Why Sleep Apnea Victims Cannot Sleep On Their Backs?

mcpascaln wrote:

archangle wrote:Many people get more apnea when sleeping on their back.

In effect, you are stating that sleeping on the back can cause sleep apnea in non-sleep apnea people? Sorry for misunderstanding, are you meaning that people already with sleep apnea register increased incidents of sleep apnea when they sleep on their backs compared to those who have sleep apnea but sleep on their shoulders?

"Normal" people will have no apnea in any position.

Some people will have apnea when sleeping on their back, but not when sleeping in other positions. They're still considered to have sleep apnea.

Some people will have apnea in all positions, but it may be worse on their back than when sleeping in other positions.

Side note for this discussion.
Some people have more events during REM stage sleep....sometimes a lot more. I happen to be this type of person. I am not rare though...this happens to a lot of people.
My diagnostic sleep study showed AHI of only 12 in non REM sleep (but I still had some monster long 45 second events with desats to 73%). Slept primarily on my back the entire sleep study.
But in REM stage sleep I had an AHI of 53 (don't remember longest event or desat and it doesn't really matter).
Even if I had a strong positional component to my OSA I would also still have the REM stage sleep thing. Another reason for APAP machine in my situation. Sometimes I need more pressure (sometimes a little and sometimes a lot) in what appears to be REM stage sleep pattern.

I can't control REM stage sleep nor would I want to limit it. We need the normal stages of sleep for sleep cycles to do their magic and let the body and mind rejuvenate and get their energy restored.
So that is why I use auto adjusting pressures. I am lucky in that pressure changes have never really disturbed my sleep. I never know about any high pressures reached (and I have seen almost 20 cm on occasion) until I see the reports. Some nights I have minimal increases in pressure (like maybe 2 cm and see only 12 cm max reached) and some nights I spend a brief amount of time at much higher pressures...almost always within what would be a time frame where I was probably in REM stage sleep.

So for me it doesn't really matter if I sleep on my back or not and if things are worse on my back or not because I still have the REM stage sleep variable. As it turns out it doesn't seem like sleep position offers any huge difference in pressure needs or events occurring in my situation but even if it did I would still have the REM stage sleep thing to face. This is why I just let my machine do its job no matter what position I sleep in. It's going to be working anyway preventing REM stage sleep events.

When I was having so much trouble in adjusting to my apap and couldn't even figure out the right pressure, I tried several times to sleep on my side to see what would happen.

I used a backpack with books in an attempt to stay on my side. It was an utter disaster and I was extremely uncomfortable

I just decided I am sleeping on my back no matter what and I found that using a neck collar with a pressure of 5 gets me an AHI of usually 2 and below. Still have to other issues to deal with but that is another post.

Finally, even though this was not verified during my HTS, I suspect due to having severe apnea that I would not have a positional component. At least that is what I read.

49er

Pugsy wrote: I can't control REM stage sleep nor would I want to limit it. We need the normal stages of sleep for sleep cycles to do their magic and let the body and mind rejuvenate and get their energy restored.
So that is why I use auto adjusting pressures. I am lucky in that pressure changes have never really disturbed my sleep. I never know about any high pressures reached (and I have seen almost 20 cm on occasion) until I see the reports. Some nights I have minimal increases in pressure (like maybe 2 cm and see only 12 cm max reached) and some nights I spend a brief amount of time at much higher pressures...almost always within what would be a time frame where I was probably in REM stage sleep.

I didn't reach REM during the diagnostic phase, so I have no idea if mine is worse during REM or not. But I have my auto machine, so it takes care of me. I am also fortunate that the changes in pressure do not bother me. I am only bothered by the pressure if I happen to sleep on my back, and my jaw opens far enough that my cheeks start to flap. Then I wake up and notice the pressure.

When I did t he sleep study, they had me use it for a few minutes before the diagnostic phase so that I would be familiar with it. Then they put it on my during the night. The next morning, I asked if it had gone up during the night (I never noticed it), and they said yes. I thought cool, I didn't notice it, so it wasn't as bad as I expected.

Some nights, it goes up to 15 or 17, and without checking the data, I have no idea that it did that. I am really glad that apap machines are available. Mine really does take good care of me.

archangle wrote: . . . "Normal" people will have no apnea in any position. . . .

Any source for that statement? TIA.

