Sleep position affecting sleep test AHI/OSA classification

[Fox66]

Just out of curiosity. The name classification of severity (mild, moderate, severe OSA), as i understand it, seems to be based on sleep test total average AHI per hour ? not the other important things like O2" etc. (witch i get would account greatly for overall more real actual severity classification i guess) ?

Let´s for example say someone got the result at testing about AHI 35, low end of severe sleep apnea. Total sleep/test time 50% on back, 50% on side/other position. The AHI for back sleeping 60, for side/other sleeping "only" 16, meaning high ratio of problems based on sleep position.

If for this single test, that same person where to instead sleep 75% on side/other, and only 25% of the total time on back, that would classify that person having "moderate sleep apnea" instead. If sleeping let's say 90% on side/other, for this guy, on the test, that person's AHI total would be more in lower moderate, around 18 - 20 roughly ? And if closer to 100% on back, way over severe limit, closer to AHI 60 ? Just interesting compared to someone having 35/35, theoretically (same in all positions), would look the same based on overall AHI, but i guess have some different things affecting treatment, maybe ?  Again, just curious.

[Fox66]

To clarify, for a person in this example, with this variation, i presume sleeping all/most on back, on side or turning and tossing flipping from back to side, would have consequences on APAP treatment. I guess the less variation, all/most side sleeping, would need least pressure, less ups and down of machine changing pressure etc. 

I`m sure there are a thousand other aspects to consider, and yes, i get the mask on, sleep, SD card, OSCAR, organise charts correctly, post here, and  .... then all you gurus can ship in ;-) I'm coming to that, very soon, just like to feel I got the ergonomic sleeping arrangements decently good, which I soon will have (for optimal side sleeping). I am a very slow starter, will have to allow all these little side tracks, to kind of "coax" myself into the things that really matters right now, that's just how it is.

[Jay51]

I, too, have found that sleeping position affects me a lot.  On a home sleep study, my AHI was 40 on my back and 20 on my side.  

Some people get a camera to video their sleep at night to calculate the time spent in each position and can even look at OSCAR data during that occurs at the same time. 

A big factor is how a person feels in the morning after sleep also.  Tweaking pressure(s) to compensate for movement at night can be a fine art, but it seems like most people find their sweet spot eventually.

[staceyburke]

What you are discussing is positional sleep apnea. It is also called chin tucking where in any position but more likely back sleeping causes your chin to drop to your sternum cutting off your own airway.

Think of it as garden hose with a kink. While the hose is linked no water can move through it. You must remove the kink.

Many people can not stop the kink without a collar. I have a link to show how well collars work in my signature at the bottom of the post.

[Fox66]

Although this was an example, my own, actual numbers was, on my back 57, and on side/other 16. I only slept for 4 hours, only home tests where i live (equipment seemed quite banged up, old) and 40% on back. I'm certain I normally sleep mostly on my side, because i thought you should try only sleeping on you back for the test so everytime i woke up, i forced myself to fall asleep again on my back (with i never do), also, with, what i now realise, brutal chin tuck (very wrong pillow), so ... many mistakes ;-). I have neck collars incoming, I am very convinced this is a very good thing for me, and that i will tolerate that well.

Also, as a side note, although i most definitely think my actual O2 values are, well very bad, I was so paranoid not losing the equipment when sleeping that i taped it up, a lot, the oximeter i wired the entire finger with surgical tape, which i'm sure made those reading a bit weird (embarrassing, based on my previous career/experience, but it is what it is). I know i have between 98-100% O2 awake from a previous test for other ailments a year ago, but sleep test says started at 94%. Well, have not started PAPing, yet, but will of course get O2 meter and everything along the way and we will see. Just read another post about constriction affecting O2 readings, and figured I might have sabotages the test a bit, unintentionally. 

[Fox66]

staceyburke, yes, a collar is one of the thing in the CPAPing arsenal i understand the most, the need, I have serious issues with this, and I also know i will tolerate well (have previous experience). Have some incoming to get right fit. I have exact neck as Mike Tyson in his prime, not muscle though ;-), (20 inches), which is of course contributing to my problem, that i will try to effect. In my prime had a 14 inch neck, soo, well, not good. Also, even before starting with mask, no matter what mask, i know for sure i seriously drop my jaw/open mouth, a lot. Have a completely new bed, mattress, special side sleeping pillow, CPAP pillow all king of things soon to be set up, but a collar of right size will be part of my set up for sure.

[Fox66]

With my size, weight, posture and anatomy, and up till now, very poor sleeping arrangements (wrong pillows etc.) i think i have had quite some chin tuck and disadvantaged air way kinks also in side sleeping position. Well, nice this could hopefully be improved a lot then :-) I have so much excess fat and tissue, and when sleeping on side, with wrong pillow i kink my neck not only chin to chest, but like sideways. This is stupid and should be easily fixed also with correct pillow, but i really feel a collar will work great for me, we will see.

[Fox66]

So positional sleep apnea refers to chin tucking, it's that what generally generates more apneas on your back ? I thought also, maybe even without tucking shin, the weight/forces from tongue etc most often give more constrictions on your back, but maybe it's just all of this combined i guess. I figure, correctly or not, that if  can avoid chin tucking, magically lose all excess weight, left would be any anatomical things born with/developed (i have all the characteristics, in jaw, teeth, mouth breeder etc.), possible born with and/or age related looseness of tissues etc. and whatever level of OSA that would generate. 

A side note, since sleep testing is such a hassle/expense, i saw a set of modern home sleep testing (not as good, but like me and many others the only thing we have gotten) costs about 20000-30000 dollar something. I saw in a EU CPAP store you could get a test for about 250 dollar (deposit about 500 dollar,  paid back when equipment safely returned). Would be cool if a larger group of Apnea folks could buy together, and "rent" out just for low fee that would cover buying new equipment after life time use likely over. Like let's say 300 people, 100 dollar each, and you would get the equipment (realize logistics etc.), just an idea ;-)