a question for those consistently under 5 AHI

Hi all. So a few months back, I went for my one-year checkup with my sleepy doc. I dutifully took a digital version of my SleeyHead chart showing my "changes to prescription settings" that I had made over the months (which of course caused him to harrumph a bit) and wanted to talk about my continuing issues with supine-positioned slumber. When I did my original sleep study, it clearly showed that the bulk of my events occurred while I was on my back.

I had assumed that being initiated into the CPAPer club would at last allow me to go supine and spare my injured shoulders. Alas, that has not happened. While I occasionally get my AHI down below five, a reading between 5-10 is more likely, with readings in the 10+ range not out of the question. Most of the events occur in clusters, some of them lasting nearly one hour at a time.

My question for those of you who have consistent sub-five results: what's the trick, or tricks? Or perhaps supine is not an issue for you? I would love to be able to simply sleep on my back, as my shoulder problems are gradually getting worse, but I'm at a loss for how to accomplish that, and my sleep doc was clueless as well.

Thanks much!

Sign me "Raw Sienna."

Finding the right pressure setting and getting other settings dialed in. Finding a comfortable mask and the right humidity setting and hose temperature help make it more comfortable, too.

First, you must define the problem. What is the composition of your AHI? Is it primarily central apneas, obstructive apneas, hypopneas, or a mixture of all? Once the type of events you are having is known, a reasonable course of action might be suggested.

Best to post a couple typical SleepyHead charts so people can see what's going on.

Principally obstructives and centrals. They seem to take turns being the issue. Obstructives seem to be the key flag for supine sleeping, because the epiglottis (?) still seems to close while breathing. My pressure is setting at a permanent 13.5. Can't post charts presently as I'm away from my desktop.

M

mrcrayola wrote: ↑

Wed Mar 27, 2019 6:28 am

My question for those of you who have consistent sub-five results: what's the trick, or tricks?

the trick is to post sleepyhead charts here for peer review. each of us responds differently to our cpap journey and thus need to focus on different fixes. an ahi is made up of many events, events that can be managed so that one can get a lower ahi.

there is no secret sauce. there is no "one weird trick that doctors don't want you to know". if thatw ere the case, this forum could just be boiled down to one post which would contain just that information.

so, when you get the chance, please see the links in my sig and post some charts.

good luck!

I also have a lot of shoulder pain (arthritis) and cannot lay on my side for any length of time without pain. I sleep on an adjustable bed with my head and feet raised, similar to sleeping in a recliner. When we travel, I cary two wedge pillows which I use to prop up my upper body and place one or two pillows under my knees. When I had my last two sleep studies, I slept in a hospital bed. My AHI is normally under 1 every night. I do have occasional nights where it goes higher, but those are nights I have trouble sleeping because of back pain.

My events quadruple when I sleep on my back. Had to do when I fell on one shoulder and then the other went "frozen" . PT helped the shoulders but it was a miserable 6 months or so. Doc put me on anti-inflammatories. Wedge under upper body helped, needed skinny pillows to keep shoulders as comfortable as possible.

The biggest benefit for me came from losing 70 pounds. I did it in stages over a 10 year period. Now my AHI is consistently below 1. FWIW I have always been a back sleeper. I got initially diagnosed in 2001 and have used a CPAP continuously since then.

Every 10 pounds of weight loss got me to a weight plateau that required a change in some behavior to overcome. They are too numerous to mention. I still have another 10-15 pounds to go.

At my last session with my neurologist, we discussed possible discontinuation of treatment. I plan to stop using my CPAP for a few days while on vacation and see how I feel.

I too have shoulder problems. Bursitis in both shoulders plus a few surgeries on my left one. I switch from side to side frequently throught the night trying to get comfortable. Routing the hose between two pillows has helped to keep me from strangling myself and my ahi is usually below 2 when I can keep the mask from leaking to badly.

I remember seeing some specialty pillows discussed on here quite some time ago that have a deep groove for the arm and shoulder to fit into to take pressure off the shoulder when side sleeping. Wondering if anyone with shoulder issues found them helpful, and for which specific shoulder issues. Anyone here using one?

I know I get on this soapbox a lot, but using the technique of training the tongue to stay sealed to the roof of my mouth has enabled me to back sleep without increasing my pressure. Used to have to also support my chin so my jaw didn't fall open, but don't even need that any longer. Took me months of doing it both when sleeping and awake for it to become second nature, but was so worth the effort.

Maybe the issue is the fixed pressure. Perhaps you need more pressure when on your back???

kteague wrote: ↑

Fri Mar 29, 2019 1:24 pm

I remember seeing some specialty pillows discussed on here quite some time ago that have a deep groove for the arm and shoulder to fit into to take pressure off the shoulder when side sleeping. Wondering if anyone with shoulder issues found them helpful, and for which specific shoulder issues. Anyone here using one?

I know I get on this soapbox a lot, but using the technique of training the tongue to stay sealed to the roof of my mouth has enabled me to back sleep without increasing my pressure. Used to have to also support my chin so my jaw didn't fall open, but don't even need that any longer. Took me months of doing it both when sleeping and awake for it to become second nature, but was so worth the effort.

I can't use the speciality pillows. I need something really flat, I've also heard this from others with shoulder problems but that ymmv sticker is pretty huge when it comes to pillows just like with masks.

mrcrayola wrote: ↑

Wed Mar 27, 2019 6:28 am

My question for those of you who have consistent sub-five results: what's the trick, or tricks? Or perhaps supine is not an issue for you?

Took me 5 months, and open heart surgery, to be able to get more than 3 hours use out of my machine.

BUT, once I DID have surgery, I kept the mask on all night most of the time.

But after a while here, I found that *I* could change the settings,
so boosted my starting pressure to 6 (from 5), and minimum
pressure to 12 from 11. That dropped my average AHI from 5 to less than 2
(last 3 weeks, avg. is less than 1 and highest has been 2.1 for 1 night).

I NEVER sleep on my back, haven't for over 40 years. Just not comfortable.

SDBud wrote: ↑

Fri Mar 29, 2019 6:53 pm

and open heart surgery,*

* Open heart surgery not normally required for cpap success. Your Mileage May Vary. Batteries not included. Offer void where prohibited.

palerider wrote: ↑

Fri Mar 29, 2019 7:14 pm

SDBud wrote: ↑

Fri Mar 29, 2019 6:53 pm

and open heart surgery,*

* Open heart surgery not normally required for cpap success. Your Mileage May Vary. Batteries not included. Offer void where prohibited.

Of course not, but it happened to coincide with my ability to get the max out of my treatment.