[Treatment] Defeating bumper belt -- more or less over time? (CPAP Alternatives)

[Don in Austin]

I am one who absolutely can not tolerate the C-Pap machine. I have an oral jaw advancement device custom fitted by an expert sleep dentist, which bothers me hardly at all. I am 67 years old and my apnea is medium/severe. When I can stay off my back, the numbers and sleep quality are good. The problem is, I am extraordinarily resourceful at defeating a backpack filled with clothing, tennis balls, etc. etc. Currently I am using the Zzoma bumper belt, but have ordered a Rem-A-Tee. I manage to slide the Zzoma around and sleep on my back at times and this shows up a lot in the numbers I track with a pulse oximeter.

What is the experience of bumper belt users?

Over time you train yourself not to sleep on you back? This is what my sleep dentist told me.

Or, over time, you learn to defeat any kind of anti-supine device?

This is important, because I don't hear ANYTHING good about any surgical options that might apply to me, and I gave CPAP the good old college try and then some. When I can stay off my back, I have gone an entire night with a total of less than 20 seconds of O2 under 90%, and I will take that.

Thanks in advance for your experience.

[trish6hundred]

Hi Don,
WELCOME! to the forum.!
I'm sorry you have been unable to get CPAP to work for you. You say you gave it the good ole' colledge try and then some, it can sometimes take quite a while to get used to it and the mask is the most difficult part of the therapy.
I'm not familiar with the bumper belt so I am unable to offer you any experience with that and I've successfully made CPAP work very well for me.
Hang in there for more responses to your post and best of luck to you.

[PaulaO2]

Have you tried using a tight tshirt with the tennis balls duct taped into place? Perhaps 5 placed in a + position so it would take a lot of sliding to move it out of the way.

I'd not spend money on something I could make myself. A pair of shorts with jacks sewn into the top everywhere but the side. Tshirt with tennisballs duct taped on. One of those bed alarms (they go off when someone stands) on my side. A wedge pillow taped or velcroed to my back.

[Don in Austin]

Have you tried using a tight tshirt with the tennis balls duct taped into place? Perhaps 5 placed in a + position so it would take a lot of sliding to move it out of the way.

I'd not spend money on something I could make myself. A pair of shorts with jacks sewn into the top everywhere but the side. Tshirt with tennisballs duct taped on. One of those bed alarms (they go off when someone stands) on my side. A wedge pillow taped or velcroed to my back.

Not really that concerned about cost. Just want it to be hard to defeat. Improvised home solutions have not worked too well. I am curious as to which way the training goes -- your become more resourceful at defeating the device or you let the device defeat your urge to sleep on your back.

[RonWessels]

If I could just side-track for a moment, what was it about the CPAP that you could not tolerate? Was it wearing the mask (ie. with the hose disconnected, whenever the mask came close to your face it became intolerable)? Was it the feeling of air pressure (ie. wearing the mask with the hose disconnected was fine, but turning the machine on became intolerable)? Was it fine when you were sitting at the side of your bed awake, but just "too strange" to fall asleep with? Was it the "stuffiness" of the humidified air?

What type of mask(s) did you try, and what pressure setting were you on?

[Don in Austin]

If I could just side-track for a moment, what was it about the CPAP that you could not tolerate? Was it wearing the mask (ie. with the hose disconnected, whenever the mask came close to your face it became intolerable)? Was it the feeling of air pressure (ie. wearing the mask with the hose disconnected was fine, but turning the machine on became intolerable)? Was it fine when you were sitting at the side of your bed awake, but just "too strange" to fall asleep with? Was it the "stuffiness" of the humidified air?

What type of mask(s) did you try, and what pressure setting were you on?

I tried at least a half dozen different masks. Due to mouth breathing I could not use a nose mask only. Problems included leaks and whistles, soreness across the bridge of my nose, general discomfort. Falling asleep was far from "fine," but somewhere during the night, the pressure would ramp up where nothing I could do would prevent leaks. I was constantly trying to adjust the mask and ending up wide awake. I could prevent leaks only by tightening straps so much as to cause considerable pain. Given the good numbers with an oral appliance and staying off my back -- actually BETTER numbers than I could ever achieve with CPAP alone -- that is going to be my focus. I ask readers to take my word for it I DID give CPAP a good try. I know it works for some -- works great for my wife -- but it is not for me.

[Don in Austin]

If I could just side-track for a moment, what was it about the CPAP that you could not tolerate? Was it wearing the mask (ie. with the hose disconnected, whenever the mask came close to your face it became intolerable)? Was it the feeling of air pressure (ie. wearing the mask with the hose disconnected was fine, but turning the machine on became intolerable)? Was it fine when you were sitting at the side of your bed awake, but just "too strange" to fall asleep with? Was it the "stuffiness" of the humidified air?

What type of mask(s) did you try, and what pressure setting were you on?

