Leaks and mask displacement for side-to-stomach sleepers. Tape down nasal pillows?

[Bostonsnow]

Hi all

I'm generally a side sleeper but tend to roll even further from side towards stomach during the night, meaning my face gets pressed sideways into the pillow. Somehow over the years I have become used to this sleeping pattern.    The problem with over-rotating from side towards stomach is that puts pressure from the pillow onto the nose and creates leaks from the mask, if not displacing it completely, both of which wake me up and I have to re-adjust the mask.  This has happened both with a FFM (very stable Vitera)  and a couple of low profile nasal pillows ( P10 and Brevida).  The FFM is big so one really cannot roll onto your face so I wake right up.  The 2 nasal pillows are probably the best I can be, but still if one rolls over onto one's face/nose, they will get displaced.

Any tips?  I wish I could just stop rolling beyond a side position!  Maybe I will just start to adjust?

I dont want to change pillow as the current pillow is just right for protecting the neck with side-to-stomach sleeping.

Maybe the Bleep nasal pillows might work in this situation where they are taped on, or would rolling onto my face even displace these?
Or I suppose I could try some cover roll tape and tape the Brevida or P10 so they dont displace?  But hate to have more and more tape on my face.  Has anyone tried taping down nasal pillows for more stability?

thanks for any tips

[dsjstc]

I'm struggling with this right now, and I'm wondering if you've had any success?

I've started a parallel discussion at r/CPAP -- not sure if I'm allowed to direct link here or not.

[super7pilot]

You could try this. https://www.amazon.com/dp/B09JSPD7N1?ref...title&th=1

[Big Guy]

I'm a die-hard side-sleeper, as well as a mouth breather. 

I use a ResMed AirFit F30 mask. I don't use any special pillows and I do fine by it. Part of the success though, is realizing that you might need to slightly readjust the mask positioning during the night. 

I do that, but it's minimal and not very often. For me, it's almost always needing to pull the lower portion of the cushion back down a bit under my lower lip. I know that I do that more-often-than-not in my sleep.

[2SleepBetta]

Bostonsnow,

Questions similar to yours come up fairly frequently from new and longtime still struggling members (as I still am in some ways). Accordingly, I take time to go into more detail than necessary for an appropriate simple response to you. For the next struggling member I see who posts a similar question, I'll be able to reply with only a few words and a link to this post. Besides, I am an incurable, once- farm-boy DIYer, a hoarder of pieces and scraps for some future project I cannot yet imagine, but will take on.

Before spending $, you might try (as I did) fashioning a fanny-pack-like restraint. But my early experiences trying to prevent supine sleep with such things failed. I could sleep on the too "roundable" packs no matter how box like they were or how firmly I packed them. It took drastic measures to stop my rolling back to supine sleep, but I succeeded. OSA, particularly, and FL were reduced sharply. 

Re spending a few $, it might be best for you as suggested in a post above. But, in the past, I bought an expensive special CPAP pillow, a [flax?]-husk filled pillow and three different types of chin straps. I still have them, but I only tried them briefly after finding them to be of little benefit. I have now long used a tiny sponge pillow, one of our parents had many years ago, and a 4 in. C-Collar to stop tucking my chin—both benefit me a lot, far more than those other trial usages.  

The only trouble with my supine block solution, described below, is that I cannot roll to my other side without half sitting up in bed to do so. For that reason, and my sometimes sleeping all night on one side (which I deem physiologically bad), I lapsed into not using that blocker. But recent incomplete work, soon to be posted in another thread, goads me again, after another review of my March, 2024, sleep test. It mentioned three times my need to solve my supine sleep problem, its need for higher pressures. No solution was offered. 

I'm going back (maybe temporarily) to wearing my vest-knapsack supine block, stuffed as it is with two nested boxes (a "cube": 4.5 x  9.5 x 13.0 in. their overall). The vest does allow me to come within 45 degrees of supine without noticeable compromise of effectiveness. It would allow prone sleep. The 45 degrees of rotational freedom arises from slight twisting of the knapsack by the boxes' restraining force (when I try to roll too far), as well as facts that the boxes are only 9.5 in. across while the distance between outer tangents to my lowest ribs is 12 in—allowing some rotational movement. As to sleeping all night on one side, a little management of my water drinking, a half-night alarm buzzer (maybe), and my reliable old-man's nocturia will take care of my need to get up and soon go back and sleep the second half the night on my other side. 

