Do I really need a machine at all?

After feeling tired a lot at work, this fall I had a home sleep study that showed my AHI was 29.9. I've been using an APAP machine for about a month, trying different masks, and tracking my data in SleepyHead.

I've noticed that my AHI is around 2 to 4 when I sleep on my side, but it goes up to approx 11 or 12 for the night overall when I spend some time sleeping on my back. So I've been making a concentrated effort to sleep on my side.

Today I was at the sleep clinic to try another mask, and I asked them what my AHI was during the original sleep study when I slept on my back vs side. It turned out that, when I slept on my back, they measured my AHI (without CPAP treatment) at 59.8. But my AHI sleeping on my side was 0!

This makes me wonder: Do I really need a machine? Or do I just have to make sure I always sleep on my side?

I asked the tech at the sleep clinic -- she said, yes, maybe just sleeping on my side is enough, and she seemed to indicate it was up to me to experiment and decide. She said I might want to check out a full-body pregnancy pillow as one way to make sure I stay on my side.

Now I'm wondering how to run this to ground. Besides my own perception of how refreshed I feel in the morning -- or asking the sleep clinic to run another home sleep study on me -- or spouse reports of apnea events -- is there anything else I can do to try to sort out if sleeping on my side by itself is treatment enough of my apnea symptoms?

To answer your question......YES

Staying on your side is hard and you still have events as is recorded by you machine - events it couldn't control.

"I've noticed that my AHI is around 2 to 4 when I sleep on my side, but it goes up to approx 11 or 12 for the night overall when I spend some time sleeping on my back. So I've been making a concentrated effort to sleep on my side."

YES
Is the 11-12 overall AHI with cpap?

Dyssomniac wrote:After feeling tired a lot at work, this fall I had a home sleep study that showed my AHI was 29.9. I've been using an APAP machine for about a month, trying different masks, and tracking my data in SleepyHead.

I've noticed that my AHI is around 2 to 4 when I sleep on my side, but it goes up to approx 11 or 12 for the night overall when I spend some time sleeping on my back. So I've been making a concentrated effort to sleep on my side.

Today I was at the sleep clinic to try another mask, and I asked them what my AHI was during the original sleep study when I slept on my back vs side. It turned out that, when I slept on my back, they measured my AHI (without CPAP treatment) at 59.8. But my AHI sleeping on my side was 0!

This makes me wonder: Do I really need a machine? Or do I just have to make sure I always sleep on my side?

I asked the tech at the sleep clinic -- she said, yes, maybe just sleeping on my side is enough, and she seemed to indicate it was up to me to experiment and decide. She said I might want to check out a full-body pregnancy pillow as one way to make sure I stay on my side.

Now I'm wondering how to run this to ground. Besides my own perception of how refreshed I feel in the morning -- or asking the sleep clinic to run another home sleep study on me -- or spouse reports of apnea events -- is there anything else I can do to try to sort out if sleeping on my side by itself is treatment enough of my apnea symptoms?

Ummmmmm yeah.......you still need the machine. The numbers you're seeing from your reports are your "treated" AHI numbers. Without therapy, your numbers would still be way up there. You can't guarantee you're always going to be sleeping on your side. And, the sleep studies are typically only a short look at one or a few nights.

And, and AHI of 2 - 4 still isn't all that great. It's less than 5.0, but many of us are able to achieve AHI numbers less than 1.0 on a regular basis. There's still more to it than AHI, too.......like keeping blood oxygen levels where they should be.

Tweaking the settings on your APAP may help get your numbers down, too.


Den

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webbie73 wrote:Is the 11-12 overall AHI with cpap?

Yes, that's for the entire night with CPAP when I might be on my back for an hour and a half or so.

The fact that my AHI is 2 to 4 when I spend the entire night on my side is interesting. These nights tend to show zero amount of Cheynes-Stokes breathing, but some amount of other phenomena such as hyponea which I suspect is caused by changes in my breathing pattern when I lay awake in the early morning before getting up. I'm wondering if there is something there that the machine is really treating, or would I have the same score whether I used the machine or not?

One interesting data point would be to use a pulse oximeter to see how my blood O2 level does through the night in different situations. Are there reasonably inexpensive oximeters available now that you can hook up to, say, a computer or mobile phone?

Wulfman... wrote:And, and AHI of 2 - 4 still isn't all that great. It's less than 5.0, but many of us are able to achieve AHI numbers less than 1.0 on a regular basis. There's still more to it than AHI, too.......like keeping blood oxygen levels where they should be.

Tweaking the settings on your APAP may help get your numbers down, too.