My understanding is much the same as this statement:

Most people have the occasional apnea during sleep, when breathing stops, following by a snort. People with OSA, however, have several episodes of no breathing while they sleep. -- http://www.medicalnewstoday.com/articles/178633.php

Here is an abstract on an interesting study by some Swedish dudes on the prevalence of position-dependent OSA:

http://www.ncbi.nlm.nih.gov/pubmed/22382651

jnk wrote:

archangle wrote: . . . "Normal" people will have no apnea in any position. . . .

Any source for that statement? TIA.

An abstract on an interesting study by some Swedish dudes on the prevalence of position-dependent OSA:

http://www.ncbi.nlm.nih.gov/pubmed/22382651

That's very interesting. For anyone who didn't follow the link, the study found that there are many people with positional obstructive sleep apnea (POSA), but who have too few events to be diagnosed with obstructive sleep apnea because they don't spend much time sleeping on their backs. If these folks slept only on their backs, their AHIs for the whole night would be high enough to classify as moderate to severe OSA and to require treatment. It suggests that there might be people who are normally fine, because of their usual sleep position, but if something happened to require them to sleep on their backs, a broken arm for instance, they could face the consequences of OSA.

I imagine an old married couple who spoon every night. After 30 years, they even roll over in unison. They are 100 percent side sleepers, but they wouldn't even know how to sleep on their sides any more except nested together. Then they have a terrible argument and say unforgivable things. From that night forward, they cling to opposite edges of the bed and sleep only on their backs. Their POSA kicks in big time now that it has all night to work on them, and their health deteriorates. One morning neither wakes up. She's had a stroke, and he's suffered a fatal cardiac arrhythmia. They are done in by their undiagnosed positional apnea and their failure to heed the universal advice that couples should never go to bed angry.

PST wrote:...
I try not to think of myself as a sleep apnea victim any more than I think of myself as a nearsightedness victim. I realize that kind of comment can make me sound like some sort of PC jerk or like criticism, but honestly I mean well. After a while everyone has some health issues. Fortunately, we now have tools to avoid most of the disadvantages. It is a medium level problem with a rational solution, made easier with the advice of others who have dealt with it already.

Agreed. I don't think it makes you sound PC, quite the opposite in fact. I think the US is growing a culture of victimhood.

jnk wrote:

archangle wrote: . . . "Normal" people will have no apnea in any position. . . .

Any source for that statement? TIA.

How about everyone who takes an in-lab sleep test and has a negative result?

davelikesbeer wrote:

PST wrote:...
I try not to think of myself as a sleep apnea victim any more than I think of myself as a nearsightedness victim. I realize that kind of comment can make me sound like some sort of PC jerk or like criticism, but honestly I mean well. After a while everyone has some health issues. Fortunately, we now have tools to avoid most of the disadvantages. It is a medium level problem with a rational solution, made easier with the advice of others who have dealt with it already.

Agreed. I don't think it makes you sound PC, quite the opposite in fact. I think the US is growing a culture of victimhood.

A little bit harsh in my opinion.

Anyway, I think depending on someone's circumstance, it would be totally appropriate to call yourself a victim of sleep apnea. That person doesn't have health insurance and/or can't afford to buy a machine and/or supplies and doesn't have access to aid programs that might help and/or doesn't qualify.

49er

jnk wrote:

archangle wrote: . . . "Normal" people will have no apnea in any position. . . .

Any source for that statement? TIA.

My understanding is much the same as this statement:

Most people have the occasional apnea during sleep, when breathing stops, following by a snort. People with OSA, however, have several episodes of no breathing while they sleep. -- http://www.medicalnewstoday.com/articles/178633.php

Here is an abstract on an interesting study by some Swedish dudes on the prevalence of position-dependent OSA:

http://www.ncbi.nlm.nih.gov/pubmed/22382651

My doctor told me that everyone has events, and under five per hour is considered normal. Five events and above are the threshold for the diagnosis for SA.

I can never get to sleep while on my back. I guess its the increase in pressure that keeps me awake. however if I roll onto my back while asleep i seem to be ok.(so I am told) I also have some pain issues which limit staying in one position.

Mcpascaln asks...Please, why sleep apnea victims are forbidden to sleep On their backs? And this is a perfectly reasonable question that many newly diagnosed patients will have.

As others have stated, airways are often more easily occluded when one sleeps on one's back (there are likely exceptions, of course). You can lay on your back and actually feel your lower jaw being pulled back due to gravity. Side sleeping can make xpap therapy work with a lower pressure, which is a worthy goal.

Also, it may be helpful to remember... you are not a "victim".

Perhaps it will be useful, I see myself as a "patient" lucky enough to be diagnosed at a time in which therapy is available.

.