I link here to a page that has at its foot a link to my supine block and mouth leak block. It makes accessible in one place my now-four actual and intended "positional" countermeasures: https://www.apneaboard.com/forums/Thread...#pid424601 .

Here's my idea how I'd proceed to force side sleep and prevent prone sleep. Just conceptually the reverse how I solved my supine sleep problem. I will soon try this for myself to improve on my blocker of supine sleep. The pipe concept below should work for that need too.

One way I would assemble your block to prevent prone sleep: gather and combine items along these lines:

-One length of plastic-pipe-like foam or equivalent, say, 4 in. OD, with a lumen or bore of about 1in. It is to be at least as long as the distance between the outermost points of your bottom ribs. Maybe start a bit longer to ensure very little rotation.
-One piece of pvc (white) pipe, preferably 3/4" - 1" O.D. which is to be slipped inside the foam  pipe 
-One sturdy belt to run through the pvc pipe and be fastened behind your back). 
-Before other tailoring, try the block rigorously, shortening it only as necessary. Note that the pvc pipe is to prevent bending of the foam which would enable more bodily rotation.
-A heavy stocking-like pad may be needed to cover ends of the assembly to make sharp edges and forces easier on bed sheets. The belt can pass through the stocking toe.

I'm confident the scheme will work and plan to put my like device together soon. Thank you for triggering my thinking about this matter and for my plan to use what I think is a better approach than my present one to stop supine sleep. It promises an easier rollover from side to side.  But, of course, "the proof—if any—will be in the pudding".

An edited-in second, very similar, but better scheme I will fashion for myself very soon: 
-Use a length of perforated white PVC sewer pipe and plastic end caps for each end: 3" or 4" or ? O.D. (outside diameter).
-Cut two belt or strap slots in the side of the pipe. Place them up to about 8-12 inches apart, as seems fitting for width, with the pair of them centered along the length of pipe.
More slots can be cut and the belt be moved to them if the first trial spacing needs adjustment.
-Pass the belt end or strap through the slots from inside to go outside the pipe and be fastened together behind the back.
-Put knots or other blocks of strap movement outside or inside the pipe to prevent belt movement when the wearer twists or turns (as I came to realize would be a problem for other scheme).  

2SB

[paulag1955]

I'm having good luck with the ResMed N20 mask. I'm getting far fewer leaks than I ever did with the P10. I do wear it fastened perhaps more snugly than other people might, but my leak rate is acceptable. Most nights it doesn't wake me at all, even when I roll full onto my stomach.

[radarrab]

I tried to reply after I created an account a few days ago and had to wait, but between then and now I don't remember if I actually completed it (or one of my own). I have other issues besides this. 

But what I was going to say if I actually didn't, is that I had trouble with masks that had the hose in front, 'face-hugger' style. I don't think I sleep face-down much, though sometimes I want to especially when  tossing and turning. 

In any event, the mask would get pulled by the hose and me tossing around, so the nasal pillows would get misaligned and I'd frequently have to adjust them. When I couldn't stand it any more, I made an appointment for the sleep clinic. By then they had a mask with the hose at the top. Much better, in terms of staying put. AirFit P30i.

[Rickyricardo]

They still sell the Swift FX which to me has a superior restraint system than the P10 because the frame goes completely vertically around the head and is adjustable at the top (vs. the P10 quickly relaxing rubber strap system). And it also has a velcro strap that goes laterally behind the head so you have two means of getting a secure fit. The whole structure is more secure than the P10.

The pillows are the same as far as I can tell, size wise.

I don't know if I ever sleep on my face but I have never had the Swift FX come off.

