Sleeping on back in sleep test

[SleepyBobR]

Over the years, I have learned to sleep only on my side and, as far as I know, I never sleep on my back. That said, I'm comfortable on my back and I'd like to sleep that way but I'm conditioned not to because of the increased frequency and severity of my apneas. My titration sleep study is coming up and I'm wondering whether I should be sleeping on my back during this session. I'm thinking that if I sleep only on my side during this study, the titrated pressure will be appropriate only for side sleeping. If I somehow manage to sleep on my back then will the titrated pressure be appropriate for back sleeping as well as side sleeping? How can I make myself sleep on my back during this session if it is appropriate to do so? Is this question even relevant or are the test results not dependent upon sleeping position?

I'm wanting to get the most out of this study.

[fidelfs]

They will make you sleep in your back to find the highest pressure between sleep on side and back.

[kteague]

I'm thinking that if I sleep only on my side during this study, the titrated pressure will be appropriate only for side sleeping.

Probably, but can't say that absolutely. Back sleeping while in REM is generally considered a worst case scenario. It sounds like experientially you've already discovered a positional difference in your symptoms. In your diagnostic study, did they record a significant difference in events between positions in the same stages of sleep? Back sleeping in titrations is encouraged. If your pressure needed while on your back is significantly higher, enough to be problematic, there's always the option later of lowering the pressure and taking steps to be sure you cannot roll onto you back. Otherwise, knowing your pressure is adequate for that scenario should allow you to sleep without worrying about it. Another option could be to use an autotitrating machine that adjusts to pressure needs. Whether that's a very good option for you could depend on how wide the gap is between side and back sleeping, as the machine has to climb methodically to the higher pressure.

Hope your titration night brings you plenty of sleep and adequate data to get your treatment off to a good start.

Kathy

[Wulfman]

I don't think they can MAKE you sleep on your back if you don't normally sleep in that position.
When I went in for my sleep study, at the very beginning, I asked the person who was monitoring/recording the sleep study whether I would be asked to sleep on my back. I told her that I never sleep on my back and would absolutely not be able to sleep in that position if asked to (I'm a side-sleeper). She told me to just sleep in whatever position I normally sleep in.


Den

[roster]

My titration sleep study is coming up and I'm wondering whether I should be sleeping on my back during this session.

They mostly sit in there doing nothing all night. Make them earn their money. Insist on titrations on back and on side. It's important to know. I know both of mine (actually three including tummy).

[hybridvigor]

I too only sleep on my side but would sleep on my back if I could. When I looked at my sleep study data I saw that I had slept on my back for a significant amount of time. I suspect that I was finally able to breath on my back and so I did not roll over. Also went from an AHI of 20.8 on my own to 0 on the cpap.
Good luck

[fidelfs]

In my second study they asked me how I sleep. I told them on my side, she said that she would like to try me on supine position.

She woke me up several times but one of them was to make me sleep on my back. So she can record the worst case scenario, thanks to that I got the right pressure in case I sleep on my back.

[JohnBFisher]

... They mostly sit in there doing nothing all night. Make them earn their money. ...

It's okay. One turn with me and they will earn their money for all those slow nights. Between restless legs, leg cramps, periodic limb jerks, frequent arousals and need to walk out cramps ... Trust me, they earn their pay. I actually feel sorry for them that (prior to my ASV unit) I would be such an "interesting" patient.

[roster]

... Trust me, they earn their pay. I actually feel sorry for them that (prior to my ASV unit) I would be such an "interesting" patient.

Acually it is a horrible occupation.

-They can only work at night.
-It is boring - 95% of the cases are plain old OSA.
-Most are doing separate night studies for diagnosis and titration, so 50% of the time they just sit there watching people suffer with apnea.
-They are confined to a little operator's room.
-They have almost no opportunity for enjoying teamwork and relations with good work associates.
-No business lunches or dinners. No ball games, golf outings or fishing trips with key customers. (I would die.)
-Their patients are unhealthy and crabby.
-And the pay is low with no opportunity for advancement.

Do the portable home testing routine and let them find better jobs. John, with all your difficulties they can still give you good in-lab attention.

[montana user]

... Trust me, they earn their pay. I actually feel sorry for them that (prior to my ASV unit) I would be such an "interesting" patient.

Acually it is a horrible occupation.

-They can only work at night.
-It is boring - 95% of the cases are plain old OSA.
-Most are doing separate night studies for diagnosis and titration, so 50% of the time they just sit there watching people suffer with apnea.
-They are confined to a little operator's room.
-They have almost no opportunity for enjoying teamwork and relations with good work associates.
-No business lunches or dinners. No ball games, golf outings or fishing trips with key customers. (I would die.)
-Their patients are unhealthy and crabby.
-And the pay is low with no opportunity for advancement.

