Should I just accept I should never sleep on my back?!

[bass-man]

Hi all!

This is my first post but I've already found the forum a massive source of help, so thanks to all who post regularly on here!!

I've been using APAP for around 3 months now and at first simply couldn't understand why my ahi, although usually below 5, varied so wildly from night to night, but more recently I've come to understand it's a lot to do with when I roll onto my back whilst asleep! It seems when I tuck my chin into my chest whilst sleeping on my back, it REALLY closes my airway up.

Once I sussed this, I tried the 'backpack' idea, and lo-and-behold, my ahi dropped to below consistently to less than 2 consistently for several nights! So I decided to' re-titrate' and set my APAP wide open (4-20) whilst using the backpack. My AHI stayed low, and my 95% pressure worked out around 6 (WAYYY lower than when I wasn't using the back pack).

I really enjoy 'sleeping' on my back, so after this, I decided to experiment with 1st a soft cervical collar, then a Putnam's Cpap pillow (which keeps your neck straight and stops chin-tucking) to see if I could get away with sleeping on my back. I intentionally slept on my back a couple of nights and the pressure started climbing as I fell asleep and reached 18-19 before it managed to take control of my apneas. (Low leak values so this isn't the issue).

So it looks like I need around 18 cm H2O to keep my airway open on my back, and only 6 cm H2O on my side!!!! Has anyone met such extremes before? I think it's safe to assume I have 'positional apnea'?

It looks like the safest bet is to always avoid sleeping on my back - just wondered if anyone else on here suffers the same wild swings in pressure needs between side and back?

Scott.

[ChicagoGranny]

I intentionally slept on my back a couple of nights and the pressure started climbing as I fell asleep and reached 18-19 before it managed to take control of my apneas. (Low leak values so this isn't the issue).

Before offering an opinion, I would like to see Sleepyhead charts of a typical night on your back and a typical night on your side.

BTW, I don't think a Putnam pillow will do for you what a properly fitted firm foam collar will do.

[Gasper62]

My AHI numbers are very low whether on my back or my side. (0.2 avg.) What does go to Hell, are my large leak numbers when side-sleeping. So, I try to stay on my back and not disturb my mask seal enough to make the leaks go crazy.

[bass-man]

Unfortunately I'm using a Transcend Auto so have to use their software. These may help...

A night where I slept on my back a lot (particularly disastrous after getting up a couple of times near the end lol)...



A night wearing the backpack sleeping on my side...

[RogerSC]

Even before starting on cpap I had stopped sleeping on my back, switched to sleeping on my side. Really helped with my snoring, brought it down from too disturbing to my wife to an occasional disturbance. When I had a sleep study, and found that my AHI on my back was about 42, and on my side was about 6.5, that confirmed for me that sleeping on my back wasn't doing me a lot of good. The cpap has taken care of my snoring for good and all, of course. Now there are just other miscellaneous noises *smile*.

[bryansong]

The only time I sleep on my back is when I have tossed that way in the night. I am a stomach sleeper, sometimes the Falcon positon
but mostly Superman with my feet hanging off the bed. When I lay on my back even before going to sleep my soft palate drops back
into my throat closing off the airway to my nose. I learned this long ago and have been sleeping on my stomach ever since. My AHI
numbers are really good but the down side is I can't hardly find a mask and head gear that accommodates stomach sleeping.

I think to sleep on my back my numbers would be through the roof but I'd be exhausted from such disruptive sleep. I'd be awakened
constantly adjusting my leaking mask.

I'm a pro stomach sleeper and find your findings fully understandable and correct, at least that's the way it works for me.

Bryan

[Sir NoddinOff]

From my experience, it's very hard to generalize about back-sleeping vs side-sleeping... everybody is different. I'm using high-pressure ASV and love to sleep on my back. Sometimes my AHI is a bit higher but I just tolerate it for the comfort I get from sleeping in multiple positions. My old bones just get too achy if I sleep in one position all night long. The general rule should be: One has to experiment to find what works best in their case.

