Fat mouthbreather, sleeps on side

[TSSleepy]

Hi All,

I live alone and really hadn't thought about sleep apnea as a source for my exhaustion, weight gain, hypertension, et cetera... until I started falling asleep at work, stop lights, et cetera.

I'm now slowly making my way through the vast and tedious bureaucracy of my HMO, but am convinced I have serious OSA.

I've never in my life been able to breathe freely through my nose. Apparently that's not normal?

I saw an ENT (otolaryngologist), and my left nasal airway is blocked by severe deviated septum. A turbinate "filled" the void and blocked the right nasal airway. They want to do a septoplasty and turbinectomy surgery on me after they get my hypothetical OSA under control.

I saw the pulmonology group's nurse practitioner. She thinks I have OSA and has ordered an urgent sleep study, which is scheduled for 2 weeks from now.

I'm 99% positive that my issue is:
1) Can't breathe through my nose, so if my mouth closes I suffer a hypopnea at bare minimum and an apnea if there's even slight congestion.
2) When lying on my back awake and relaxing my jaw/tongue, my tongue flops right back and closes off my mouthbreathing, leaving me what little breath I can drag through my occluded nasal airways.

So I'm pretty sure that the only sleep I'm getting at all is on my side with my mouth open. I can only fall asleep on my side with my mouth open, and I think that the only sleep I get is on my side with my mouth open.

Anyway, I'm babbling (soooo tired). So here are my questions:

1) Will they make me fall asleep on my back in the sleep study? I don't think I am capable of falling asleep on my back, because my tongue blocks my throat when I relax.

2) Are there any people with mostly-blocked sinuses that are successful sleeping on their side with a full face CPAP mask? I almost imagine needing a mouthpiece on underneath the full face mask to ensure that my mouth stays open?

Thanks for any input. I want to be pre-armed for when my doc dishes out a prescription!

[OCNorsk]

I don't have a completely blocked airway, but I do have a deviated septum. I was supposed to have surgery, I think the turbinates, a couple years ago, but I got a cold so it was cancelled. Then I decided I wasn't going to do it at all. I always have difficulty breathing, even when I'm awake as I just can't get in enough air (small nose, blocked airway, and chest pressing on diaphragm) unless I'm consciously taking a deep breath....which takes a long time to do.
I had to sleep sitting up for the last years until I got the CPAP, but I still sleep in an elevated position. I've had two sleep studies, at different places and the procedure was different in the two places, so I can't say for sure if you have to sleep on your back.

[Wulfman]

If you don't normally sleep on your back, don't let them "make" you sleep on your back.
I had read about some of the things that happen in a sleep study prior to having mine, and I specifically asked what position(s) I would have to sleep in.....and that I absolutely could not sleep on my back. I was told that I would be able to sleep in whatever position I normally sleep in.

Even though I've never been to an ENT and neither of my doctors asked me "Can you breathe?" before having my sleep study, I have come to think that quite a bit of my problem lies in my nasal passages......maybe turbinates......and a deviated septum from a broken nose playing high school football. In any case, I have always used a full face mask throughout my therapy and between that and the cool water and no heat in my humidifier (passover humidification), my nasal passages stay open on most nights and I'm able to breathe very well while I'm sleeping. Nasal cleansing before bedtime helps greatly, too.

Den

[Woody3]

I found out real early in the sleep study that I was a mouth breather and needed a full face mask. I too sleep on my side
and haven't had any major problems besides breaking a mask once so I always keep a spair one. I found that a cpap
pillow helps a lot. It can be a pain at times but at least I don't fall asleep when driving or wonder if I am geting Alhimers
yes my memory was that bad before I started cpap.

[Victoria]

Well....not by any means an expert here, but they didn't seem to care what position I slept in. I usually sleep on my side, but I know they I got some time logged in on my back, too.

[ichitumi]

Oddly enough ... I'd always thought I was a mouth breather and would probably need a full face mask because of that. I'd ALWAYS sleep with my mouth open at night and half the time during the day when I'm awake as well.

The sleep lab I went to was very nice. They told me to just make myself comfortable and just sleep whichever way I'm comfortable with. They told me what they were going to do during the sleep study and asked me to try out a mask to find out if I was going to freak out ... I guess. They also told me that I would need to start sleeping at by 11PM and if I was unable to, they would give me a pill to help.

Lucky, I've always been a very good sleeper. Apparently fell asleep within 5 minutes. I think she left me to go check her equipment and found me fast asleep with the lights on and the TV going.

They put me on a nasal pillow-type mask during my tiltration and I slept very well with it. No opening and breathing with my mouth or anything.

From that experience, I decided to forgo the full mask that I was prepared to be "married" to.

I'm a happy camper now. Still pretty tired, but sleeping well ... at least much better.

A curious thing though. I was prescribed for 8CM. When I was on a trip and found that I couldn't breathe ... I woke up in the middle of the night and increased the pressure to 8.5CM. That worked until about a week ago. I woke up with a very dry mouth/throat two nights in a row. I have since increased my pressure to 9CM. That seemed to do the trick.

Does our pressure change without much change with anything else? I think I'm going to need to invest in getting a better machine with apap and data capabilities.

[Jason S.]