[2SleepBetta]

   

Bostonsnow,
 
Below, I continue from my post No. 5 above, as further edited here for necessary subsequent changes. Besides following up as promised, why belabor this sleep positioning topic to the extent I have? It's because a) prevention of supine sleep is a serious challenge and the diverse needs for many, almost like needs for diverse masks, indicates those troubled by a certain  sleep position won't find one solution/method works for all; b) my vest-knapsack-box method, as linked below has been downloaded extensively showing a need and interest in that vest method, but I've searched for copies and concluded that that vest (which I was blessed to spot while looking for alternatives in a hospice thrift store) was not commercially marketed, but apparently was custom made; c) being humans that we are, some DYI kind of member might scan my blather, instantly think of a "far better way" and post it, even disdainfully, but for the benefit of us all.  
 
I'm confident the first of two sleep position blocking schemes presented here have promise to reduce two things: apneic and flow limited breathing for certain of persons who cannot sleep healthfully in the supine position, no matter how they may favor it as I do. But stopping prone-positioning caused mask leakage for you, Bostonsnow, and for those who sleep in the mask-leak-promoting prone position is more problematic and, regrettably, only some suggestions are presented here for that, too. Those two mentioned breathing disturbances, apart from other deleterious effects, increase sleep-fragmenting arousals—as leakage can, as well—and, for many (me included), those ill effects are definitely exacerbated by supine sleep.  I think the first blocking scheme, below, is a better approach than that of my present device for preventing supine sleep https://www.apneaboard.com/forums/attach...?aid=28627 .
 
The first mentioned supine prevention scheme, below, aside from being effective and cooler to wear (cooler than that vest at the linked page) makes it somewhat easier to rollover from side to side without having to sit up or get up and be fully awakened.  But, of course, for both purposes and schemes, "the proof—if any—will be in the pudding".
 
Simple materials and procedure:
-Use a light-weight sufficient length of 3 or 4 in. (outside diameter) white sewer pipe and two plastic end caps for each end.
-Get and pass a belt or buckling strap through the pipe. Fasten the belt ends together loosely and push the pipe to the rear, behind the back, and cinch it very firmly—but not uncomfortably—taut. Try and test effectiveness before placing end caps, which might best be taped in-place for a time. (Obviously, belt slots must be cut into the caps.)
-One might, in some fashion, fashion some form of stop to prevent strap and pipe movement relative to each other and to the wearer. (My awake trial lying on my bed did not show that as necessary.)  
 
Have awake-tested these ideas a bit. I'm confident I will permanently switch to using the block described and pictured here, rather than continue use of my box-filled knapsack as my linked picture, above, shows. (Please excuse my careless misspelling there of "elbow" and note that I no longer use that pictured elbow, that I lapsed from using the vest-block for a time but must resume prevention of supine sleep, that I have never quit using the Gel-E-Roll mouth sealer and my improved, brown elastic retainer and that I have added mouth taping to boot.) 
 
The attached picture, above, shows all essentials. Those gait belts come 2" x 48". 
 
That black and very light styrofoam object could be adapted as a position block-out, too, if straps were added. (My daughter once had to place on their floor as her toes stretching device after a broken-toe required surgery.) It might be higher density, sturdier foam than that of the white styrofoam rounds which come in half rounds like that one. It is 1/2 of a 6" x 12" cylinder. I suppose local craft shops, maybe florists have them. All manner of them are available online. 
 
Regrettably, my testing shows I cannot recommend the rigid pipe method for prevention of prone sleep, Bostonsnow. I can only recommend it for prevention of supine sleep. Neither obese nor skinny, with BMI 23 and waist 36 in., I, and I expect most people, are too soft in our half-circle frontal midsections, our bellies–the curve of our "D"-waist-high cross sections, for the pipe-blocker method to work. Upon trying it, I could even foresee me sleeping on top of the 3 in. pipe. 
 