Hi Bryan. Superman position: Hadn't heard of that one before

[Morchella]

I have the same pattern you describe. I don't even know what pressure it would take to keep my airway open on my back -- I've gone as high as 12 but that gives me massive air-swallowing (aerophagia) without solving the problem. So now I sleep with a tennis ball in a sock pinned to my nightgown!

Here's a sample graph for me (guess where I rolled onto my back):

[ChicagoGranny]

These may help...

I don't know why people come in telling you what their experience is after you have posted charts clearly showing the difficulty you have breathing on your back versus the relative ease you have on your sides. (WIth CPAP of course.) This is often an adviser-centric forum instead of the patient-centered forum it should be.

Here are my suggestions -

1. If you can learn to tolerate it well, sleep exclusively on your sides or stomach (Falcon position for stomach - http://www.uarsrelief.com/sleeppositions.html).

2. Primarily sleep on your sides with some occasional back sleeping as experiment.

3. From the one night chart of back sleeping, it could be that your worse problems happen during the long REM periods that are typical of final sleep in the morning. (During REM, your airway muscles are at maximum relaxation, and your airway is at peak collapse danger.) So, you could experiment with back sleeping the first part of the night and switching to side sleeping the latter part. This would give your shoulders a break during the early part of the night.

4. I encourage you to give a firm foam cervical collar a good try. I currently recommend a DMI Firm Foam - http://www.walmart.com/ip/23057188?wmls ... 52&veh=sem . For starters, I recommend the 3.5 inch width for an average size man and 3.0 inch width for a smaller person. I order from Walmart online site and pickup at the store to avoid shipping charges. The cervical collar helps prevent jaw drop and holds the neck in the best posture for airway patency.

BTW, when sleeping on the sides, many people find a pillow between the knees makes things more comfortable.

Good luck.

[bryansong]

These may help...

I don't know why people come in telling you what their experience is after you have posted charts clearly showing the difficulty you have breathing on your back versus the relative ease you have on your sides. (WIth CPAP of course.) This is often an adviser-centric forum instead of the patient-centered forum it should be.

Granny, I take it you don't want to read what my experience is. I don't read the fancy charts like you do and don't plan to learn how to do so. From now on I'll just keep to myself.

Bryan

[DreamStalker]

The best laid schemes o' mice an' men ... grrrrr damn be Newton and his gravity. Not forget, mony a mickle maks a muckle ... keep an eye on yer leaks or find a new mask.

[ChicagoGranny]

From now on I'll just keep to myself.

Well, you don't HAVE to act like that.

[bryansong]

I'm sorry Granny, I am being an old poop this morning. I take it back.

Bryan

[bass-man]

Thanks for the advice, and for sharing experiences....

I'd searched the forum a lot re the back/side thing, and for the most part people were saying they needed only a little more pressure on their backs. Good to know other folks suffer the same issue (makes one feel less of a freak lol).

I've taken your suggestions on board ChicagoGranny - particularly the Collar!!

Thanks again...

[Sir NoddinOff]

I think if one relates their personal experience on CPAPtalk it can be a valuable addition when presented in reference to group-speak... it sort of balances things out and shouldn't be considered arm twisting or chest thumping. In Bass-Man's case, continual side-sleeping might be a good idea and worth pursuing, however (a big however) it isn't just Bass-Man who's reading this thread - there are lots of other people reading this thread -271 as I type this - who may benefit when someone veers away from the standard party line, in this case side-sleeping. Another example: Many claim eight hours sleep is necessary every night, but the record clearly shows many people do fine with six or seven hours per night... I see no problem if someone stands up and says, "Hey, I sleep six or seven hours and am doing just great". See what I mean? As I said above, everybody is different, or at the very least, many are. To say that side-sleeping (or eight hours sleep) is the only solution is short-sighted IMO.

I'd searched the forum a lot re the back/side thing, and for the most part people were saying they needed only a little more pressure on their backs.
Thanks again...

I rest my case. Thanks, Bass-Man