It looks like this forum is pretty much focused on CPAP use as opposed to apnea solutions in general. Of course CPAP is great for those who can tolerate it -- for example my wife who, after initial frustration with hard plastic masks, bought a fabric mask online and found it quite acceptable and has enjoyed greatly improved sleep ever since. I haven't heard her snore or gasp for a year now. I am the opposite, and, despite trying to convince myself the CPAP machine was my friend that would help me sleep, CPAP was a total disaster for me. And yes, I have tried the fabric mask -- mouth breathing was just one of the problems with it. Also, CPAP does not get me where I should be without fairly high pressures that cause leaks. Fortunately, I have had success with positional therapy and an oral device -- which I tolerate easily. The positional therapy needs some tweaking to be more consistent and thus more consistently effective. I am looking for comments from those who have had experience with different devices that prevent sleeping on your back. Perhaps I am in the wrong forum.

[SuperSleeper]

Fortunately, I have had success with positional therapy and an oral device -- which I tolerate easily. The positional therapy needs some tweaking to be more consistent and thus more consistently effective. I am looking for comments from those who have had experience with different devices that prevent sleeping on your back. Perhaps I am in the wrong forum.

Hi Don - welcome to Apnea Board.

Much of the scepticism about non-CPAP solutions is because there's just not a lot of scientifically sound impartial data supporting a conclusion that surgery, positional therapies or oral devices provide adequate solutions for the average OSA patient. CPAP is the proven gold standard for treatment with much independent and impartial data supporting that fact.

Just out of curiosity, what device or scientific method are you using to determine that your positional therapy and oral device are providing better AHI numbers than CPAP? The pulse oximeter does not record or monitor AHI, only blood oxygen levels. Many people have OSA but their blood oxygen levels seldom go below 90%... but they still have severe OSA that negatively affects the heart in the long term. Good blood oxygenation (while it is one indicator) does not always equate to no apnea events.

If you have measurable data to support your conclusion that these non-CPAP methods are working to lower AHI, I'd be interested in how much your AHI has been lowered using these two non-CPAP methods.

[RonWessels]

If I could just side-track for a moment, ...

It looks like this forum is pretty much focused on CPAP use as opposed to apnea solutions in general.

My questions were not because we are CPAP-centered. My questions were curiosity as to why your CPAP treatment failed. For obvious reasons, there aren't many people on this forum for whom CPAP failed.

[Don in Austin]

Fortunately, I have had success with positional therapy and an oral device -- which I tolerate easily. The positional therapy needs some tweaking to be more consistent and thus more consistently effective. I am looking for comments from those who have had experience with different devices that prevent sleeping on your back. Perhaps I am in the wrong forum.

Hi Don - welcome to Apnea Board.

Much of the scepticism about non-CPAP solutions is because there's just not a lot of scientifically sound impartial data supporting a conclusion that surgery, positional therapies

My first sleep study showed my OSA to be highly position dependent. I had an overall AHI of 21.6, but an AHI more than 50% greater, 37.2 while on my back. I was on my back 57% of the night. This was without CPAP or an oral device. Unfortunately the report did not specify AHI while not on my back, but it would obviously be lower than 21.6

or oral devices

I have read studies showing oral devices to be beneficial.
I tried to include links but forum rules do not permit me to do that at this time. Google "austinapnea" and you will find several studies regarding benefits of oral devices for mild to moderate -- and in some cases severe -- apnea. My apnea while not on my back is mild.

provide adequate solutions for the average OSA patient. CPAP is the proven gold standard

Its not a gold standard when its not tolerated, and its well known that compliance statistics for CPAP are pretty dismal. I personally know several people who own CPAP machines that never get plugged in. Please understand, I am aware of it being the "gold standard" so, being stubborn by nature, I gave it a good try.

for treatment with much independent and impartial data supporting that fact.

Just out of curiosity, what device or scientific method are you using to determine that your positional therapy and oral device are providing better AHI numbers than CPAP? The pulse oximeter does not record or monitor AHI, only blood oxygen levels. Many people have OSA but their blood oxygen levels seldom go below 90%... but they still have severe OSA that negatively affects the heart in the long term. Good blood oxygenation (while it is one indicator) does not always equate to no apnea events.

If you have measurable data to support your conclusion that these non-CPAP methods are working to lower AHI, I'd be interested in how much your AHI has been lowered using these two non-CPAP methods.

Medicare does not pay for sleep study after sleep study after sleep study so I have to rely on:

1. A sleep study which showed something like double the AHI when on my back as opposed to not on my back, as I mentioned above.

2. The professional opinion of an ENT who specializes in sleep disorders.

3. A sleep doctor I highly respect and who encouraged me to try CPAP as long as I could, but agrees I have found viable alternatives.

5. A highly respected sleep specialist dentist.

6. My oximeter reports which, by my understanding DO show events in the reports I generate. When there is an event, there is a negative O2 spike and a positive heart rate spike and the software analyzes and reports that. Its not perfect, but neither is a sleep study perfect, because there is no question my sleep in a sleep lab is very different from my sleep at home. Also, I see considerable variation from night-to-night so my oximeter tracking has the advantage of far more nights to evaluate.

5. My own -- subjective, of course -- perception of sleeping through the night as opposed to waking every two hours with great difficulty getting back to sleep, and my -- again subjective -- perception of decreased daytime sleepiness.

I am a little puzzled about OSA occurrences which cause heart damage while not dropping oxygen level or raising pulse rate.

I am going to continue to work on solutions that make sense for me.