Do the portable home testing routine and let them find better jobs. John, with all your difficulties they can still give you good in-lab attention.

Thank you, someone understands our job!!...I also miss allot of my Search and Rescue metings. But I do LOVE my job!!!!


To add my 2 cents on the topic of sleeping on your back. We consider a patient "fixed" on CPAP when they are on there back AND in REM sleep and the OSA is gone or slowed. I personally do not ask them to sleep on their back. If they do, then they do. I did not think I slept on my back at all. I went to bed on my side, and woke on my side. It was not until my own sleep study did I find out that I spend quit a bit of time on my back. My AHI on my side is 34, when I go supine it jumps to 62. My technician ( who is now my girlfriend I have mentioned in another post) found a good pressure while I was supine. So I say sleep the way you normally sleep( not all sleep labs follow this). We had a doctor who wanted us to wake up a patient if they were in REM and on their side. He was under the impression they would roll to their back and go right back to sleep. Well we did this on 15 patients and only 3 were able to go right back to sleep. The rest stayed awake for a while and most rolled right back to their side anyway. Needless to say this practice was stopped!

[DoriC]

Montana, the technical stuff about sleep positions is very interesting but I really like the story about meeting your girlfriend in the lab. How cute! I'm a sucker for love stories.

[montana user]

DoriC you made my night, I laughed out loud when I read your post and almost woke my patient..lol

Beleive me I have the best support system at home!! Who else to understand and be tolerant of CPAP then anotehr sleep tech! I apologized one night for the machie making the small hum it makes and she stated " I like it! It means that you are brathing good and will be around for allot longer". She is the best! I can PM you with the whole story if you like so I dont bore everyone on this forum. Sorry folks that was way off topic..

[roster]

Thank you, someone understands our job!!...I also miss allot of my Search and Rescue metings. But I do LOVE my job!!!!

Well that is good for me to know. I like to hear about people who have very difficult jobs and love it. If the job does not present challenges, the human is not living a full life.

[SleepyBobR]

Thanks for all the great responses! I love the insight into the sleep technicians' workplace.

Since posting this, I tried sleeping on my back and it's clear that my current pressure (10.6) is inadequate for the supine position as I wake up with sleep onset apneas just as I'm drifting off. My doctor has allowed me to vary my pressure within his prescribed limits (up to 12) during the period prior to the titration test so I have pretty well zeroed in on a pressure of 10.6 for side sleeping. At this pressure my AI is less than 1 and AHI is less than 5, some nights significantly lower. Last night I tried the pressure at 11 to see if I could sleep on my back. Problem was I couldn't sleep at all in any position. It was like I kept stopping breathing or something and I kept waking up to breathe deeply so I put it back to 10.6. Seems like I need a higher pressure to suppress back apneas but at that level, my breathing itself is suppressed. Is that possible or did I just not give it enough time at the higher pressure? ; I don't want to make adjustments that don't yield immediate improvement in AHI (up to now, that has been the case) so I think I'll just leave the pressure at 10.6 and will sleep on my side until the study.

Thanks again for all the great input.

[split_city]

Some of my own personal comments.

Acually it is a horrible occupation. I would disagree

-They can only work at night. True but the people in our lab don't work every night. I think the most anyone does is three shifts a week.
-It is boring - 95% of the cases are plain old OSA. Yeah I tend to agree with this. But I can think of a lot worse jobs that are boring.
-Most are doing separate night studies for diagnosis and titration, so 50% of the time they just sit there watching people suffer with apnea. There's plenty of other stuff which can be done during the diagnosis part of the night. I was able to write some manuscripts and a PhD during my night shifts. Others have done/are doing the same.
-They are confined to a little operator's room. Must be different over there. We have quite a large room. It's the same room where the day staff work.
-They have almost no opportunity for enjoying teamwork and relations with good work associates. We always have two overnight staff with an afternoon staff member working from 4pm-12am. We also have researchers (such as myself) who are commonly running their own projects in the same buidling. The same people who work at night also tend to mix it up doing day shifts.
-No business lunches or dinners. No ball games, golf outings or fishing trips with key customers. (I would die.) Not really a big issue as no-one works 5 nights a week.
-Their patients are unhealthy and crabby. Haha, you certainly do come across some "interesting" people!
-And the pay is low with no opportunity for advancement. Really? What's the pay like over in the States? I was loving the pay when I was doing overnight shifts. With all the penalty rates for working overnight, weekends, public holidays, I could get up to AUS$300+ after tax for a single overnight shift! Not bad for watching people sleep! But hey, compared to a PhD scholarship, almost anything looks like a million dollars