Back Sleeping

After failing CPAP therapy 12 years ago, I wanted to try again. After much fuss with doctors and insurance companies, I finally had an in lab study and just got the results today. Moderate apnea on my back, and no apnea at all on my side. "No effective" CPAP levels were found due to frequent "central apneas" on sleep/wake transitions and the short length of the sleep study -- they titrated the pressure from 4 to 10 but didn't have time to go higher I guess.

Haven't seen the doc yet, and he hasn't posted his interpretation yet, but my armchair interpretation is that I'm headed not for CPAP, but for a "device" to prevent back sleeping. In other words, I probably could have taped a tennis ball to my back and saved myself a lot of trouble.

Any of these devices actually work? I am extremely skeptical, and very shocked that this is where my journey is apparently leading.

ArtNJ wrote: ↑

Tue Jul 26, 2022 2:43 pm

Any of these devices actually work? I am extremely skeptical, and very shocked that this is where my journey is apparently leading.

it's known that many people(myself included) have higher incidences of apnea events when back sleeping. and yeah, you can train yourself to sleep on your side. i did and lowered my ahi.

but our situations are different. even on my side, i need a cpap machine because my sleep apnea is worse than yours.

do you have a copy of that sleep report that you could post here?

also, what symptoms are you having that you think a machine would help with?

good luck!

eta: i wouldn't be so worried about the centrals coming out of sleep. while it MAY be crucial, it rarely IS in most cases. would be good to see that sleep report. just make sure you cover up any personal info on it.

My main symptoms are getting up 2-3 times a night on average, needing a 1 hour nap during the day or being very tired, often being tired anyway, and zero margin for error. Meaning that if I have a cold for a couple of days, I might have several days of fatigue headaches as I try to catch up. I'm lousy with tech stuff, tried to attach a jpg of the first page but it was too big, and I don't know how to redact the PDF. But I think this is the important part:

Baseline Sleep Summary: The patient was monitored for 258.1 minutes. Sleep time was 182.0 minutes and sleep efficiency was 70.5%. Sleep latency was 37.6 minutes. REM latency was 194.5 minutes. N1 was 20.0 min, N2 was 66.5 min, n3 was 85.0 min. The patient slept suppine for 32.7% of sleep time. The arousal index was 19.1

Baseline Limb Movement Summary: The periodic lim movmeent (PLM) index was 26.7 and the PLM arousal index was 1.0

Baseline Respiratory Summary: The apnea-hyponea index (AHI) was 9.9. REM AHI was 34.3. Supine AHI was 29.2. The oxygen saturation nadir during sleep was 88.0%. The patient spent .2 minutes with Sa02<90%. Snoring was noted.

CPAP/Bilevel Sleep Summary: That patient was monitored for 257.9 minutes. Sleep time was 117.0 minutes and sleep efficiency was 45.4%. Sleep latency was 59.5 minutes. REM latency was 147.5 minutes. N1 was 14.0 min, N2 was 57.0 min, n3 was 20.5 min REM was 25.5 min. The patient slept suppin for 32.7% of the time. The arousal index was 17.9.

CPAP/Bilevel Limb Movement Summary: The periodic limb movement (PLM) index was 0.0 and the PLM arousal index was 0.0. [This doesn't explain why my wife used to kick me for leg twitching and face rubbing on pillow or why I was previously prescrimbed stuff for PLM!

CPAP/Bilevel Respiratory Summary: CPAP was started at a pressure of 4 cm H20 and titrated to a final pressure of 10 cm H20

Cardiac Profile: Heart rate averaged 66.6 in the awake state, 64.8 during non-REM sleep, and 64.5 during REM sleep. Disordered breathing events were not associated with significant reductions in heart rate. Significant cardiac arythmias were not noted during the study.

Diagnosis: Obstructive sleep apnea (G47.33)

Interpretation: The study demonstrates evidence for mild obstructive sleep apnea (OSA). The OSA was positional, the OSA was moderate in the supine position and absent in the non-supine position.

During the diagnostic portion of the study, the periodic limb movement (PLM) index was elevated, but the PLM arousal index was normal therefore this study did not meet the diagnositc criteria for periodic limb movement disorder [Again, I dont understand this part at all! When we slept in the same room, wife used to kick me specifically for leg movement and face rubbing]

No effective CPAP settings were found due to frequent central apneas observed at wake-sleep transition points and short titration study time.

Clinical correlation will be provided separately.

ArtNJ wrote: ↑

Tue Jul 26, 2022 4:46 pm

My main symptoms are getting up 2-3 times a night on average, needing a 1 hour nap during the day or being very tired, often being tired anyway, and zero margin for error. Meaning that if I have a cold for a couple of days, I might have several days of fatigue headaches as I try to catch up.

so it does look like you'll benefit from therapy.

I'm lousy with tech stuff, tried to attach a jpg of the first page but it was too big, and I don't know how to redact the PDF.

do you know how to post something on a picture hosting website and link to it here? or is that too technical?

as to the text itself, i'm not the one to interpret the sleep report stuff. we'll have to wait a bit for someone with a better skill set than mine.

good luck!

Try using a pregnancy pillow....