Newbie question, side sleeper

Hello all, I'm brand new to this forum. I was diagnosed with sleep apnea a few weeks ago. I just received my CPAP on Friday and have been using it for two nights. I actually came to this site on the recommendation of the tech that delivered my equipment.

Here's what I've got:

Respironics REMstar Pro 2 w/C-Flex and heat/humidifier. I'm set to 12.
My mask is a Flexifit 431 which is a full-face mask.

Background:

I have to wear a full-face mask due to bad allergies. I know from reading through other posts that some folks recommend that I get the allergies taken care of. Believe me when I say that after 35 years of being treated for allergies I've had everything on your shopping list and then some, antihistamines, histimanine blockers, decongestants, pills, sprays, you name it. Last year I was on Nasacort, this year it's Nasonex. Nothing will consistantly keep my sinuses open. Treating the allergies before treating the apnea just isn't happening.

Also, I've never been able to sleep on my back, I've always been a stomach sleeper. I've let everyone and their brother know this during the course of the initial diagnostic through the sleep studies ( I swear, if I heard "Sir, we need you to turn over onto your back" just one more time...), and I told the tech that dropped off the equipment this. Everyone seemed to think I would be ok.

Ok, now for my question:

When I'm flat on my back everything with the mask is fine (at least I assume so). My cheeks puff out like a balloon, there's definate presure when I exhale. Everything is just like during the sleep test.

Now, when I turn to my side (I've accepted that I'll never make it all the way to my stomach with the gear on) I don't feel any pressure. My cheeks don't fill out, there's no pressure to work against when I exhale, etc. I know that the air is still flowing because I can feel it against my face, there's still air coming out though the vents, and if I break the seal of the mask a flood of air comes out. There are no leaks aroung the mask that I can find.

During the sleep test the only full-face mask that the lab had was broken (at a major hospital no less). I had to do the entire test with just a nose mask on. They ended up strapping my jaw shut to keep my mouth closed (my allergies kicked in last week, if they had been in effect during the test I would have never made it). The downside to all of this is I have no idea what to expect from the full-face mask. Also my '12' setting is based on just a nose mask.

I guess my questions are:

1. Is the mask having any effect when I'm on my side?
2. Would using a full-face mask and sleeping on my side require a higher setting then what I tested at the lab with a nose mask and being forced to sleep on my back every time I moved?
3. If number 2 is the correct answer who do I need to contact, my neurosurgon or the DME provider?

Thanks for any info.

Hi Snowdog, and please allow me to welcome you to the forum!

From what I have learned both here and from my doctors, sleeping on your side is usually easier on your breathing muscles and airways. Maybe that's because sleeping on your back requires your muscles to raise your chest and move your stomach to breathe. And people tend to have more apneas and hypopneas while sleeping on their back. I've just been studying my sleep study reports, and for both tests, all od the epneas and all but one of the hypopneas were while I was on my back.
- JB

I always sleep on my stomache, occasionally on my side. I did not sleep on my back at all during the sleep study. I do not sleep on my back at home, ever! I did not sleep on my back during the titration study. My report said that they would expect more apneas if I slept on my back. So what, I do not, have never and probably will never sleep on my back. By forcing you on your back, they will probably have your machine set too high. Generally, there are fewer apneas etc when side sleeping or stomache sleeping. I have devised several stomache sleeping solutions. My favorite is 2 gigantic down pillows, one on either side of my head - face down in between the 2 pillows. Because the pillows are so thick there is plenty of space for your face between the pillows - mask never moves, sides of face rest comfortably on edges of pillows. Secondly, I bought an el cheapo foam pillow at WalMart, put the mask on it and using an exacto knife, cut out the shape of the mask in the foam, mask sits right in there, cut out an opening to accomodate hose and air venting. When I use this method, I do not use the headgear ever because the mask will seal right against your face. Or if you sleep on your stomache with your head to the side, the best solution is a very soft down pillow that you can position your head comfortably on and just let the front of the mask hang off the edge. Trust me, it is possible. It just takes some determination. The nurse in my doctor's office told me she bought a pillow with foam pellets in it at WalMart and it had enough give that allowed for stomache sleeping with head to the side. Now, I have never used a fullface mask so I do not know how much more difficult that would make it. Try to devise something for your favorite sleeping position or you will be uncomfortable and fight with the mask, hose etc all night long.

Above and beyond that, titrating you with the incorrect equipment should be an absolute complaint to your sleep doctor. You absolutely will need different levels for different equipment. That is absolutely unacceptable and you should have been titrated in your natural sleeping position. I can understand that they might want to get a high, but what they did was absurd. Request your sleep doctor put you on an auto machine with a card in it and testdrive it for a month. They should do a printout every 5 days so you can see the settings. They need to confirm that your setting is accurate. The seal on your mask will break for any number of reasons. Do not feel that it is your responsibility to sleep like a mummy because that is how they titrated you. If you are having a problem, complain NOW.......LOUD and CLEAR. Do not suffer in silence.it is not helping you. The DME can only follow the doctor's orders - so go right to the source! Good Luck!

