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

[LoQ]

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.

As long as you continue to view CPAP therapy as torture, it is going to be difficult for you to accept and adjust to this new issue in your life. I suggest you cultivate a new attitude towards the equipment.

[trytryagain]

For many years now I usually fall asleep on my back, change from left to right sides then finally end up sleeping on my stomach.
I have only been on Cpap for a month now, and I am training myself to sleep on sides. I believe sleeping on my stomach has caused many of my lower back and neck pains. Laying on stomach with your head raised on pillow is unatural and causes strain on the neck. For me anyways.

[Sillyme]

I am a new cpap user and am having my own new user issues trying to adjust.

Sorry you're having a hard time adjusting. I expected more problems adjusting than I actually had. Maybe finding a distraction would help. I'm listening to a light-hearted book on CD as I fall asleep. I find it isn't taking me as long as I thought because I'm having trouble getting past the chapter I'm on. Try a pleasant scent - lemon or vanilla, just a tiny amount- near the air intake. Find other ways to associate going to bed and putting on your mask with something pleasant. Good luck.

[elena88]

I use the swift fx and I sleep on my sides and tummy.. to sleep on my stomach, I have to use a few pillows to make a "basin" for
my face so I dont squish my nose pillows to pieces.. when I sleep on my stomach, I dont have any apneas. Also I have learned to keep my
mouth shut, and rest my teeth on each other in a way that opens my airway more..

[M.D.Hosehead]

However, when the CPAP is set at the right pressure using a nasal mask, the air pressure forces the mouth to stay closed

Guest, this makes no sense. Perhaps you can explain.

[Guest]

I'm a stomach sleeper as well and LOVE the Headrest Nasal Pillow mask. Even if you burrow your head in the pillow, you won't block the vent holes as they are higher. Check it out...you won't be sorry.

[elena88]

oh yes, be careful, one night I didnt make my little basin, and did a face plant in my pillow and it was a disaster..
I think I rebreathed all my vent air!

It wasnt a fun day after that..

that was my swift fx big boo boo..

[Guest]

This is the ‘guest’ sleep tech. I generally do not post on patient forums. However, this forum came up on a search I was doing. When I went to the site, this thread was at the top of the list so I thought I might respond to offer some help. I knew I did not intend to continue posting so there was no reason in my mind to register. With all the responses this thread received though I felt compelled to respond.

If the members of this forum work hard at trying to have readers avoid sleeping on their back, then there is a widespread fundamental misunderstanding of PAP therapy. Obstructive sleep apnea is just that, a physical obstruction in your airway that occurs during sleep that causes you to stop breathing. The soft tissue surrounding the airway collapses and it is as if you are choking. The therapy to correct that obstruction is PAP. The force of the air moving through the airway holds the airway open, essentially removing the obstruction.

How much pressure do you need to keep your airway open? That is determined by your physician based on your PAP titration sleep study. The key to getting the best results is to do the PAP titration study while lying on your back. If the PAP machine can keep your airway open while lying on your back when your sleep apnea is at its worst, then the pressure is correct. Because the PAP machine has corrected the obstruction and the airway is now open, there is no need to avoid sleeping on your back. It’s as if you do not have sleep apnea while using the PAP machine. This is why I stated that sleeping in any position is generally not an issue for people with sleep apnea who are on PAP therapy.

Some might have pulmonary disorders that complicate their sleep apnea and they have to avoid supine sleep out of necessity. Some have pain issues and also have to avoid supine sleep out of necessity. Others might have positional sleep apnea, which is very mild sleep apnea usually presenting in supine sleep (generally not most patients).Others though, after starting PAP therapy have had physiological changes that affect their sleep apnea. Perhaps the body made an adjustment after staring PAP. Perhaps some have put on or lost weight. Or some might be taking medications that have an effect on sleep apnea. In these cases the physician might find it more practical to advise you to avoid supine sleep. However, if you feel as though you cannot sleep on your back that may indicate that you are not set at a pressure that is adequate to keep your airway open. What position you sleep in should be your preference and not a necessity. Prone (stomach) sleep is often not recommended due obvious issues but also it does not allow the carbon dioxide to properly escape the mask. Prolonged carbon dioxide in the blood can cause headaches, which is why many sleep apnea patients had headaches before they started on PAP therapy.

For those who mentioned about full face masks the question I would pose to you is ‘how do you breathe while you are awake?’ If you generally do not mouth breath during wake you should not be mouth breathing during sleep. Again, the PAP machine normalizes your breathing. That is why a full face mask is usually not necessary. When your PAP machine is set at a pressure that is adequate for you, then a nasal mask is all that is warranted. The force of the air travelling through the airway pushes the soft tissue at the back of the throat closed, cutting off its exit through your mouth. So you will not mouth breath. The full face mask also has been proven in many cases to push the jaw slightly backwards which often causes obstruction of the airway, thus causing worse sleep apnea. The full face mask also requires typically between 6-7cm of additional pressure to compensate for that. So higher pressures, potential worsening of your apnea, and comfort issues are reasons to avoid full face masks if at all possible. For persistent mouth breathers, which is a small fraction of patients (many patients think they are but are not in actuality) a full face mask might be appropriate. However, that is a last resort and again most people breathe normally using the nasal mask when PAP is set at an adequate pressure.

I hope this explains more clearly my previous posts. I wish you all good sleep health.

[Calist]

If the members of this forum work hard at trying to have readers avoid sleeping on their back, then there is a widespread fundamental misunderstanding of PAP therapy.

Oh hello there Guest tech. Yes, there is a widespread fundamental misunderstanding of PAP therapy on this forum and they are trying to spread it to others because they feel that independent "I just made it up" research is better than medical science. Hi, I'm Calist and I've been waiting for an RPSGT to come in here and back me up. Keep going, you are doing great.

