Sleeping Position - Therapy Suggestions???

Wouldn't it be nice if there was a way to rig a position sensor, such as is found in some cell phones, to the settings on the trilogy so that it would just change automatically?

Is it hard to change from one set of settings to another or is it more like a toggle switch?

Just what I was thinking. Position sensor, bluetoothed to the Trilogy, the machine would switch itself.
Wonder if the manufacturer is looking for an Alpha tester.

I too take 600mg. of Gabapentin at night, use to take Tramadol, did nothing for the pain. I went on 1 25mg. of amitryptline to sleep though the spine, neck and leg nerve pain and it is wonderful, I don't have to constantly move due to pain, and therefore my cpap treatment has greatly improved. One of our wonderful folks here suggested I try this drug and it works great. It is not a controlled substance either. Best of Luck!

MidnightOwl wrote:Wouldn't it be nice if there was a way to rig a position sensor, such as is found in some cell phones, to the settings on the trilogy so that it would just change automatically?

That would be nice!!

MidnightOwl wrote:Is it hard to change from one set of settings to another or is it more like a toggle switch?

It's not difficult to change, but waking up enough and making myself do it is the problem. I would have to get propped up on my elbow, pull up the menu, scroll one or two lines down, select "Switch to Secondary Settings" then confirm it when prompted.

Not at all difficult, but possibly more work than I'd be willing to do in the middle of the night, groggy and in pain.

However, I've had to learn to do far worse than that so I know if it's my only choice, I can make myself do it.

I brought my husband up to speed yesterday. He didn't say a lot, but with him, he needs to digest something like this and will be thinking about it for a while. What usually happens is that all of a sudden, days or weeks down the road, he'll mention that he's got an idea. And his ideas usually work out very well.

I'm sure he's thinking....

Im in a similar situation, although with OSA.

Im a natural back sleeper.

Id' probably elevate the head of the bed with those plastic cones from walmart, but my wife would probably not like that.

Im curious if you could post more data comparing when you slept on your back at a higher number, and when you
slept on your side at a lower.

As we all know, OSA is not an exact science across the board for every patient.

DavidCarolina wrote:Id' probably elevate the head of the bed with those plastic cones from walmart, but my wife would probably not like that.

That's a big problem for us as well. Even if we could raise our current bed (and I'm not sure we can) I don't think my husband would like it. One thing we discussed yesterday is down the road, getting an adjustable bed with separate controls. Right now, it's out of the question so we need to come up with something else.

DavidCarolina wrote:Im curious if you could post more data comparing when you slept on your back at a higher number, and when you slept on your side at a lower.

As we all know, OSA is not an exact science across the board for every patient.

Inititally, I was diagnosed with OSA ONLY and when cpap & bipap didn't work for me, my doctor THEN changed it to diaphragm muscle weakness. She claimed that differentiating, during a sleep study, was difficult. True? False? Don't know at this point, but that's what I was told.

She agreed after a year or so that I most likely have BOTH diaphragm muscle weakness AND OSA. Lucky me.

As far as data is concerned...hmm. Right now, the only thing I'm basing this on is my LAST sleep study, where the documentation indicates "smooth sailing" as long as I was on my side. Things got interesting when they put me on my back, thus the higher settings.

I could attempt to look at a ventilator download after a night I've spent on my back, but the downloads from DirectView don't show the same type of thing as those from the Encore or Sleepyhead.

Madalot wrote: . . . She claimed that differentiating, during a sleep study, was difficult. True? False? Don't know at this point, but that's what I was told. . . .

My guess is "true" on the "difficult" aspect.

Respiratory effort is generally measured indirectly using belts across abdomen and chest during a run-of-the-mill lab/center PSG. Although someone highly trained might be able to deduce indications of muscle weakness specifically of the diaphragm from the supine data (if the data were very carefully gathered in a highly controlled environment) so that he would then order approapriate evaluation for clinical diagnosis, my guess as a patient is that the method of data-gathering used during your average PSG is so indirect and so inexact as to make that deduction very "difficult," using the squiggly lines alone, even if a tech/doc team were planning on looking for that relatively rare condition--which, as a general rule, they are not, during an average NPSG, as I understand it. Sleep tests are often more about sleep than they are about breathing in general, it seems. Routine respiratory evaluations don't seem to be part of the PSG process, even when the sleep doc is a pulmonologist, from what I understand. How many sleep-test patients are ever even asked to cough or sniff in front of the doc, I wonder?

Since it looks like I am going to have to spend some time on my back, I set up the Trilogy's secondary prescription to what they used for supine sleep in April 2011.

While they increased the tidal volume to 440 (I'm currently at 400), they indicated that they felt it needed to go HIGHER than 440 to allow the IPAP to increase more. Since I have no clue how MUCH higher to set it, I went with 440 for now.

They indicated the EPAP was at 12. Back in 2009, they indicated that I couldn't exhale against an IPAP of 13 (when I was on straight cpap) so I have a few reservations about this. And a RR of 9 is very uncomfortable for me when awake or on my side, but I guess we'll see how it goes.

