Guess what happens when you sleep on your back!

[Haley]

I started out with a CPAP machine after being classified as OA.  After I began therapy Central Apneas accounted for 50% of my events.  This being the first test you needed to pass for Medicare to fund an ASV machine I passed and began the process of getting approval for an ASV machine.  I went in for a third night of sleep study to try an ASV machine and to titrate the pressure.  The machine helped get rid of some of the Centrals and my sleep clinic gave me a Resmed VPAP ADAPT ASV on loan for two weeks.  It was the model before the one they have out now and it was called " D Model ".  The first night I used it all of my Central Apneas disappeared and by the third night I had 0 AHI'S which continued for ten days.  It was time to give the loaner back and I got the new Resmed AirSense Curve 10 which I started using the very first night.  From the very beginning of use I constantly fought the high pressure that would go up to 21 and remain there for long periods of time.  My AHI'S went up and being a mouth breather I slept on my back the whole night.  My Dreamwear Full Face Mask could not hold up against that kind of pressure and would almost blow off my face.  My Large Leaks were so predominate that I decided I would sleep on my side because I had nothing to lose.  I had assumed the mask would leak if you were on your side but the opposite was true. The data from the side sleeping showed  very few snores, my AHI went down, pressure was in the normal range and there were very few leaks. Even though things looked good I just could not fight that howling pressure and the flapping/snorting of my mask.  I loved my Dreamwear Full Face Mask and I did not want to have to give it up. I called the DME store to see if they had the Resmed VPAP ADAPT AVS Model D which was like the loaner I used and they had one.  I went over to get it before they closed. This morning when I got up I loaded the disc into Sleepyhead to check the data from last night.  Everything was clear until 2:00am till 4:00am and the graphs before that two hour time period and after that two two hour period showed normal pressure, no mask leaks, no snores, AHI dropped and all the other graphs showed normal activity. At two it was like all hell broke lose with the pressure going up to 21 and staying there almost the whole two hours, lots of snores, almost all Large Leaks, a majority of Hypopneas occurring and all the other Sleepyhead graphs showing a distinct activity happening..  I remember waking up and realizing I was lying on my back even though I had a Buckwheat Hull body pillow to keep me from rolling over onto my back.  I quickly turned over on my side and everything became calm again. MAI's were good, no snores, no leaks what so ever, pressure was calm and only a very few Hypopneas showing before 2:00 and after 4:00. All the other graphs went back into there near normal range.  I am sure that the RESMED VPAP ADAP ASV Model C is a great machine I realized that the pressure had beat me which is just what it wanted.  I am using it and everything seems so calm as if the D wanted to perform its high pressure softly so as not to wake the owner. Sleeping the entire night on my side is my goal but I just have to program myself to remain on my side.

[Fats Drywaller]

A suggestion: search the discussions here for "tennis ball".

[snorybob]

Haley:
In case you don't find many posts on this subject, you sew a tennis ball in the center back of a t-shirt, shoulder blades height or you can buy a fanny pack (2 tennis balls) & attach it where you want, usually at around the same height. It's not the most comfortable thing to wear but it will keep you sleeping on your side (not as bad as it sounds). It worked for me, used it a couple of months. Now I only sleep sideways.


   Bob.

[Fats Drywaller]

In case you don't find many posts on this subject, ...

Google says there are over 100 pages on apneaboard.com with the phrase "tennis ball" (not just those two words), but I don't know whether that's accurate. I haven't bothered to count 'em.

[snorybob]

FD:
I thought you were talking about posts on the forum.

Bob.

[Sleeprider]

A better alternative to tennis balls, is to use a soft cervical collar. If you experience clusters of obstructive apnea OA, or UA that force your EPAP pressure higher, then you will have constant blasts of high pressure that really doesn't solve the problem...chin tucking. A soft cervical collar can keep your airway aligned in any sleep position, your side or back. I'm certain the problem is not sleeping on your back, but the poor airway alignment or pressure on the soft tissues of the anterior jaw or throat that results in apnea regardless of high pressure. Avoiding this with a soft cervical collar will keep pressure low and will work to return you to the efficacy you previously experienced. Check this out: http://www.apneaboard.com/wiki/index.php...onal_Apnea

[Fats Drywaller]

I thought you were talking about posts on the forum.

Yes, I was. When I said pages on apneaboard.com, I meant posts on the forum and/or wiki pages, whatever the search engine finds. Just not necessarily with "tennis ball" in the title; the phrase could be anywhere on the page.

[cbombzzz]

I have been using the cervical collar for about a year now. Purchased from Amazon for around $13. I've tracked results with and without, back and side.
Without on back = elevated AHI out of control OA & CA
Without on side = acceptable AHI higher than normal OA & CA
With on back = acceptable AHI higher than normal OA & CA
With on side = best AHI results and very low OA & CA (0 or1)

The biggest issue I face with side sleeping is smashing my face into the pillow moves the mask out of position then I get a blast of air that wakes me up. I've considered buying a pillow designed for mask wearers, but haven't pulled the trigger yet. Yet another thing to research on this site.

wishing you the best.