Hi 2listless,

That was a great post. I am not a stomach sleeper so did not undersand the issues you have and the steps you must take. They should frame your post for future reference!!!

Bob F

One thing you did not mention regarding your allergies, is if you have had the skin patch tests and have been on antigen treatments. This is probably the best way to treat allergies and their subsequent chronic sinusitis, bronchitis, etc.

Good luck on your CPAP therapy. I was only required to lay on my back for 30 minutes. After that they let me sleep any way I wanted. You had a mean titrator. Oddly enough, however, I had lower pressure needs on my back than on my side.

I so understand how you feel...they made me lay on my back for both tests too...they tie you up with all this stuff, lay in a way you aren't used too and then tell you to go to sleep...its crazy....they said I was snored severely...my hubby told me I dont snore like that...its all so confusing..they sleep doc said I should lay prone...thats on the back right?? grrrr...something has to be done...I feel like I am slowly dying...losing weight would help I am sure but I have been down that road too many times too....soooo sorry for all this...but it feels good to vent....thank u

Thanks everyone for your replies.

ahjudybear, I'm not suprised that more apnea's happen when people are on their back. When my results came back from the initial study they told me that when I was on my side/stomach I would have an episode on the average of one every three minutes. When I moved to my back it would be one every two minutes. Probably why I've never been comfortable with sleeping on my back, my body probably just finds it too much work.

Janelle, I've never had the skin patch tests. Is that like the old scratch tests? I never had those either because when I was a kid my parents didn't want to pay for it and as an adult my doctors always tell me "at your age you already know what you're allergic to". I've got a new doctor that I started with a few months ago who seems to be pretty open minded. At my next appointment I'll bring up being tested.

2 listless, thanks for the advice. I'll definately get a hold of my sleep doctor today. Third day in a row and I'm wiped out. I feel worse now then I ever did not being treated.

honeydewNM, thanks for letting me know I'm not the only one this happened to. I also need to lose some weight (20-30 pounds). I used to be an athlete but stopped working out then married a girl that's just too good of a cook and never learned the concept of cooking for two.

UncleBob, ever hear of a band called "Bob's your Uncle"?

Snowdog wrote: Janelle, I've never had the skin patch tests. Is that like the old scratch tests? I never had those either because when I was a kid my parents didn't want to pay for it and as an adult my doctors always tell me "at your age you already know what you're allergic to". I've got a new doctor that I started with a few months ago who seems to be pretty open minded. At my next appointment I'll bring up being tested.

I'm not Janelle, but...

Snowdog, look at my intro (see my signature for link) - if a doctor were to treat you with immunotherapy for your allergies, he would need to test you first, to see what to put into your shots and/or drops. Treating allergies is a long process, but my ENT is promising me great things. I don't know how old you are, but I didn't get allergy tested until age 41.

Have you tried irrigating your sinuses? 1 gallon of distilled water, 1 tablespoon of NON-IODIZED salt (sea salt, kosher, pickling...), and 1 teaspoon baking soda, sterilize by boiling, cool it down (store up to a week), then squirt it up your nose with a big syringe. Like surfing in the ocean, but sterile

My ENT also decided to have me put Nystatin in the sinus-washing solution because he suspected a fungus allergy (yes, we ALL have fungus living inside our noses). It's kind of gross, so I don't still do it (I should), but it helped me get over a sinus infection recently.

After reading through everyone's responses here, plus some time in chat, plus talking to someone at the DME I decided to go with the flow for now, at least with the machine and side sleeping.

Last night I didn't even mess around with the sleeping on my back. Mask went on, straight to my side. I told myself I wasn't going to worry about what the pressure was. I spent about 15 minutes looking for a sweet spot. I fell asleep at about 9:45 and slept solid until about 4:20am. Ages better than what I got the three previous nights. If I can stretch it out to 5am I'll consider it a success.

I'm still going to talk to my neurologist about the bad experience I had at the sleep lab and will probably end up writing a letter to the hospital.

Snowdog,

My primary doctor told me they don't do much allergy testing any more, they just treat symptoms. I was absolutely miserable & got sinus infections etc. In addition to constant congestion I had severe itching. When the doc couldn't find any reason for the itching, he gently suggested I see a psychiatrist. (I didn't) A year later my insurance changed & I went to an allergist directly & got tested. (I also got a new primary Physician.) Allergy shots have reduced my congestion by 90%. I also found out about a food allergy I didn't know I had that was causing my itching. (It killed me to have to give up beef.)

Take charge of your own treatment. See an allergist. Ask questions. Read forums. You've found a great forum here to help with your sleep apnea. Keep it up. And, if your allergies are as bad as they sound, I would strongly recommend allergy shots.

Dan