Tennis Ball or CPAP?

Hello everyone! I’m new here (based in UK)

I had a home sleep rest a few weeks ago.

Result came back with a total AHI of 9.5 and a REM AHI of 27.9, Supine AHI of 19.8

I’m therefore diagnosed with mild positional OSA.

Although the diagnosis is mild, I have seen some alarming SPO2 drops to low 70’s for a few seconds at times. This worries me.

I started off seeing if this could be addressed with the old tennis ball in the t-shirt trick. It seems to work.

I use a Wellue ring to measure my SPO2 and a device called Snooore to measure my sleeping position.

It’s clear that my problem is mostly positional. But, I suspect not completely. There may also be some UARS going on as well.

Therefore, I elected to pay for a one month trial of CPAP.

I’m using a Lowenstein Prisma 20a machine with a Resmed p30i mask (nasal pillows).

I’m using APAP (8-12 pressure range)

I’ve only attempted to use the machine for two days so far.

I’ve got to a point where I’m very comfortable with the breathing sensation on APAP. But, I just can’t get to sleep.

It’s like I’m excited to see how it works and I can’t switch off.

I’m excited because I think this could also address some other issues I have (anxiety, insomnia, high blood pressure, fatigue, obesity).

However, no-one wants to be on CPAP if they don’t need it.

My question is this; given what I’ve described, do you think I should stick with the CPAP trial or go back to my tennis ball?

Secondly, do you have any tips on how I can mentally switch off from all this?

Many thanks for your time.

Paul.

1. What is your age?

2. Do you really think back-sleeping can be entirely avoided? This is very difficult for many people.

3. You don't mention energy levels and excess sleepiness during the day??? The idea of CPAP is to have normal energy and no excess sleepiness.

Hi!

1) 51yr old Male. BMI=30
2) I don't know yet. I am accurately measuring it and certainly with the tennis ball trick its working. (Thats probably less intrusive than CPAP!)
3) Well, I have low energy and am tired, with anxiety. Although, I have never unintentionally fallen asleep during the day. I feel like I've been like that forever. Although its got worse this past year.

I certainly do not feel like my sleep is of sufficient quality or duration whether I use the tennis ball trick or not. But, I was hoping that with weight loss and alcohol cessation, this would improve.

In the meantime I'm trying out CPAP to see if that works for me.

It's clearly an investment of both money and effort to get used to it (I'm guessing quite a few weeks of adjustment).

Thats why I was seeking guidance as to whether it sounded like I need to commit to it.

I guess no-one knows without trying and its impossible to predict whether;

a) it will work for me
b) I'll be able to adapt sufficiently.

At the end of my month trial, if its clear its needed and works, I would then buy my own machine.

Thanks for your response.

Paul.

Maybe the details of your report shows how much of that REM sleep was while supine. If there is a REM component independent of a supine component, side sleeping will not fix the REM aspect. An overall AHI within the mild range means little when the REM AHI is so problematic. Duration of events matters too even if there are a lesser number of non supine events. Arousals matter too. If 4 events per hour cause arousal, in an 8 hour night those 32 sleep stage disruptions could be pretty detrimental to getting restorative sleep. You are wise to weigh things carefully before deciding against treatment.

Although your active mind is likely not the same cause as mine, in general I have found that playing soft rock oldies just loud enough to make out the words helps my brain to settle into the comfortably familiar sounds. It's like my attention is directed and less likely to dart here and there. The input of words I know by heart means I don't have to stay alert to hear the words, yet my brain has input to process, hopefully long enough to fall asleep. Never hurts to try. And establishing a routine can help send signals it's time to sleep. For me it was putting a few drops of a pleasant essential oil on a cotton pad behind the air intake of my machine. (Don't lay it on the wood, it will damage it.) Good luck figuring out what might help you.

Hi kteague,

Many thanks for your response.

During my home sleep test all of my REM sleep was while on my back. This is why they diagnosed me with positional sleep apnea.

However, I believe a home sleep test is somewhat limited. In addition, the duration of the test was only 3.5 hours.

REM sleep could easily be a component of apneas whatever way I happen to be lying.

The more I study this, the more I reflect on how I feel and the more experience I get of my CPAP machine (rented), the more I think I need CPAP therapy at least until lifestyle changes (weight/alchohol use/stress) can take an affect.

I find listening to audiobooks is another great way of drifting off. Also blocks out the noise from the machine. Just don't like sleeping for hours with headphones in.

Thank you again.

Paul.

Hi pbrankin,

I don't know what 'total AHI' is. Do you mean 'average across the whole night'?

You say you had a home sleep study – was this one you paid for, and provided by Eu-pap or by ResMed or Philips Respironics (or some other)? Or was it via an NHS sleep-medicine department?

I'm inclined to think it was via an 'independent' since SMDs don't usually go into detail wrt to REM sleep.

And if it were via the NHS, they'd might already be treating you. (The NHS treatment starts at an AHI of 15 and above.)

With respect to your question "tennis ball or machine?" I would say machine.

One, because 19 supine is bad. It suggests quite a tendency for the tongue to fall back. And that tendency may increase as you get older.

Two, because the tennis ball trick – or a similar device – a back pack, a bolster – isn't reliable and may not last. As I said, your supine AHI may get worse as you get older. Mine's did.

An APAP machine is the 'gold standard' in treatment for sleep apnea.

As to buying a machine, to keep your GP happy, buy from one of the two main manufacturers – ResMed UK in Abingdon or Philips Respironics UK in Chichester. Either of whom will need a 'scrip' – your GP can sign that. And you can download a blank electronic scrip from the website of either of these two.

For me, the tennis ball would be far more invasive than cpap.
Too much like a rock that cannot be tossed out of the bed.
Cpap let me sleep on my back for several months following surgery for breast cancer,
and allowed me to sleep well while both shoulders were healing from strains.
You will understand when you get older--(IF you get older . . . )
I use tennis balls in my dryer to fluff things like coats and pillows.
They live in a can next to the detergent.
Where they BELONG.

rick blaine wrote: ↑

Tue Dec 07, 2021 9:14 am

. . .
buy from one of the two main manufacturers.

If one of the two is Respironics, where have you been all year?

Pbrankin, creating a going-to-bed ritual is a great suggestion, and I second it. Also, go to bed at the same time every night and make sure you're not ingesting caffeine after around 2 p.m. You might also find a noise machine helpful, especially if the noise it generates is truly random.

If you have any choice at all, get a ResMed Airsense 10 or 11 Autoset. The majority of people who've tried both RM and PR machines prefer RM, which has an algorithm that follows your breathing very naturally. Be aware that the newest PR machine is not (yet) compatible with the Oscar software that is such a boon to so many of us.

Good luck, and keep us posted!