Positional Apneas

[racprops]

Yes Virginia there are Positional Apneas!!

For the past two months I have fought to get used to using my new ASV machine. (See: http://www.apneaboard.com/forums/Thread-...ASV-to-get For details...More about the findings of positional apneas start with http://www.apneaboard.com/forums/Thread-...need-these

During this time I was sleeping in a recliner (still recovering from a quad bypass) and ever so often I would get a low AHI reading..Even on night a 4 and 1/2 hour sleep run with a reading of ZERO AHI.

BUT I could not repeat this "Happening", I just could not do it twice...

It seemed that on top of having Apneas, then Complex sleep apneas needing a ASV machine I now find that I also have POSITIONAL APNEAS.

That is: my number of apneas and kind of apneas are caused or changed by what position I am sleeping in.

For weeks I have tried to figure what relined (leaned back) position was working every so often in my recliner.

I was sure all I need was to find the right reclined position that worked and I would have it done...

I could not find it.

I tried a wedge in bed and failed to get better numbers...I tried it in bed flat on my back again high numbers.

Then I found that I could now sleep on my left side and get low numbers, in fact ZEROs and I could do it every time.

But why?? And what was happening with those good nights in the recliner?

Well I have found my smoking gun.

It is NOT that I need to sleep at 90 degrees off my back, it is that I need to be not flat on my back.

And this maybe how I had good nights in my recliner, I could turn a little to the left (or perhaps right, will check…) and lower my AHI.

SO I tried putting a thin pillow under my right side in the recliner… and turned to the left a little bit and I got less than 5 AHI. I again woke with pain..but it was a little AHI.

SO I tried it in bed. Propped my right side up with pillows and again I got low AHIs. In fact crude as my set up was I still stayed below 10 AHIs overall.

Well I was right…I only need to keep myself from lying FLAT on my back, my last test I slept on my left side with pillows set to catch me if I roll over and stop me and keep me slightly raised so I do not get flat on my back.

I woke up lying against the pillows and with low numbers so now as I can shift position in bed in my sleep I have less body pain.

I am a much happier camper/sleeper now.

It was hard hunt with the chair confusing things as I seemed to be sleeping flat and only tilting myself back…I can in hine sight see I may have been twisting just enough to change my apneas.

Tonight will be the final proof of the pudding.

Zeros is nice, but I got too much body pain in a fixed position, sleeping with pillows holding me at 90 degrees to the bed on my left side... so if I can sleep better and stay below 10 AHI I should be happy.

Next day:

Getting better, still having pain in bed, but I feel it will stop being a problem soon. (I just need to get used to a bed again...I hope)

Now I will need to break my four+ month habit of waking up 5 to 6 times every night after only a hour to a hour 1/2 of sleep.

I started this as a new topic for those whom may not even heard or considered position as part of sleep apneas.

Rich

[PaulaO2]

The muscles in our throats are voluntary, meaning we control them (vs heart muscles). As we relax in sleep, so do our voluntary muscles. But what happens with those throat muscles is when they relax, they can vibrate as we breathe (flapping the air, causing the snore sound) and they can collapse onto each other (causing an obstructive apnea event).

It is a well known fact that laying on your back will cause more apnea events because the machine has to fight gravity which is helping your throat to close. Add in the weight of neck fat, and it is harder for the CPAP to prevent or stop an event. In theory, laying flat on your side should do the same thing but it doesn't. My thinking is because there's not anything for the throat muscles to be stopped by. There's no cervical spine holding it stiff, not allowing any give. This makes the throat "softer" which allows the CPAP more ability to keep it open.

There's a lot of tricks we can try to keep us off our backs. The most popular is to sew a pocket onto the back of an old shirt and put a tennis ball in the pocket. When you roll onto your back, it is uncomfortable, so you roll back over. The trick is to find where to put that ball that it is uncomfortable enough to make us roll off our backs. Several people have noted it needs to be higher, like between the shoulder blades. Others have used backpacks with tennis balls or using simple duct tape to tape a ball onto the back of a shirt.

The pillow method you found that works for you, wouldn't work for anyone who moves around a lot. The pillow will get moved (or pushed onto the floor) and they'd sleep on their back.

Positions wouldn't do much for central apnea events, however, since it is a brain thing and not a structural thing.

[racprops]

That is the really funny thing about my apneas, I get mainly Clear Air Apneas... at lease accoutring to my machines reports.

I cannot show pictures but check out my other thread and you will see I get Napopneas and clear air and almost no Obstruction apneas.

Rich

[iSnooze]

Hi Rich,
I'm glad that you have discovered what causes your higher AHI readings. I am not surprised that the position affects AHIs. As Paula said, usually AHI is higher when people sleep on their back. It's interesting that most of your events are central apneas. Hopefully your pain will soon be a thing of the past and you'll be able to sleep long and fitfully.

[CactusRoper]

I too have positional apnea. I use two tennis balls on the back of a tee shirt. When I only sleep on my side I do not have any CA's or OA's.
The problem was my hips and shoulders would hurt. After doing a lot of research, I obtained a memory foam mattress topper and I no longer experience any pain.

[PaulaO2]

It could be, then, that somehow the CA events are linked to the pain level so any position that is comfortable would help. Interesting.

I have chronic pain as well but I've never really noted if a high pain night resulted in more CA events. I'll have to start keeping track of it and see.

[racprops]

One of the reasons I keep posting IS for those that follow me and will want to read up on these problems...

First was learning to use a ASV machine:

I read that my complex apneas is in the 17% range and I have no idea where positional apneas fall but I bet it is less.

Well I am still fighting the battle of a good nights sleep and losing.

I cannot seem to sleep longer than a 1.5 hour.

I am writing this after one such sleep cycle.

Today I will be seeing two Doctors and one will give me a prescription for some pain meds.

Wish me luck and a good nights sleep.

Rich

[iSnooze]

Good luck, Rich. I know that pain, even low level pain can affect a lot of aspects of life especially sleep. I hope you can find a solution so that you will be able to sleep for longer periods of time. Keep us posted.

[PaulaO2]

Please keep us updated.

A lot of pain medications will effect your sleep which is where watching the trends come in handy. However, at this point, if it helps you sleep, take it! You can always later adjust your pressure to compensate for the meds.

[SuperSleeper]

Man oh man, Rich... you sure are having a tough time of it. I applaud you for having the fortitude to stick with the treatment - lesser patients would have given up long ago.

Keep at it, and I know others will benefit from what you've learned through the whole process.

Thanks for posting!