Wondering whether changing sleep position can "cure" apnea

[NewlyDiagnosed]

I was very recently diagnosed with moderate sleep apnea from a Lofta home test  (pAHI=20.6, pRDI=21.1 and O2 nadir of 84%).  The diagnosis was a shock; I took the test at my son's urging, after he was recently diagnosed.  I am usually tired but had not thought of this as the cause. 

I had been sleeping flat on my back, never changing position during the night.  I did have a very dry mouth and throat, clearly from breathing through my mouth during sleeping, and I woke up frequently through the night to drink water, going through 2 large glasses most nights.  Rarely, I woke myself up by snorting.  I slept on my back for the sleep test, and it reflected this (100% in this position). 

A few nights ago I decided to try sleeping on a wedge.  I've also been experimenting with sleeping on my side, although that is less comfortable.  There have been some changes.  My mouth no longer gets dry, and I drink very little water during the night. I'm wondering if I have apnea only when I'm lying flat?  Short of another test, is there a way to find out?  The Lofta salesperson told me that the apnea events caused the transient reductions in O2.  If I were to use a pulse oximeter which puts out data all night (I believe there are such devices), and I had very few reductions in O2, could I conclude that I don't need the CPAP machine?

The Lofta rep has recommended the Airsense 10 and 11 machines, and I've read enough to know that they are good choices.  I'm just wondering whether I need one.  I did call a university-based sleep clinic but their first appointment is 10 months away. 

I would be grateful for any advice.

[SarcasticDave94]

Welcome,

I think the test would be accurate enough in needing a CPAP. The ResMed 10 and 11 AutoSet will be great choices.

Position can help sometimes, but maybe not enough to eliminate CPAP necessity.

Treatment with CPAP isn't the end of the world. Yes, there's recorded failures due to poor pressure setup, lack of doctor discussion and support. We can help with this by enabling you to get the info that will provide methods to self advocate and give direction on how to adjust your CPAP for yourself.

[BoxcarPete]

Unfortunately, there's no way to be sure without taking another test. Also, it's not as simple as it sounds to retrain yourself to sleep a certain way consistently, it takes a lot of persistence and stubbornness. O2 isn't everything either, you can still have sleep disturbances that cause your sleep to be unrestful without necessarily dropping your O2 to problematic levels. In fact my O2 never dropped below 94% during my sleep study and I definitely need CPAP to sleep soundly.

[PaulaO2]

I think the only position someone could sleep in to "cure" obstructive sleep apnea, would be to sleep sitting straight up. And even then, it most likely wouldn't work.

The muscles in our throat are voluntary. So when we fall asleep, so do they. In that relaxed state, they and other tissue in the mouth and throat, can block the air passage. A snore is that tissue literally flapping in the breeze. Side sleeping can, at times, lessen that blockage, but it is still going to happen.

Some people have sewn pockets into the back of a shirt and put tennis balls in there. This keeps them off their back. I know there was one guy here who wore a backpack with stuff in it to keep him on his side.

Get the machine and use it.

[NewlyDiagnosed]

Thank you all for the very helpful responses.  Sounds like I'm being unrealistic. I've learned enough to know that prescribers/suppliers won't be of much use in learning to use the machine, so I'm sure I'll be back soon for help there.

I really appreciate the information.

[TechieHippie]

It's very normal to have no idea you may have apnea. I think that happens most of the time, so don't feel badly. Have you posted the actual sleep test? I can't remember. Post it and let us take a look (remove the personal info). We can tell a lot from the graphs. But, a low of 84 is a sign that your sleep is troubled. Something is going on.

Getting an oxygen monitor is worthwhile in my opinion; you can share it around the family... It's close to a sleep test in itself over time- a better deal than another home level 3 sleep test IMO.  What I tell people that I lend the oxygen monitor to, is to use it for at LEAST a week.  At first you know it is there and are more conscious of breathing, and sleep more lightly. Not universal but pretty common. So your sleep test may have *under* counted your events.

So, that said, there is really no need to futz around. I spent over a year trying to avoid a CPAP by restricting my position, monitoring my overnight o2 with a buzzing alarm when I went low, etc.  In hindsight, I was partially just keeping myself out of sleep stages where I had the most apnea ending up in REM deprivation. The truth is, you may have to switch your sleep position AND wear the CPAP. But you will be surprised at how much it is effecting you in hindsight, I'm guessing, unless that 84% was a complete anomaly. 

There are Resmed AirSense Autoset (you want Autoset) 10 machines available for < $400 if insurance won't cover it...My suggestion, get the machine, skip the University sleep lab and post data here to help you get the treatment dialed in.  I read here a lot that people like the 10 better than the 11 which switched to a smaller motor. If you want to start with the oxygen monitor while you are in the process or can afford both, my favorite is the SleepU from Supplier #40.  Some prefer the O2 ring (I think it can be a little less robust over time, looking at reviews), and some need the extra features of the Checkme; but they are all good. (I got my off-brand APAP from them too; I've been very happy with it but since the Resmed can be found for a similar price, go with that).  

Lisa

[NewlyDiagnosed]

Thank you so much, Lisa! Yes, the diagnosis was a shock. But something you said worries me - "So your sleep test may have *under* counted your events." I definitely didn't sleep all that well during the test, because the pulse oximeter on my finger was tight enough to disturb me enough that I woke up multiple times.

I was not thinking of waiting for the university/hospital sleep test before addressing this. Unless I get lucky with a cancellation, I won't even see a doctor for 10 months. I am going to go ahead with the CPAP machine, and possibly the SleepU that you recommended. On the SleepU, I just have to check reviews to see if it is tight enough to disturb my sleep as the one for the Lofta test did. Does you get used to it over time, therefore your suggestion to use it for at least a week?

I have to call my insurance company and find out how their coverage works. I have the impression from reading here that it may not be worth the trouble to use them. I certainly would not use a machine other than the 2 Resmed systems.

I have not posted my results; will do that tonight. I'm looking forward to the feedback from the generous people here.

I really appreciate your advice, Lisa!

[TechieHippie]

I don't know that your test was over or under counted, but it is a possibility since it's just one night of data. Stress can make events higher, and disrupted sleep can make them lower.

Yes, the sleepU isn't too hard to get used to but it takes time. The sensor can go on any of the outside fingers or thumbs, and it can go below or above the second knuckle. It does not cover the fingertip. It does stretch a bit over time, my current sensor is a little loose for my pinkie. It's replacement is about $26. The o2 ring doesn't have a replaceable sensor but most people never need to. If the sensor comes off or is removed you have 10 seconds to put it back and continue the same session, after that it starts a new one. It holds 4 sessions regardless of length. that is not a big issue using Oscar to see all sessions in the day together. So I don't worry about it and just download every day, usually I have 2-3 sessions.

The oxygen alarm is helpful. The checkme has an audible alarm I believe, too, but I find the buzzing alarm to be plenty for me. You can set the strength.

My point about the sleep center is that you will get great info here, and if you need more refinement you may want a different type of specialist or just your primary care doc.

[G. Szabo]

Indeed, it is quite a problem. Hence, I posted a "Slide sleep enforcer" device, which I am happy about.