[Calist]

However, when the CPAP is set at the right pressure using a nasal mask, the air pressure forces the mouth to stay closed

Guest, this makes no sense. Perhaps you can explain.

Got six months?

[jonquiljo]

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.

I agree wholeheartedly. Why do the moderators and owners of this forum allow people to post without registering? It's anonymous in any case and will cover these "odd" people coming in who make these outrageous claims as to what they are qualified to say.

There are phrases and excepts from this "guest's" posts that remind me of other "guest" posts that I have seen recently. I would track these posts down but it would take more time than it's worth.

[The Guest]

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.

I agree wholeheartedly. Why do the moderators and owners of this forum allow people to post without registering? It's anonymous in any case and will cover these "odd" people coming in who make these outrageous claims as to what they are qualified to say.

There are phrases and excepts from this "guest's" posts that remind me of other "guest" posts that I have seen recently. I would track these posts down but it would take more time than it's worth.

I am the "guest" sleep tech. Let me just say that I read a few posts written by calist and most of it was very offensive. We may be in the same profession and understand the same medical principles but I would never treat any patients with such poor manners. My posts have not contained any name calling or personal attacks. My goal was simply to help fellow sleep apnea patients by offering my professional knowledge in this thread.

As a dedicated sleep tech I spend a lot of my time educating patients about how they can be successful on PAP therapy. I know how important that is because I personally suffered from severe sleep apnea for many years. When I had my sleep study my AHI was over 100 events per hour. That is why I became a sleep tech because I personally understand how it can ruin your life. I wanted to help others as I had been helped.

It seems however that my few attempts to correct some misperceptions are not welcome here. That is unfortunate. I am very successful with my own therapy, even though it's severe and most of my patients are very happy as well. I keep in frequent contact with them. Because they listen to my advice they are not saddled with what position they can't sleep in or what problems with masks they have to worry about. They gave up their misperceptions, like I did when I started PAP therapy, and benefitted.

To call the medical science I wrote 'quasi-medical information' or 'outrageous claims' is quite unfortunate. When I first read this my mind was blown that years of scientific medical certainties were being labled this way. Now I am just saddened that many who are on this forum will continue to suffer when PAP therapy could really work for them. My education was two years training by the American Academy of Sleep Medicine and I passed the board exam to become a Registered Polysomnographic Technologist. My education was very expensive yet I was offering it free. I wish you all the best but I truly believe that many of you are suffering needlessly. Although I have apparently overstayed my welcome, I do wish all of you good health.

[M.D.Hosehead]

The force of the air travelling through the airway pushes the soft tissue at the back of the throat closed, cutting off its exit through your mouth. So you will not mouth breath.

Guest, you may be a very pleasant person and dedicated health worker. Most of your patients may be benefiting from your attention.


But, respectfully, if this is your answer to my previous question,

Guest wrote:
However, when the CPAP is set at the right pressure using a nasal mask, the air pressure forces the mouth to stay closed

Guest, this makes no sense. Perhaps you can explain.

you need to review the anatomy. You are imparting incorrect information.


I'm going to the trouble of pointing this out so that others can draw their own conclusions:

1. First you say air pressure forces the soft tissue at the back of the throat to stay open to prevent obstruction.
2. Then you say the same air pressure forces the mouth to stay closed.
3. Finally, you say the same air pressure pushes the soft tissue in the back of the throat to close, which is the opposite of #1.

It isn't logical, and if you care about your patients, as you say, you will go back to the books and check out what you are telling people.

[Calist]

The force of the air travelling through the airway pushes the soft tissue at the back of the throat closed, cutting off its exit through your mouth. So you will not mouth breath.

Guest, you may be a very pleasant person and dedicated health worker. Most of your patients may be benefiting from your attention.


But, respectfully, if this is your answer to my previous question,

Guest wrote:
However, when the CPAP is set at the right pressure using a nasal mask, the air pressure forces the mouth to stay closed

Guest, this makes no sense. Perhaps you can explain.

you need to review the anatomy. You are imparting incorrect information.


I'm going to the trouble of pointing this out so that others can draw their own conclusions:

1. First you say air pressure forces the soft tissue at the back of the throat to stay open to prevent obstruction.
2. Then you say the same air pressure forces the mouth to stay closed.
3. Finally, you say the same air pressure pushes the soft tissue in the back of the throat to close, which is the opposite of #1.

It isn't logical, and if you care about your patients, as you say, you will go back to the books and check out what you are telling people.

Actually it is correct information if you would reffer to the Atlas of Clinical Polysomnography. It sounds as if this Guest RPSGT knows exactly what he or she is talking about. Has anyone in this thread ever run a PSG besides guest and myself? From all of the threads on this forum it sounds as if people are trying to re-invent sleep science with absolutely no research or testing.

It is okay to question medicine but unless the person posing the question has at least run a handful of titrations, everything they present will be personal speculation.

[cwied]

Actually it is correct information if you would reffer to the Atlas of Clinical Polysomnography. It sounds as if this Guest RPSGT knows exactly what he or she is talking about. Has anyone in this thread ever run a PSG besides guest and myself? From all of the threads on this forum it sounds as if people are trying to re-invent sleep science with absolutely no research or testing.

It is okay to question medicine but unless the person posing the question has at least run a handful of titrations, everything they present will be personal speculation.

You know, I happen to believe you, but the way you're presenting this information seems to be more designed to attack than to convince. I understand you are frustrated because you feel people are ignoring facts and just going with their misconceptions, but it seems like

Perhaps you could explain the mechanism through which the air pressure forces the mouth to stay closed? I'm guessing it's something like the external pressure on the lip or the pressure on the palate somehow forces the mouth shut.