CPAP therapy not working anymore!

[DZee]

I didn't know a wedge pillow could cause more CAs. I was thinking of a long wedge pillow - inclining my entire back and head much like an inclining hospital bed. A cervical collar would be essential as the tendency to chin drop would increase with incline.
It seems it would be more comfortable than elevating the entire head of the bed as was discussed in a recent thread.

Does anyone else have experience with inclining their entire back and head? Did it have a positive or negative affect on positional apnea?

[Jay51]

I sleep on a 45 degree angle full body wedge (36" x 36") every night.  I will explain why. 

When I first got into sleep apnea therapy, I had trouble falling asleep with my ST (A) and then Astral ventilator.  I started coming here to ApneaBoard to learn more about my treatment and become more proactive in my therapy.  I read a thread about what to do if you have sleep apnea, but are not currently using a machine.  Basically, the thread said to sleep in a recliner.  So I tried this.  And lo and behold my SPO2 numbers increased dramatically. I took a Capnography test sleeping supine on my back and one on my wedge.  Results:  66% of the time hypoventilating on my back.  Only 33% on the wedge.  Also, around 30 AHI or so supine flat on my back.  Around 7 AHI on the wedge.  I did use a soft cervical collar with the wedge, too, though.  

I also noticed that my pressures (both EPAP and IPAP) decreased using the wedge.  Gravity affects the soft tissue of the airway to a lesser degree inclined vs. laying down flat (supine).  At least in my case it did.  Sleeping on an incline is recommended for people with severe GERD.  I have not been diagnosed with GERD, but this can help.  

About the only negative from the wedge it a little bit of back/hip pain from 8 hours or so in that same position.  I can't sleep on my side on the wedge because it causes me too much hip pain.  I have numerous ergonomic seat cushions (the ones with 2 holes cut out for the hip bones to rest in), and when I use that underneath me in the bed, my hips/back don't hurt much at all.  

Your milage may vary.  I have read threads where people have tried to sleep on an incline and their results were worse than sleeping supine.  Others no change.  Some got better results.  Experiment.  Experiment.  Experiment.  This is the only advise that I can give you.  I wish you well, too, in your endeavor to find better sleep.

[DZee]

Thanks for sharing your experience of sleeping inclined, Jay51.
I may try a wedge as long as it's long enough. I'm guessing your 36"x36" wedge was a custom cut foam?

[Jay51]

Actually, it is three 36" x 36" foam wedges stacked on each other.  The thickness of each one ranges from about an inch at the thinnest end to about 10" at the thicker end.  It tapers in size. 

I got them on Amazon by using "wedge pillows" as the search term.  I am basically trying to mimic sleeping at a 45 degree angle in a recliner; but I am now able to sleep in my bed instead of exclusively in a recliner.  I put two large and thick pillows (about 12" thick) under my knees and feet to mimic an adjustable hospital bed also.  It has to be comfortable enough to be sustainable every night.