Positional or Nonpositional OSA: Do you know?

[Wednesday4Ever]

I had a night of sleep study using a "Unicorder" headgear device and this clearly showed my OSA to be far worse when supine (laid on my back). The mad thing is that, now I am using a CPAP machine, I can only sleep on my back because if I ever turn onto my side then the mask leaks massively. Paradoxical, isn't it?

Tell us which mask you are using and where it leaks. People here can help you fix it. I used to have trouble with leaks every night, and I don't have many problems now. And I sleep mostly on my side. The leaks can be solved.

I have checked my mask and it is a PHILIPS RESPIRONICS COMFORTGEL BLUE. It's a good product - comfortable and fairly light but it just seems to leak easily if I change position. I also had a strange incident a couple of weeks agoo where it seemed to collect a hell of a lot of humidity. Enough to pour out of the seal - pretty spectacular. I'll try tighteninig the straps up more, of course but I'd be happy for any thoughts on it from anyone. We might well have the problem solved tonight, though, because if it rains any more, the entire English population will drown in the night - the weather is ultra vile, I'm afraid.

Thanks for your kind attention and help.

[kaiasgram]

Hi Kaiasgram,

I am perplexed since you said things aren't going well with cpap. If you were on a roll with using the machine, your reluctance to skip a night would make more sense to me.

Forgive me if I am missing something.

Regarding positional vs. nonpositional OSA, I also had a home test so I am in a similar position to you. Due to having difficulties sleeping on the machine, I have wondered if I should try sleeping on my side to see what happens. But it is just too uncomfortable and I am not in a mood to do trial and error with side sleeping items that I doubt can be returned for a money back guarantee.

49er

Hi 49er -- I don't think you missed anything. I am not doing well one month into cpap, despite good numbers. I just don't want to go from bad to worse. It's funny how different our mindsets can be, because if I was "on a roll" I would not be that reluctant -- I would have reason to trust that I would recover quickly from one bad night. Actually I think you can relate to how I feel, because you mentioned not wanting to experiment with side sleeping given that you're still having difficulty sleeping with the machine. I don't want to experiment either.

Thanks for posting and I hope this thing gets easier for both of us.

[kaiasgram]

So I will ask the OP again,
What is your precise definition of "positional apnea"?

I don't have one. My question came from having read a few articles about different types of obstructive apnea, one of them being referred to as "circumferential" -- if I recall, this type of obstruction is less responsive to a change in position than other types of OSA (other types I've seen referred to as palatal obstruction, and combined upper and lower pharyngeal obstruction). I didn't bookmark the article(s) but if I come across them again I'll let you know if you're interested.

[ChicagoGranny]

I also had a strange incident a couple of weeks agoo where it seemed to collect a hell of a lot of humidity. Enough to pour out of the seal - pretty spectacular.

Sounds like "rainout" - humidifier vapors condense inside the hose and/or mask.

Some easy solutions:

1. Turn the humidifier setting down.

2. Buy or make a fleece hose cover for insulation and sound dampening - https://www.cpap.com/productpage/snuggl ... cover.html

3. Place the CPAP below the level of the top of the mattress and run the hose down toward the CPAP machine. If rainout occurs it will run back into the humidifier tank and not into your face!

[ChicagoGranny]

So I will ask the OP again,
What is your precise definition of "positional apnea"?

I don't have one.

That may be the best answer. Without a standard definition it forces us to talk about each individual's condition and treatment. Often we generalize and that often doesn't help or even hinders one patient's progress.

[Julie]

Then may I ask why you're still using cpap?

[kaiasgram]

Then may I ask why you're still using cpap?

I'm not sure who you're posing this question to.

[49er]

Hi 49er -- I don't think you missed anything. I am not doing well one month into cpap, despite good numbers. I just don't want to go from bad to worse. It's funny how different our mindsets can be, because if I was "on a roll" I would not be that reluctant -- I would have reason to trust that I would recover quickly from one bad night. Actually I think you can relate to how I feel, because you mentioned not wanting to experiment with side sleeping given that you're still having difficulty sleeping with the machine. I don't want to experiment either.

