Im a "stomach sleeper"! What Mask should I use?

[countrysdad]

I currently use a profile lite mask, but just wondered if there was something different that would work better.

Thanks,
Joe

[Julie]

Hi - change your heading here to What Mask Should I Use? I personally use an UltraMirage FF mask which vents NOT out the elbow as 99% do (which makes stomach sleeping hard because bedding always blocks the vent, unlike my mask), but I also did a crazy thing... i.e. cut a 1' long, 3-4" wide, 4" deep trench in my big fat memory foam bed from the head of the bed towards the foot (with top edges rounded/sliced by a great turkey slicer. The mask fits sort of diagonally into the trench not straight down but at an angle (my head turned towards one side), and it works for me. The trick is not cutting too much until you're sure of just how much you need (you can't glue foam back on very well at all).

[Guest]

I am a registered sleep tech. I see patients in the lab all the time that sleep on their stomachs. This is usually a compensation method that the brain uses to adapt to the decrease in airflow. When a person sleeps on the stomach it is usually a subconscience method to take pressure off the chest/lungs and straigten the airway to help avoid obstruction. I have never seen a patient sleep on their stomach that does not have sleep apnea. Another possibility is that this was a learned behavior usually in childhood but obviously at some point in life.

My suggestion would be to 'relearn' supine sleep, which is sleeping on your back. Attempt to sleep on the back for as long as possible each night until stomach sleeping is no longer a habit. The truth is that now you are on CPAP you no longer need to compensate for reduced breathing and the effectiveness of the mask is severely reduced by prone (stomach) sleeping. It might be hard, but you should give back sleeping a try. Now that you can breathe, you will no longer be fighting against your brain's subconscience attempt at survival, trying to force you to sleep on your stomach. At the very least, try sleeping on your side. Hope this helps!

[Julie]

NOOO! You're a sleep tech??? Sleeping on one's back is the absolute worst position for provoking apneas! We all know it and go to extreme lengths to keep it from happening. Where are you getting your information and how many patients have you passed it on to? Go fire yourself! Plus stomach sleeping, whatever else it is, does not take pressure OFF organs - it does, in fact, put pressure on them, but we continue to sleep that way regardless because it works better for us than otherwise, though lucky ones re-train to sleep on their sides.

[Guest]

Yes I am a sleep tech. Of course sleep apnea is provoked by sleeping on your back. However, the CPAP machine normalizes the breathing. Therefore, sleeping in any position is ok while using the CPAP. The problem with sleeping on your stomach is that it interferes with the mask, as you know because you started this thread. As long as you slept on your back while you did your sleep study, which is the most appropriate way, then when you sleep on your back at home your sleep apnea should be corrected while using the CPAP. If you did not sleep on your stomach in the sleep lab, then you likely will continue to have problems with sleep apnea. And sleeping on your stomach does take pressure off of the lungs as the spine and rib cage together divert some of the pressure off of the lungs. If you continue to have a problem with sleep apnea while lying on your back and using your CPAP, you should follow up with your physician, as you might need to have your CPAP pressure adjusted.

As for your question regarding a mask that works well in the prone position, I do not know of one. That is why I suggested sleep position retraining. While you were rude to me, I did not respond in kind and I hope you will benefit from these suggestions although it is not what you wanted to hear. I have absolutely passed this information onto my patients, and the vast majority of my patients do very well. Many of them were stomach sleepers but because they are on CPAP and retrained themselves, they are free to sleep in other positions.

[Guest]

Correction: Julie I wrote that you started this thread and I see that someone else was the original poster.

I re-read your previous post and if you are taking such extreme measures to sleep on your stomach it makes me wonder that perhaps your machine is not set at a pressure that is working for you. You might want to follow up with your physician if you are still symptomatic, such as morning headaches, fatigue, excessive daytime sleepiness, loud snoring, or uncontrolled high blood pressure.

[Sillyme]

This is a good topic. I'm having trouble getting my FF mask to stop leaking unless I'm on my back - which wakes me up but doesn't show up on the chart in the morning as a leak. But the last two nights when I let myself sleep on my back my AHI went back up from 5 to 12. I'm thinking about getting a neck pillow to tilt my head back or using the B&B Mouthpiece I ordered from the internet along with my mask. I'd like to find a more natural solution than cranking up the pressure.

[Guest]

Sillyme,

Full face masks are typically designed for supine (back) sleeping because of the challenges of properly fitting over both nose and mouth. Their design always causes a higher leak than other mask types which, if you sleep on your side, can cause you to wake up. In the sleep lab I almost never fit patients with full face masks for this very reason. Before they get on CPAP, almost all sleep apnea patients mouth breath to compensate for their sleep disordered breathing. However, when the CPAP is set at the right pressure using a nasal mask, the air pressure forces the mouth to stay closed for almost all people. Therefore there is no need to cover the mouth as with a full face mask. The reason that many patients are prescribed full face masks is because it is easier on the sleep tech during the sleep study or the tech is not well trained, but generally is bad for the patient because of these issues.

