Back Sleepers Beware

Those of you who have more events while sleeping on your back might want to test something I leaned by accident this afternoon.

Background: In my sleep studies I averaged 26 events per hour and 60+ while sleeping on my back. I have made a real effort to try and prevent myself from sleeping on my back.

Last night I had the following results:

Total Sleep: 7:22:17
AHI: .81
CAI: 0
OAI: 0
HI: .81

I had a total of 6 events and all of them were hypopneas.

My wife and I are on vacation and have been doing a LOT of walking. This afternoon I was a little tired and laid down. A few minutes later she poked me and said I wasn't breathing. Literally, as a joke, I said I would put on my mask so she wouldn't have to "watch me." Here were the results:

Total Masked Time: 29 minutes
Events: 7 HYPOPNEAS.

I was AWAKE the entire time because I know EXACTLY what I was thinking about and I DID NOT go to sleep!!! Again, almost as a joke, I decided to download the data.

Take a look at the 18 minutes segment of my 29 minute "nap." Normally my breathing patter is very uniform and as the prior night's result reflect, these 18 minutes were worse that my seven + hours sleep.

If these results are TYPICAL of the results I have had while actually SLEEPING, this must grossly distort my AHI results! Looks like it may be time to sow tennis ball into my shirt!!!

Hi - if you really were awake then the results won't be good for much - the machines only work on 'asleep' people and what you get if awake are all distorted, so I wouldn't put any stock in the results.

Julie wrote:Hi - if you really were awake then the results won't be good for much - the machines only work on 'asleep' people and what you get if awake are all distorted, so I wouldn't put any stock in the results.

I'd have to ditto that...

Also, it's very normal to breath in a much less uniform pattern when awake, than during sleep when breathing tends to be more regular, except when turning over or waking to any degree.

Cheers,
xena

This is yet another reason why it's important to look at airflow waveforms. x apneas in y minutes may sound frightening, until you look at the waveforms and see how long and how severe they are.

It's also a good example of why "AHI" isn't the complete story.

Before being on cpap I would be watching TV in my recliner and go to exhale and I could not. I would have to breath through my mouth for a minunte and then start breathing through my nose again only to repete it again. So yes I think you can have apnea's while awake and on your back, so I quess instead of sleep apnea it would be awake apnea. I do wake up at night on my back having apnea's and I row over to my side and all is OK. Just because you do not experience it does not mean it does not happen to other people.

Albert

When you're asleep, your breathing will fall in to certain regular breathing patterns. If you don't breathe in accordance with these patterns when asleep, something is wrong.

When you're awake, you breathe differently because your brain works differently when awake. Your breathing may not conform to normal sleep breathing patterns, but it doesn't necessarily indicate something is wrong, or that any harm is being done to your body.

Yes I agree that breating when asleep is differant than breathing when awake but when you are relaxed in your recliner awake and your airway is suddenly blocked and you can not exhale what would you call it? an obstructive ?

Albert

Could be many things - you would need to ask a pulmonologist or respiratory technician about them... breathing is a very complex business and what might seem obvious to us as being an apnea could have no relation to it, but rather be about ... asthma (difficulty exhaling), some version of COPD, a cardiac related 'glitch', something else to do with the quality of air in the room, your body's reaction to being in a recliner for some time, etc. At least don't assume it's an apnea because you are known to have apnea when asleep.

archangle wrote:This is yet another reason why it's important to look at airflow waveforms. x apneas in y minutes may sound frightening, until you look at the waveforms and see how long and how severe they are.

It's also a good example of why "AHI" isn't the complete story.

Grand-PAP wrote:I added the BOLD/RED above for emphasis.

Thanks archangle,

You got the intent of my post.

I am aware that breathing patterns are different when sleeping and when awake. But, as archangle pointed out "AHI isn't the complete story." Perhaps a person with "backsleeping event problems" should consider the potential that time on their back may have distorted the results.

HERE ARE LAST NIGHT'S RESULTS:

Normal Sleep:
Time: 6:06:15.
AHI: .33
HI: .33 (Only events -- 2 hypopneas)

When I awoke, I turned the VPAP off for a minute and then back on and left the mask on and was AWAKE:
Time: 0:40:50
AHI: 13.22
HI: 13.22 (Only events -- 9 hypopneas)

IF YOU COMBINE THE TWO:
Total Time: 6:47:5.
AHI: 1.62
HI: 1.62 (Total events -- 11 hypopneas)

AGAIN, I am not suggesting that the BACK SLEEPING would have been the same as the BACK AWAKE, but adding the 40:50 results changed the AHI from .33 to 1.62.

So perhaps one should consider back sleeping when analyzing data. IMHO

It had to be that you were not asleep. I have been on CPAP for almost 12 years. ALL of that time I have slept on my back. My AHI is almost always 1 or below- sometimes 2.

I guess it is obvious that I do not suffer from positional sleep apnea.

I had a good example of that last night. I woke up a 5:20 AM but didn't take the mask off until a little after six. I was laying there listening to the birds out side and petting the cat. When I got up I checked my AHI on the machine and it was 7.0. Checked my card in the computer and that period of time when I was awake was a total disaster.When I opened SleepyHead and counted those items and took them out of the total and recalculated my AHI by hand I got a 3.0. When you look at your outcome you have to decide what is trash and what is real and recalculate your readings sometimes by hand.

a1albert wrote:Yes I agree that breating when asleep is differant than breathing when awake but when you are relaxed in your recliner awake and your airway is suddenly blocked and you can not exhale what would you call it? an obstructive ?

Albert

Transition into sleep - you think you are awake but in reality you are in the first stages of sleep. You remember it but you are not really awake. This is the time that many people have centrals also. This is also the reason partners of people who think they have insomnia laugh at them. "How can you say you were awake until 2 when you were snoring like log and you didn't notice the 200 people having a fight, 12 cops cars racing to the scene, just under the bedroom window, at midnight?" (True story)

Sometimes I'll catch Mike starting to doze off in his recliner, mouth open, starting to have an apnea, and when I wake him he'll say "he wasn't sleeping,still listening to the TV but just resting his eyes"!

My husband does not have sleep apnea but I had to laugh Dori! My husband will fall asleep in his recliner while watching TV in the evening and I tell him he's asleep. He says, "I was listening - just resting my eyes!!