Still A Newbie with Important AHI question

Please help explain: I am still a Newbie and had been doing quite well. However, my GI Doctor said that I have to now sleep on my back with the bed raised 6 inches with blocks for acid reflux.
As we all know sleeping on the back is probably the worst position for sleep apnea. My AHI numbers sleeping on my side were low, 0.4, 0.9 was the highest. (I have mild sleep apnea() Now they are progressively getting worse. 1.1 an now 2.2. I wear a deluxe chin strap (white one) tape my lips shut, even ordered a little bit smaller WISP mask, medium. I checked for leaks before I went to sleep on the mask and there were none. My jaw could hardly open with the chin strap fairly snug, and tape on my mouth. Does sleeping on one's back cause a higher AHI or could it be the machine?
And if I pull the plug out of the machine (S9) and reboot it, will I lose my pre-set numbers? Thank you for all the help.

Luthie2006 wrote:Please help explain: I am still a Newbie and had been doing quite well. However, my GI Doctor said that I have to now sleep on my back with the bed raised 6 inches with blocks for acid reflux.

You have to do what you have to do to take care of all your problems ...

As we all know sleeping on the back is probably the worst position for sleep apnea. My AHI numbers sleeping on my side were low, 0.4, 0.9 was the highest. (I have mild sleep apnea() Now they are progressively getting worse. 1.1 an now 2.2.

These numbers are still excellent AHI numbers. And if you've only slept on your back twice it's too soon to be in a panic about the AHI going up to 2.2. But it is true that for many people, the AHI is going to be worse on the back. However, with a properly set PAP machine, back sleeping should be possible.

I wear a deluxe chin strap (white one) tape my lips shut, even ordered a little bit smaller WISP mask, medium. I checked for leaks before I went to sleep on the mask and there were none. My jaw could hardly open with the chin strap fairly snug, and tape on my mouth. Does sleeping on one's back cause a higher AHI or could it be the machine?

Most likely it's sleeping on the back. Or it could be that now that you are sleeping on your back you are getting better quality sleep because GERD issues are not causing you to sleep very lightly. And as you get more deep sleep, the airway is more prone to collapse. But in the long run, it's better to get really high quality sleep with an AHI between 1.0 and 3.0 rather than fragmented sleep with an AHI between 0.0 and 1.5 every night.

And if I pull the plug out of the machine (S9) and reboot it, will I lose my pre-set numbers? Thank you for all the help.

No, you won't lose any of the pre-set numbers if you pull the plug and reboot the machine.

Thank you Robysue: I was going to have my friend today take out the 6 inch blocks on my bed to lower the bed down. Maybe now I will not reading your reply. So you are saying that maybe my
AHI is rising because I am getting better sleep on my back not coughing all night long with GERD as I was sleeping on my side with lower AHI numbers? Interesting theory. I will tell my friend not to lower my bed tonight as I was upset my AHI numbers were going up and thinking there is a leak somewhere. Could the AHI go up without leaks through my mouth or mask? I always thought a higher AHI meant that there were leaks.

Luthie2006 wrote:Thank you Robysue: I was going to have my friend today take out the 6 inch blocks on my bed to lower the bed down. Maybe now I will not reading your reply. So you are saying that maybe my
AHI is rising because I am getting better sleep on my back not coughing all night long with GERD as I was sleeping on my side with lower AHI numbers?

If you spend all night coughing from GERD issues when the head of your bed is NOT raised, then you are NOT getting high quality sleep, regardless of what the AHI is.

The tendency of the airway to collapse increases as the sleep deepens because the muscles become more relaxed in deeper sleep. And sleeping on the back also increases the probability that the airway will collapse because of gravity acting on the relaxed tongue and upper palate. But it's also important to remember that the goal of PAP therapy is NOT an AHI close to 0.0 every night. The goal is an AHI below 5 and high quality sleep. Even normal people without any sleep apnea issues have the occasional OA now and then. Problems only occur when there are enough apneas to cause problems.

So it really is better to get high quality sleep (overall) with an AHI in the 1.0-3.0 range, than to get poorer quality sleep with a lower AHI.

Could the AHI go up without leaks through my mouth or mask? I always thought a higher AHI meant that there were leaks.

The ONLY time AHI is connected to the leak rate is when your leaks are SO high that you are loosing therapeutic pressure. Lots of things can cause a rise in AHI. Some of them are temporary and can be ignored. Some of them indicate a real problem with therapy.