C

[Claudio]

I tried different masks and finally settled for airfit nasal pillows.  I made sure that I adjust them properly for no leaks.  They last a long time but when the straps get too weak, I replace the strap or the whole mask.  The only problem is when I sleep on my back, the air flows through my nose and out my mouth (mouth breather).  My VPAP Adapt machine will set off an alarm (backup beep sound) and wakes my wife (all the time) and myself (most of the time but sometimes real late).  My wife wakes me up as it takes me too long to wake up and re-adjust.  She told me that when my VPAP alarm goes off, I am always on my back.  I noticed a product called anti snore chin strap, it prevents snoring.  I wanted to try one out to stop my mouth breathing when I sleep on my back.  I put on the chin strap and then my nasal pillows, now when I sleep on my back I very rarely get an alarm and occasionally I get a leak depending how I move around on my back and to my side.
 
The chin strap has greatly improved my sleep quality as I (we) don't wake up a few times a night anymore.  There are different types of chin straps out there and I prefer the double band style as it stays on better.  The chin strap might help anyone that sleeps on their back.  My old CPAP machine would just blow air and cause my mask to leak when I slept on my back.  My VPAP Adapt is much better, it auto adjusts breath by breath, it pushes more air when it detects me not breathing and has an alarm.  I wish I had this machine from the start, it would have made life easier and better quality of sleep.
 
I had to learn a lot of things on my own.  The professionals thought I was non-compliant because I wasn't sleeping well and thought I didn't use my CPAP.  But on checking my card, they saw that I was compliant.  Most people just give up because they can't breathe.  I found that I have flimsy nostril problem and allergies that prevent me from breathing properly.  I take an allergy pill, use nose strip and nose spray when it is hard to breathe through my nose (mouth mask doesn't work for me, only nasal pillows).  Now I rarely need nose strips or nasal spray.  When I needed them regularly, I bought them at Costco (Breathe Right and Otrivin).  When I went to bed late and forgot to use the nose strips and spray, it was hard to breath but didn't want to get up again.  I just breathed in through my nose (nasal pillows) and out my mouth and after about a minute or so my nose started working properly (I have a climate control humidifier that greatly helps).  I know this part is not directly in topic with the discussion but I needed to tell it, as it may help others or indirectly help with the same sleeping on the back problems.  
 
When I went to nose specialists, they could not find any problems with my nose or breathing.  They just found that my passage was just irritated or inflamed slightly.  Of course, they clean out my nose and then insert a camera to check things out, this makes everything work OK during the test.  For anyone that has breathing or non-compliant issues, they might have flimsy nostril problems, allergies/irritations/inflammations and might want to try my remedies and nasal pillows.  Nasal pillows allow you to breathe in real easy but not out if you have breathing problems.  So, I breathe out my mouth until I can adjust to breathing in and out through my nasal pillows.  Now, I no longer have breathing issues but when I do, I know what I need to do or what to use.
 
I hope this will help others with problems breathing and sleeping on their backs.

[2SleepBetta]

PR and All,

Cervical collars: effective in most cases (at least against chin tuck), cheap, easy to use--great too, I have long used one that has benefitted me. If that easy step works, great. I just weigh in because for me it was not enough.

Learning about the cervical collar and using it was a huge advance for me when I was using a FFM. I still and always use it, with my P10 nasal pillows. But wearing a roll-over and supinity block has stopped my OA's, my once overwhelmingly dominant problem. The block has forced me to sleep on my side. I got an accelerometer (to wear as a data logging plumb bob) and synchronized graphs of its body position data with Sleepyhead. Unmistakable. Stay away from supine. 


A sizeable hard-stuffed fanny pack wasn't enough, I'd awaken on my back or close enough to it to have the OA's (sleeping within 30 degrees of supine). I looked at the Rematee device, in lieu of tennis balls, but I thought I'd just defeat it, too. Reviews of it were so so: efficacy and durability issues if I remember correctly. 


I now sleep happily with an old fashioned surveyor's vest on. Made of light canvas with industrial grade snap metal buttons, it's just tight enough and has enough friction worn over a T-shirt to stop/minimize rotational slippage. It has a huge box-shaped pocket for plan rolls, etc., on the back, which I filled tight with two nested cardboard boxes, roughly 10 X 15 X 5 in. (I had gone into a cancer society thrift store looking for a cowboy's heavy denim jacket to sew a big pocket onto and stumbled onto that vest, which I had never seen the likes of before. Must have been some old surveyor of civic structures or timber stands that had it made so well.)


I'm going to try leaving off the CC for the first time and see what happens with that simplification of my complex PAP-sleep prep--probably will find I have to continue wearing it. No problem, if so, just gotta try.

2SB