If your AHI is 12 when you sleep supine it is likely that your sleep apnea is not well controlled. Having to sleep on your side to get a normal AHI is indicative of the need for an adjustment of your CPAP pressure. Use of the CPAP machine should result in normal breathing in any position, provided you don't have other pulmonary disorders. If it has been some time since you have been on CPAP, perhaps you can have another sleep study to reset your pressure. An alternative is to ask the physician to prescribe an autoPAP machine for about a month while using a nasal mask. The information can then be dowloaded and the CPAP machine can be adjusted accordingly. Talk to your physician about this, especially if you are symptomatic. Hope this helps.

[torontoCPAPguy]

I use the Mirage Quattro Pro and sleep on my stomache (mostly) with my head turned slightly to the side. Always have as it serves to decrease my back and joint pains from prior injuries and now arthritic pain. The Mirage Quattro FFM seems to seal well and maintain that seal through the night generally but it does take some fiddling in getting it adjusted first while sitting up and then again, fine adjustments while laying in bed. If I am going to watch baseball or golf on TV I put on my Mirage Activa LT as I generally nod off on the couch. If I am watching anything else I am awake.

[Julie]

To Guest... I can see where you might think I was rude, but you should understand that when you come here, don't register, and call yourself a sleep tech, then proceed to advise people to do something we work so hard at trying to have them avoid, as well as topping it off with some quasi-medical information that's not valid, it does stir up a little emotion. Perhaps if you were to join the forum, at least explain your awareness that back sleeping is not, in fact, normally a good thing for people with apnea and also the part about organs and pressure, I'd have been more inclined to be nicer. In fact, there are people on Cpap who sleep on their back for various reasons, and some of them have found that not doing it definitely improved their numbers, so I don't believe that 'just' being on cpap automatically neutralizes the effect of back sleeping. Sorry.

[adksleepygal]

I am a new cpap user and am having my own new user issues trying to adjust. Just a comment, I too am a side and stomach sleeper and while in the sleep lab was never told I needed to sleep on my back with the cpap on. In fact the sleep tech commented at how well I did while sleeping on my stomach as I managed to get my Optilife with Cradle cushion into position where I slept the best of the night and had no trouble with maintaining a seal. I cannot sleep on my back due to back pain, arthritis, severe neck issues which have been with me for over 20 years. So obviously my apnea problem is not caused from being a back sleeper. It may take some adjusting but if you need to be on your stomach to sleep as do I, it is possible to do. My own issues with cpap are more linked to maintaining sleep or getting to sleep due to the noise from my machine and the whole feeling of having something on my head and face - just torture.

[TX18366]

I currently use a profile lite mask, but just wondered if there was something different that would work better.

Thanks,
Joe

Joe, I'm a stomach and side sleeper also. I find the Resmed Mirage Quattro to work out pretty nicely. I also have a CPAP pillow (https://www.cpap.com/productpage/bicor- ... fresh.html) that allows the mask "elbow" and hose to drape rather than get crushed between my face and the pillow. The exhaust vent is on the bridge of the nose. While the CPAP pillow is not required, it does help. I did find that you have to more or less have your head at the edge of the pillow to work.

Cheers and good luck!
-Cory

[Sillyme]

Sillyme,
Full face masks are typically designed for supine (back) sleeping because of the challenges of properly fitting over both nose and mouth. Their design always causes a higher leak than other mask types which, if you sleep on your side, can cause you to wake up. In the sleep lab I almost never fit patients with full face masks for this very reason. Before they get on CPAP, almost all sleep apnea patients mouth breath to compensate for their sleep disordered breathing. However, when the CPAP is set at the right pressure using a nasal mask, the air pressure forces the mouth to stay closed for almost all people. Therefore there is no need to cover the mouth as with a full face mask.

Thanks for the reply. I tried a Swift FX and liked it, but had to wear a chin strap as well as tape my mouth shut. I think the hybrid I tried was just a bad fit. It leaks too much if I try to sleep on my side. My numbers improved when I went to the FF Quatro (AHI of 5) and I was able to side-sleep until I went up a size to keep from sawing through my nose at the bridge. Now that one leaks when on my side. I guess it's a very expensive game of trial and error. You seem conscientious (or you wouldn't be here). Do you have a method for matching the patient to the mask? My DME guy said he has been doing this for 20 years and I was hoping he would have a feel for it by now, but he hasn't had much to offer.
And what about a neck pillow to tilt the head back. Would that help make up for being supine?

[Slartybartfast]

What the mysterious "Guest" mentioned about sleep positions is interesting. Up until I got on CPAP, I always rolled around a lot in bed as I slept. As soon as I got on CPAP,though, I noticed that if I dropped off to sleep while lying on my back, I'd either wake up the next morning in the same position and have a backache all day, or I'd awaken during the middle of the night with a backache and roll onto my side, which has always been my preferred sleep position. Because of that, I've made sure to roll onto my side before I began sleeping.

[Sillyme]

And what about a neck pillow to tilt the head back. Would that help make up for being supine?

I just remembered that when doing CPR, if the airway is blocked you should tilt the head back and pull the jaw forward. Same problem with the airway collapsing? Wouldn't a neck pillow help? And isn't that the rationelle behind the mouthpiece?