Thanks. As noted in my other reply, I don't seem to do any Cheynes-Stokes breathing on my side. The phenomena which the machine is tallying as AHI are in other categories such as hyponea. These events appear to occur right before I get up in the morning, during time periods when I'm awake and may be altering my breathing patterns.

As noted in the other message, I'm very interested in seeing if I can find out what's going on with blood oxygen.

There are NUMEROUS discussion threads about pulse oximeters. In fact, I think there are several active ones on this first page.
If they don't answer your questions, do a forum search on "oximeter" or "pulse oximeter".

Den

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I guess I'll echo what others have said, but first... I have a Resmed S-8 as a backup that I got from a friend who is doing exactly what you are doing. I told him I would keep the machine until he needed it back. Last time I asked how things were going, he was less than convincing that his forced side sleep position was working.

I have tried to do the side sleep to reduce my AHI and I'll tell what I found. If you normally sleep on your back, it is really difficult to "never-ever" sleep or rest on your back. I've tried pillows, tennis balls, actually the best one was a paintball pod carrier with 4 pods, but even that made it difficult not to try and roll on my back. My hip also started to hurt so we got a mattress topper. I will say that with CPAP I was able to get down to that 2-4 AHI range on my side. I have since abandoned the side sleeping and worked to reduce my AHI "with CPAP" in other ways and I am in the 2-4 AHI range regardless of my position.

Finally, your sleep study is a good starting point, but it is not much more than that. For all you know you only sleep an hour without an REM on your side and got great results. My sleep study showed zero centrals but I have more of them than obstructives. As already noted noted 2-4 is not anything to write home about, even though it is less than 5. I didn't catch your machine pressure, but it better be at 4 with zero or close to zero on your side the entire night. Then you may want to get a new sleep study. I'm not saying you can't do this, but you first have to be successful at side sleeping at getting to zero AHI.

John

Thanks for all the comments, very helpful.

70sSanO wrote:If you normally sleep on your back, it is really difficult to "never-ever" sleep or rest on your back. I've tried pillows, tennis balls, actually the best one was a paintball pod carrier with 4 pods, but even that made it difficult not to try and roll on my back. My hip also started to hurt so we got a mattress topper.

The tech at the sleep clinic showed me this page:

http://www.walmart.com/ip/Leachco-All-N ... y/13360480

Has anyone tried something like that?

70sSanO wrote:I have since abandoned the side sleeping and worked to reduce my AHI "with CPAP" in other ways and I am in the 2-4 AHI range regardless of my position.

What's been working for you to accomplish that?

Post your SleepyHead results when sleeping on your side. What's the pressure you're getting when you're sleeping on your side?

Wulfman... wrote:There are NUMEROUS discussion threads about pulse oximeters. In fact, I think there are several active ones on this first page.
If they don't answer your questions, do a forum search on "oximeter" or "pulse oximeter".

Thanks, I found a helpful thread and ordered a CMS 50D Plus.

archangle wrote:Post your SleepyHead results when sleeping on your side. What's the pressure you're getting when you're sleeping on your side?

Would this mean posting a screen print of the daily data display? Any particular rows, apart from the one for Pressure?

On one recent night, my AHI overall was 1.80. The machine is set to vary its pressure from 4 to 20 cm. On that night, the pressure varied between 4 and 6 cm. The event flags were 2 CSR, 0 LL, 2 CA, 0 OA, 10 H, 7 FL, 8 RE, 0 VS, 2 VS2.

Dyssomniac wrote:

archangle wrote:Post your SleepyHead results when sleeping on your side. What's the pressure you're getting when you're sleeping on your side?

Would this mean posting a screen print of the daily data display? Any particular rows, apart from the one for Pressure?

On one recent night, my AHI overall was 1.80. The machine is set to vary its pressure from 4 to 20 cm. On that night, the pressure varied between 4 and 6 cm. The event flags were 2 CSR, 0 LL, 2 CA, 0 OA, 10 H, 7 FL, 8 RE, 0 VS, 2 VS2.

as has been mentioned hundreds of times here,

print screen of a sleepyhead display, turn off the calendar, select details on the left, then event flags, flow, pressure OR mask pressure, not both, leaks, and if space permits, snores and flow limitations, if your machine charts them

palerider wrote:as has been mentioned hundreds of times here,

print screen of a sleepyhead display, turn off the calendar, select details on the left, then event flags, flow, pressure OR mask pressure, not both, leaks, and if space permits, snores and flow limitations, if your machine charts them

My apologies! Below is a screen print. I can really only get about 2-1/2 rows under the Event Flags row on my Windows screen.