

Is there a better sleeping position for gastric insufflation?

Is there a mask/headgear better than the Wisp for this sleeping position?

I've been using the CPAP for 14 months now. I will be using a BiPap for the first time tonight. The CPAP pressure was at 18, the BiPAP is set for 16 in / 12 out. If anyone has tips on BiPAP pressures, particularly for gastric insufflation, I'd like to hear about that too. The gap of 4 seems odd because it is really not much different than the flex which gives a gap of 3 if I understood it correctly.

I asked the doctor for Auto, but he said insurance likes to see a set pressure and gave me BiPAP instead. My gastric insufflation was a lot better when I turned the APAP trial on using the CPAP machine. He also wasn't thrilled with me self-adjusting the pressures, but, he didn't make it any easier to get an appointment with him either (usually takes 3 months to get on the schedule). I didn't see an Auto setting on this new machine. It is a RemStar BiPAP Pro with Bi-Flex (660P).

Thanks in advance for the tips!

Sleeping on one's left side is reported to be the best position. I don't remember reading about any mask preferences though.

Edit: It may also help to raise the head of the bed a few inches, too.

Sounds like you're dealing with a "jerk" for a doctor, too. He's the kind that many of us have fired. Yep, he made sure you got a straight Bi-PAP machine. No "auto" on the Pro 660.


Den

.

[grayghost4]

The DR ownes the sleep lab ... makes more money this way

I also have a DR that ownes the lap here in CA.