But I do recommend, here, alternatives I think could be better than the rigid white pipe method for blocking your prone sleep. I recommend you consider them and those may spark your or other AB members' better ideas: 
 
1.  Do much the same thing, as I am doing with white pipe, but do it with black ABS flex drain-pipe, 4 in. O.D. in this instance. I believe some, if not all that ABS pipe is flexible enough to assume the curve of our "D" cross section when tension of the tightened belt is applied. I'd be careful to make the flex pipe long enough and have caps for the pipe ends. My test observation is that it must be long enough to slightly more than just barely touch the bottom bedsheet, whether you sleep left or right lateral. The necessary pipe length should be determined as if the flex pipe is glued to your rib cage. That to reduce rotational free play when you measure for that minimum length required and, also, to stop you sooner and better when you attempt to roll into prone position. (The same notion applies to the pipe method: if the pipe is too short or the belt not tight, one can rock toward supine position.)
2.  Consider using a flexible 4 in. duct like those for household clothes dryers but check that any plastics do not emit noxious gases. But when the hollow tubing end bears against the bed sheet and its supporting mattress it will be prone to bend or crimp the coiled wire cored tubing angularly (like slim tree tops lean parallel and bend downwind in a windstorm) as one's encroaching body weight begins to stress and squeeze together the wire (spiral) coils on one side the coil structured tube.
3. Conceptually, but impracticably (?), I can envision affixing two tightly constrictive straps, halves of a sturdy leather belt, 180 degrees apart, on an uninflated small bicycle, or, better yet, a more suitable wheelbarrow inner tube. Then inflate it. Serendipitously, one might find a pressure at which the tube is firm and large enough, the inflated innertube can be donned properly and the belt can be buckled tightly behind the wearer's back; then one could be pleased at how the donut shaped inflated tire has been stretched diametrically to have an elongated outer figure like a very skinny, rounder-ended football. That "football, happily would be the prone position blocker. I dream on. 
 
The attachment shows what I tested when awake while lying on my bed and shifting positions. I doubt I'll need to prevent circumferential slippages among the belt, pipe block and my waistline. It seemed the block stayed put, would of its own weight and friction against the sheet become wedged-in preventing excessive free travel if I rocked toward supine. But I had the pipe open ended. If belt slots are too narrow the pipe may hang up. I expect to cut slots and affix the end caps (tape them on, temporarily) and pass that gait belt I have through them. (My deceased MIL, a stroke victim, left that belt behind, but one of my sturdy old leather belts would work too.)
 
The white not-perforated sewer pipe comes in 10 ft. lengths, about $18, and caps were $3 each, both came from a large, national builders' supplier. For costs, I could cut a few pieces to send out. All would be simple if I could simply affix a shipping label to the clean, new, short pipe piece. Note: Habit for Humanity has Restore stores: those are one of their charitable operations around the U.S. They sell the public's donated goods and manufacturers' clearance donations. They often have, nearby me anyway, remnants of this kind of pipe. 
 
My 9" length block seems to work well for me with my stated waist and BMI, my weight of 165 lb. and the widest spacing of my lowest ribs and the spacing of the tops of my pelvic bones are 13 in. I will try that length tonight, see how it compares to my sleep with the 9 in. pipe last night.
 
If there are significant negative outcomes to reconsider, and make changes, I'll post here accordingly after use my new block for at least three sleep sessions. I'll see, too, if my friendly small town tire dealer will do a preliminary test of the inner tube idea.

[2SleepBetta]

Oops! Sleep was not good last session. Must hit the pause, if not, the kill button on the back, belly belt, soft midsection and pipe scheme. The trouble came from the belt finding my true minimum "wasp waist", becoming loose therein and the pipe getting out of position. Can't see a way to reliably keep the pipe in place, except, possibly, by trapping it between my shoulders. 

My apologies to you, Bostonsnow, for this pipe block thing has unintentionally come to hi-jacking your thread. I lapsed into that "When he got a hammer he saw everything as a nail to be hammered in" thing.  Solving your prone-sleep mask-leak problem is not so easy. However, it might be solved by fashioning a frontal block anchored by your shoulders.

Will work on breakthroughs fore and aft , but anything further about supine sleep, alone, will be posted elsewhere.

Late it comes to mind that's why the vest, knapsack and box method works so well for me; the block moves a little, but stays where it must. Also, others have mentioned sewing a tennis ball onto the back of their night shirt...which depends on shoulder loops to maintain position.  

'Will work on fashioning similar DIY methods, ones with the pipe or other block anchored by shoulders. As for me, I need a far more provocative block than a tennis ball which would allow me to sleep close to supine position.