Some causes for a increase in AHI that really should NOT be fretted about include:

• The random bad night. Our sleep is not the same every night, and neither is our apnea. On some nights the apnea is simply worse than average, and we don't always know why. Pugsy calls these nights "visits from the aliens."
• New pain OR an intensification of old pain. When I broke my left pinky in a serious fashion a couple of years back, the AHI was quite elevated for several days. When I tore my right MCL skiing a few years back, the AHI was elevated for about a week. When hubby broke his big toe a week and a half ago, his AHI went up. Pain does all kinds of things to our sleep and our breathing.
• Head colds, the flu, and other upper respiratory illnesses. Anything that affects the upper airway can make the upper air more prone to collapse. I've notice that an increase in my AHI is pretty common 1-2 days before I start feeling the symptoms. I've come to consider a slightly increased AHI as an early warning that I'm probably coming down with something.
• Allergies acting up. Anything that leads to congestion can increase the AHI; if the airway is swollen from all the mucous irritation, it's not a surprise that it's more prone to collapse.

The time to worry about an increased AHI is when the increased AHI is close to 5 or above 5 AND it stays high for 1-2 weeks AND there seems to be no real cause for it. It's also worth worrying about if you see the AHI steadily climbing for several weeks AND you aren't feeling as good as you used to feel.

My ENT said that elevating the head of my bed would improve the apnea symptoms (as well as GERD). AHI of 2.2 is still considered well-treated.

Thank you RobySue and Nick Danger: It's unfortunate that I have to sleep high up on my back with the bed elevated 6 inches in the head portion area for GERD. I cannot sleep on my side with the bed elevated 6 inches because it makes my back ache. On my back, it does not. So thank you both for the information, as always! It does make sense, that although my AHI is climbing every night, I may be sleeping deeper (although tired this morning) on my back without coughing all night from GERD (on my side with the bed down). It's a tricky combination, not to even mention the chin strap, band aid on my nose, tape on my mouth, smaller size WISP mask. For a "newbie" I am surprised I can do this! And to make matters worse (LOL) my air conditioner blew and I am waiting until next Saturday for a new one so my bedroom is humid. Yikes, the cards are stacked against me, but I will not give up (yet). I think as a newbie, the biggest challenge is sleeping with a mask on my face (nose) I can do that.
I feel with this wide with this wide white chin strap covering my ears, tape on face, pad a cheek on the silicone straps, I feel like I am wearing a winter hat to bed in this Chicago humid weather.
But the main thing is I will keep the bed up 6 inches so I don't cough all night long, even if I am on my back. I am seeing my sleep doc on July 7th for my first follow-up and I will have him review the card.
If it wasn't for RobySue and Nick Danger and others, I would have put the bed down, slept on my side and coughed all night long, negating the purpose of the sleep mask. It's one of those did the chicken or egg come first? Am I getting a much higher AHI score because I am on my back now, or because I am sleeping deeper? For now, I will keep the bed propped up even though my AHI numbers increased from
0.2 to 2.2. Thank you!

It's a really expensive option, but an adjustable bed lets me raise the head of the bed and then raise the foot of the bed enough that I can still comfortably sleep on my side.

Thanks Nick Danger: I did look into a Sleep Number Bed, but I have back issues too and I am too afraid to invest $4000 into an adjustable Sleep Number Bed that may aggravate my back. I looked into it very seriously, and I read (on their website, Sleep Number) all of the negative reviews on back aches from the bed, although it is supposed to help back problems. There were so many negative reviews, that it scared me into buying one. I was ready to purchase, but became scared off with some reviewers stating that their back never hurt so bad as on that bed. And of course positive reviews too. I think with my luck, I would be one of the purchasers that would regret it. So for now, I had my friend elevate my bed 6 inches on the head of the bed, and I will have to sleep on my back like Robysue stated, unless my AHI goes up considerably more. Thanks Nick Danger. I appreciate it, just so many negative reviews on the Sleep Number site, it frightened me away from buying one. Very good idea though, and so glad that it works for you. Three different co workers have one and love it. (they don't have sleep apnea). Lucky ducks!

For what it's worth, many people get away with raising the bed 4" (that can make a difference to not sliding down it!) and might be worth a try.

Thanks Julie. I will keep it at 6 inches and see how it works with sleeping on my back. I will definitely consider the 4 inches as well. Thank you so much.

I think you're right to stick with your doctor's recommendation regarding the GERD. You really have to get both GERD and OSA under control. Either can totally wreck your health.

I went with a foam based bed (Thermapedic - but there are less expensive alternatives) that has worked for my back (along with some help from a great chiropractor), but this stuff is all so individual, that what works for one person may not work for another.

Sleeping in a recliner is an option that helps some people.

Thank you Archangel and Nick Danger:
I will continue to lay on my back on one pillow and see what happens. I appreciate it. Now I just have to get rid of the red blister on my nose from the nasal mask. Do mask liners work well?
Thank you.