I have a deviated septum and went to two different ENT's. Both advised me to have septoplasty which is nose, not sinus, surgery. My problem was chronic sinus headache. I never knew I had sleep apnea until recently, although now I'm sure I've had it for 15-20 years.

I didn't have the surgery because ENT said 50-50 it would improve my headaches but 100% I would breathe better. I heard it was not a fun surgery. I am a side sleeper. I never stopped breathing while on my side. What alerted me to it was on the few times I slept on my back, or fell asleep in a recliner, I woke up gasping for air. I mentioned it at my last physical and internist's wife is on CPAP and so he told me to get a sleep study. Now I purposely tried to sleep on my back during the sleep study because I knew I had serious problem. Since I was all wired up and monitored I wasn't worried about stopping breathing. My results came back moderate on my side but severe on my back.

I presume I am mouth breather, I have a full-face mask. pressure set to 8. Now since starting the treatment my morning sinus headaches, which are especially bad in dry winter, have all but disappeared. I still get some headaches but much improved. So now I see no reason to get septoplasty. I'm still fairly new to CPAP but really glad I got the study done.

Anyway you might want to consider doing the sleep study/CPAP first, since neither is invasive or painful before deciding on surgery. Good luck and hope this helps.

[CorgiGirl]

At my sleep study, they asked me to start off on my back and to stay there as long as possible so they could get some readings with me sleeping that way, but that I could roll on my side whenever I felt I needed to. Sounded like an okay compromise to me. I think I stayed on my back for about 20 minutes.

I have enough sinus problems that I have trouble breathing through my nose all night long. A full face mask works just fine for me.

Hang in there. You and your doc will get this figured out and get you on the road to treating your sleep disorder.

[jda1000]

My sleep study was in a motel; they apparently did such all the time as my room was pre-wired with video monitors, etcetera, and I got the impression the tech was conducting at least one other study. I don't recall my tech caring about my sleep position, but with all the wiring, I didn't shift much - that I know of. My tech was great - put me at ease and made the experience as pleasant as possible, and when he found out I was an engineer, let me come in and view my draft results on his computer - which I gather is not kosher.

Be sure and ask for a copy of your sleep study, when complete, and be prepared to manage your therapy and your medical team, if you're not already in the habit. My tech conducted a "split" study, putting me on CPAP about midway through, as sufficient data already showed I had OSA. I had some concern going in they'd just run the test all night, then require a second one, to maximize profit, but then I'm distrustful of anything that looks like a consultant, having been one.

Good luck!

[OCNorsk]

PS... I also have my Breathe Right Strip to help open my nose up. I just realized, it takes me longer to get ready for bed than it does to get ready for work.

[TSSleepy]

Thanks for the replies!

I'm going though Kaiser Permanente in Oregon. They've taken over a floor at a motel near the hospital.

My ENT did say that the septoplasty and turbinectomy would allow me to breathe freely through my nose, but would not necessarily cure my "theoretical" sleep apnea. She still recommended getting it done though, after the sleep study. I think I may try it regardless of the outcome of the sleep study. I've always known I couldn't breathe through my nose, and that I should probably get that taken care of. I usually get 1-2 bad colds per year. And when I get a cold, it's extremely difficult to do anything like nasal irrigation to help it out. The post-nasal drip is murder, since I can't blow my nose.

I've gained 120 pounds in the last several years, I've stopped hanging out with my friends, I've stopped "trying" at work... my life has devolved to "drive to work without killing someone", "do as little as possible without getting fired", "drive home without killing someone", and "do/think as little as possible until the next time I have to go to work". That's no way to live! It certainly doesn't describe my life several years ago!

Now that I know that my problems are probably OSA, it's been driving me nuts waiting for a genl practitioner appt, then waiting for a consult with pulmonology, now waiting for the sleep study!

I'm loving the information here!

[nate fry]

I had the exact problem. I got my septum fixed, turbinates shrunk with radiofrequency and my tounsil out and tounge advancement. Now I can breath like a normal human, I can sleep on my back without choking and sleep much better. If you have any question please feel free to ask. Life is a lot better for me now.

[nate fry]

They want you to sleep on your back but if your like me as soon as i started to fall asleep I would choke. So they let it slide.

[kopoloff]

When I had my sleep study(s) they wanted me to sleep naturally.

In my previous life, before CPAP, I would sleep on my side, front, switch to the other side, roll onto my back, do a triple somersault with half pike. And that was the first 3 minutes of sleep only. So, sleeping naturally involved twisted data leads etc, risk of strangulation (no, not really) etc etc. But that's what I did.

In my new life, with CPAP, it doesn't matter how I sleep anyway

K

[Jason S.]

I had the exact problem. I got my septum fixed, turbinates shrunk with radiofrequency and my tounsil out and tounge advancement. Now I can breath like a normal human, I can sleep on my back without choking and sleep much better. If you have any question please feel free to ask. Life is a lot better for me now.

Nate: Are you still using CPAP? How was the surgery recovery? Is the shrinkage of turbinates by radiofrequency a new technology? My ENT was basically going to go in there with an auger drill with teeth. It didn't sound pleasant. By tongue advancement you mean they cut off part of your tongue, right?