Thanks for posting and I hope this thing gets easier for both of us.

Hi Kaiasgram,

Sorry I wasn't clear. If the devices that helped people stay on their side had a money back guarantee, I would experience in a heartbeat with side sleeping off of the machine. Unfortunately, I haven't been able to come up with a pain free concoction.

Your position makes sense now that you have explained your reasoning.

49er

[Julie]

I was asking Max Darkside why he's on Cpap if he thinks he's 100% positional... or was someone not expressing themselves clearly?

[MaxDarkside]

I was asking Max Darkside why he's on Cpap if he thinks he's 100% positional... or was someone not expressing themselves clearly?

Oh, sorry. During my sleep study I think my AHI was 29 on my side/tummy. I was in the upper 40's on my back. On APAP I'm pretty clean on my side/tummy AHI < 1.0, but severe clusters on my back. So, when I say 100% positional, perhaps I'm misspeaking a bit, I am NOW, on treatment, 100% positional. I could cut my max pressure from 15 to about 10-12 now by staying off my back.

[Sir NoddinOff]

Once on treatment, can you still see a difference when you're supine vs. on your side?

Before XPAP I hadn't slept on my back for 35 years. Once my PR System One's pressure got correctly dialed in, this allowed my airways to stay open all night. As a result, I now enjoy sleeping on my back, typically for about one third of the night. My AHI is a somewhat higher during those supine periods, however I don't give a flying toss because my AHI is still easily within the recognized acceptable range (ie. below 5 events per hour).

It's easy for me to see that supine sleeping is a highly individual experience and that explains why there is a ongoing raging debate on the pros vs the cons. Supine sleepers just can't understand why everybody doesn't give it a try and side-sleepers swear they can't sleep on their backs, no matter what. Hey, to each their own, I say.

[Julie]

T Max D. again...

Have you read the thread Mars did on this? Are you not interested in possibly go the same route (as I wonder about many here who apparently could if they did their own work as Mars did)? I certainly would not want to have to use cpap forever if I had a choice...

[MaxDarkside]

T Max D. again...
Have you read the thread Mars did on this? Are you not interested in possibly go the same route (as I wonder about many here who apparently could if they did their own work as Mars did)? I certainly would not want to have to use cpap forever if I had a choice...

I have to stay on APAP else I will go back to being in the 20's AHI again on my tummy and self destruct if I roll onto my back for whatever reason... then, after a while, probably die... since I'm pretty sure my two probable strokes/TIAs and one very near fatal arrhythmia ("Significant Arrhythmic Event" the doc called it) was due to OSA. With treatment, I'm positional. On my tummy, with treatment, I'm less than 1 AHI. Over the 8 months my arrhythmias have all but gone. Only occasional fluttters now and then, thank God.

[The Choker]

If the devices that helped people stay on their side had a money back guarantee, I would experience in a heartbeat with side sleeping off of the machine. 49er

Why spend money? Surely you have a backpack lying around in some closet? Put a pair of boots or half a dozen Bibles in it. That will keep you from sleeping on your back.

Your position makes sense now that you have explained your reasoning.

49er

She is using positional reasoning.

[49er]

If the devices that helped people stay on their side had a money back guarantee, I would experience in a heartbeat with side sleeping off of the machine. 49er

Why spend money? Surely you have a backpack lying around in some closet? Put a pair of boots or half a dozen Bibles in it. That will keep you from sleeping on your back.

Hmm, your suggestion that I use bibles or boots in my backpack is interesting:) Why not books on socialism:)?

Anyway, sorry I wasn't clear in my previous posting. I did try using a backpack and put some books in it. But when I tried to sleep, I didn't like the sensation of the backpack pulling on me while sleeping.

Perhaps I just don't want to really sleep on my side. Who knows?

49er