I forced myself to stay on my left side last night and am paying dearly for it today. Man, my thigh hurts today. Yowsa.

I think I need to find a way to sleep floating in the air!!!

Would an airbed work for you? The sleep number beds are just air, apparently, so maybe a camping mattress would work - at least it would be a cheaper way of finding out than getting a sleep number mattress.

SleepyToo2 wrote:Would an airbed work for you? The sleep number beds are just air, apparently, so maybe a camping mattress would work - at least it would be a cheaper way of finding out than getting a sleep number mattress.

A sleep number bed would work great for me. The sleep lab has them and I fiddled with it during my first study. It's been a few years, but I think I got mine to a 65 and it was GREAT. The issue would be whether or not my husband can sleep on one. This is one thing we talked about - getting an adjustable (head/foot adjustments) sleep number bed.

This will probably be my first choice, but it's not in the cards at this time. Down the road hopefully.

Madalot wrote:.....
I forced myself to stay on my left side last night and am paying dearly for it today. Man, my thigh hurts today. Yowsa.
I think I need to find a way to sleep floating in the air!!!

When I read your earlier posts, Maddy, I thought of suggesting this.. now I will. You need a water closet/bed- wait- to sleep IN, not ON. Not that I know of such an animal. But I have heard of therapeutic walk-in spas for mobility challenged. Now if your skin could stand 6+ hr of water exposure at a time.
Very best to you with your continued challenges. Our prayer continues to go out to you and yours. earl

I had some diaphragm issues related to breathing at night and found that instead of raising the head of my bed (which I think unfortunately compresses the diaphragm area), I could simply shove a few old sofa type pillows under my mattress. I think they are called throw pillows? I put these just about where my lower back would rest. This extra inch or two of elevation feels really good and takes a lot of the tension out of my lower back while also relieving pressure on the diaphragm. Pretty easy to test it out and determine how much support you need under there and where the exact placement of the pillows should be. An added benefit is you don't have to disturb your sleeping partner with this method.

n0hardmask wrote:

Madalot wrote:.....
I forced myself to stay on my left side last night and am paying dearly for it today. Man, my thigh hurts today. Yowsa.
I think I need to find a way to sleep floating in the air!!!

When I read your earlier posts, Maddy, I thought of suggesting this.. now I will. You need a water closet/bed- wait- to sleep IN, not ON. Not that I know of such an animal. But I have heard of therapeutic walk-in spas for mobility challenged. Now if your skin could stand 6+ hr of water exposure at a time.

Oh, that sounds heavenly, but not very realistic I'm afraid! I love water, but swimming in pools (unless 100% handicapped accessible) or even baths -- not something I can do anymore unfortunately.

Last night has shown me that unless I am more motivated, I won't switch the Trilogy's prescription. I think I would have to start out on my back in order for this to work.

I'm not seeing any good way around this problem at the moment. But I'm not giving up. I'm just temporarily stymied.

Sir NoddinOff wrote:I had some diaphragm issues related to breathing at night and found that instead of raising the head of my bed (which I think unfortunately compresses the diaphragm area), I could simply shove a few old sofa type pillows under my mattress. I put these just about where my lower back would rest. This extra inch or two of elevation feels really good and takes a lot of the tension out of my lower back while also relieving pressure on the diaphragm. Pretty easy to test it out and determine how much support you need under there and where the exact placement of the pillows should be. An added benefit is you don't have to disturb your sleeping partner with this method.

Interesting idea. Hmm...need to think about this one. I'm having a hard time envisioning this NOT being a problem for my husband. We have a King bed and it seems like placing cushions under my side of the mattress would make the bed so lopsided. But I will still bring this up to my husband and see if he thinks it's a possible solution.

Thank you!

A very kind forum member has brought something to my attention that I want to address. And I thank this person for telling me.

In this thread, I sometimes make it appear that I am more worried about my husband's comfort than I am about my health. Looking back through this thread (and others) I would probably think the same thing were it someone else making those comments.

My husband and I want to stay together, in the same room/same bed, and won't change that unless we have to. However, if we have to, we will and we will not let my health suffer. When I make comments like "will bother my husband" or something like that, it doesn't mean we won't do anything, but would prefer to find a solution that allows us BOTH to sleep well without disturbing the the other.

When his snoring was bad, I was at the point where separate rooms was a real possibility. He finally agreed to try cpap instead, so that we could continue sleeping in the same room/bed. That worked and he's been a hosehead since the first night he tried it.

If, down the road, we have no option but to sleep separately, we'll be just fine. With all the complications from my disease, our marriage has taken hits through the years and we're still doing fine. Sleeping apart won't change that. We simply don't want to do that until we don't have any other choice.

I am not sure if you have figured this out yet... but

How about rotating your sleeping positions? You could start out on your left side, the next night change to your right side, then adjust your settings and spend the third night on your back. This amount of variation may give some relief and minimize the amount of time you spend on your back.