Iancdub88 wrote: ↑Fri Sep 06, 2024 8:11 am
So I have another question. I should have the BIPAP next week. In the meantime, I have finally found a sleeping pill that seems to help called Trazadone.
If the Trazadone allows you to sleep and you're not feeling groggy when you have to get up in the morning, then I would say keep taking it for now.
I've had a couple OK nights of sleep despite the fact that I'm still not getting deep enough breaths for REM(that's where the BIPAP comes in).
Not sure what you mean here. And I'm not sure your expectation that a bi-level machine is magically going to allow you to get more REM is a reasonable expectation.
Here's what I mean: Sleep breathing is naturally much shallower than normal wake breathing. And to the best of my knowledge, our breathing does not necessarily become "deeper" when we hit REM. It can become more irregular in REM and it can look more like "wake breathing" in the sense of being more irregular, but that does not necessarily mean that it's "deeper" than normal sleep breathing.
And whether switching from an APAP/CPAP to a bilevel will somehow increase time in REM is a very difficult question to answer. In general the only difference between using an APAP/CPAP and an (auto) bi-level machine is that the bi-level allows for a bigger difference between the IPAP (inhalation pressure) and the EPAP (exhalation pressure). The difference between IPAP and EPAP is called
pressure support or PS for short. For a person with ordinary old OSA, increasing PS from 3 (EPR = 3) on a Resmed AirSense 10 or 11 AutoSet to a PS = 4 or PS = 5 on a Resmed AirCurve 10 VPAP Auto may increase comfort breathing with the machine when trying to get to sleep and it may help reduce problems with aerophagia. So the switch can lead to fewer spontaneous arousals---if the spontaneous arousals are somehow connected to either aerophagia problems or discomfort while breathing with the machine problems. But I don't think the switch is going to do much to encourage the body to get more REM sleep.
There is another reason that people will be switched from APAP/CPAP to bi-level, but it does not seem to apply in your case: For some people a pressure of 20 cm, the maximum pressure that an ordinary APAP/CPAP can deliver, is not enough to prevent the vast majority of their obstructive events. And a bi-level machine like a Resmed AirCurve 10 VPAP or VPAP Auto can deliver pressures as high as 25cm. But your obstructive events are well controlled with pressures that are significantly less than 20 cm. So that's not why you are being switched to a bi-level machine.
Anyways, I've found that I've been waking up on my back quite a bit and that back sleeping has actually become fairly comfortable. However, I always hear people saying how bad supine sleeping is with CPAP.
Is it really that bad to sleep on your back? I only had an AHI of 0.3 last night.
Here's what you need to know about supine (back) sleeping:
1) In terms of the spine and the back muscles, back sleeping is usually preferable to sleeping in other positions
for most people. In other words, most people are less likely to wake up with a back ache when they sleep on your back. (There are people like pugsy where back sleeping tends to increase back and/or pelvic pain, however.)
2) Untreated OSA can often be worse when sleeping on your back, but it's not
always worse when sleeping on your back. Go back and look at your diagnostic sleep study. What does it say (if anything) about your untreated AHI when sleeping on your back. Was it about the same as your untreated AHI when sleeping on your sides or stomach?
3) Some people with OSA do need more pressure to prevent the vast majority of the obstructive events when sleeping on their backs. Other people don't. This is only a real issue if you have trouble sleeping with the pressure needed to control your OSA when sleeping on your back.
4) When using an auto adjusting xPAP machine, the machine ought to be able to increase the pressure appropriately if you roll onto your back. But if your OSA is worse on your back or you do need more pressure to control your OSA when sleeping on your back, then it is important to have the
minimum pressure setting close enough to what's needed to control the OSA on your back so that you don't wind up getting a significant cluster of events every time you roll onto your back before the machine manages to increase the pressure up to what's needed to control your apnea while back sleeping.
Putting 1-4 together means this: If your
minimum pressure is set high enough, then sleeping on your back with an xPAP machine is
NOT a problem: When you roll onto your back, the machine will be able to increase the pressure in a timely fashion after one or two events occur and there won't be any nasty clusters of events just because you are sleeping on your back. And your whole body just may prefer sleeping on your back with the higher pressure needed to manage the OSA while sleeping on your back because back sleeping will be easier on the spine and back than side sleeping or stomach sleeping often is, even though less pressure might be needed when sleeping on your side or stomach.
In other words, if you are waking up on your back, your AHI is well below 5.0, and you are waking up feeling pretty decent (i.e you are feeling rested and even refreshed), then your pressure settings are high enough to allow back sleeping and any additional pressure is not triggering problems with aerophagia, then there is no reason at all to worry about the fact that you're doing some back sleeping.