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MissDonna - Positional Therapy Thread - MissDonna - 09-27-2023
I'm new here, and I just got my sleep test results today.
I've got a question or two....or six.
While on my sides, my AHI was low....not enough for CPAP.
On my back the AHI was 11.2, and I was on my back for a little over 2 hours of the study. Would that mean that I stopped breathing or almost stopped breathing about 11 times in those two hours?
Does that mean that if I got 7 hours of sleep (which I did during the study and which is typical for me), then I only rested well for 5 hours of the night? If the answer to that is yes, then I guess that would explain why I am so tired during the day, huh?.
Here is one question I have about Sleep Apnea: When we stop breathing during an Apnea episode, do we wake up a little without realizing it? Some places I've read indicate that is the case, but the employee at the sleep lab told me that the answer is "no".
If the answer to that is "yes", is the same true of hypopneas?
One more question: Any recommendations of a product or products that could help keep me off my back?
Thanks for any information you can give.
RE: New with Lots of Questions - Jay51 - 09-27-2023
AHI is calculated per hour. 11.2 per hour. Obstructive apnea (OA), Hypopneas (H), Central apneas (CA), and even flow limitations can contribute to poor sleep. I can't recall the exact #'s off hand, but OA is pretty much a complete closure; Hypopnea is a partical closure (of your airway); and with CA, your airway is open, but you fail to breath for at least 10 seconds. 10 seconds is the criteria for diagnosing each separate apnea. Flow limitations are just what they sound like: less closure of your airway than even hypopneas, but a lot of them can still wreak havoc on your sleep (and cause many arousals during sleep).
If you wake up or not depends on the degree of arousal that the specific event causes. Each event can either: 1. not cause an arousal - you simply sleep through it; 2. cause a partial arousal; or 3. you wake up. OA's are usually worse than H's because they are just about a complete obstruction. But if you have a lot of H's; then they can be almost as bad. CA's can be bad also.
A lot of people improvise (to keep themselves off of their backs) by using something to place behind their backs when they go to sleep on their sides: a large pillow, etc. There are devices sold also that do this. Most of them have a velcro strap with something like a ball taped to your back; so when you roll over onto your back, it hurts and wakes you up and forces you back on your side.
RE: New with Lots of Questions - MissDonna - 09-27-2023
Thank you Jay.
I've tried a pretty thick pillow at my back, but that hasn't kept me off of my back. I'll look again at the types of items you mentioned. I haven't found one yet with really great reviews, but I know there must be something out there.
Years ago a massage therapist told me that I should sew 3 tennis balls vertically into a t-shirt and use that. She might be right about that.
Do you have any thoughts on this part of my post? :
On my back the AHI was 11.2, and I was on my back for a little over 2 hours of the study. Would that mean that I stopped breathing or almost stopped breathing about 11 times in those two hours?
Does that mean that if I got 7 hours of sleep (which I did during the study and which is typical for me), then I only rested well for 5 hours of the night? If the answer to that is yes, then I guess that would explain why I am so tired during the day, huh?.
I ask because I am really hoping that staying off my back when I sleep is going to help me feel better during the day.
Thanks again.
RE: New with Lots of Questions - Gideon - 09-27-2023
Quote:On my back the AHI was 11.2, and I was on my back for a little over 2 hours of the study. Would that mean that I stopped breathing or almost stopped breathing about 11 times in those two hours?22.4 times in 2 hrs, 11.2/hr
If the answer to that is "yes", is the same true of hypopneas?
Quote:Here is one question I have about Sleep Apnea: When we stop breathing during an Apnea episode, do we wake up a little without realizing it? Some places I've read indicate that is the case, but the employee at the sleep lab told me that the answer is "no".Events frequently result in you shifting to a less restful sleep, everytime no. Same for hypopneas but the changing of sleep state would be somewhat less
Too stay off your back There is the old tennis ball in the tee shirt trick or anything similar.
It would be good to post a full copy, including the charts and tables, in addition to the narrative as that would tell us more about your test.
RE: New with Lots of Questions - MissDonna - 09-27-2023
[attachment=54582][attachment=54583][attachment=54584]
This was the information I got today Gideon (or anyone else who can answer my questions).
I apologize that two of them are not turned correctly. I am NOT tech savvy at all.
RE: New with Lots of Questions - Jay51 - 09-28-2023
Thank you for posting that. These are my observations:
1. You spent a lot of time below 90% O2 saturation (78.6 minutes I think). Surely this would qualify you for supplemental oxygen at night. A cumulative 5 minutes under 88% is all it takes to qualify for supplemental oxygen according to Medicare.
2. Most of your events were either OA or H. You can try reducing your pillow height, or eventually even getting a soft cervical collar to try if everything else that you have tried has not reduced your OA's and H's. I know you are already sleeping on your side more. If you want to download OSCAR and post some charts here eventually, we can optimize your pap therapy even more.
Those were the main things. If Gideon sees something else I missed, he will post.
RE: New with Lots of Questions - MissDonna - 09-28-2023
Thank you, Jay.
I have a couple of questions:
1) On my back the AHI was 11.2, and I was on my back for a little over 2 hours of the study. Would that mean that I stopped breathing or almost stopped breathing about 11 times in those two hours?
2) Given how low my AHI was on each of my sides, should I just not worry about trying to correct my breathing while sleeping on my sides?
It looks to me like I'd only need CPAP if I was sleeping on my back.
I meant to mention the Oxygen levels when I posted this information.
First of all, I'm a good ways off from Medicare.
I don't believe my oxygen started off at 91% as the test results indicated. I have no health problems that would affect Oxygen levels, and my Oxygen has never been that low even when I have a chest cold.
As you can probably tell, this was a home sleep study, and the Oxygen indicator kept blinking on the machine I had to wear for the test. It was indicating that a connection was loose, and it would resolve on its own with no movement from me, but the tech said that it read fine on their end.
I think there was a short or some other problem with the Oxygen indicator.
Currently I use a neck roll pillow for sleeping. I have a neck issue that cause me to have to sleep really "low", and the neck roll is as low as I can sleep while still giving my neck the support it needs.
I have considered the a soft cervical collar. Would that only help when I'm on my side so that I still needed to use the tennis ball on the back of my night clothes?
I did use a tennis ball duck taped to my back last night, and it did keep me off my back.
RE: New with Lots of Questions - Jay51 - 09-28-2023
1. AHI is calculated per hour. So 11.2 means you stopped breathing (or almost stopped breathing) around 11.2 times per hour. (Technically, you may be breathing a tiny bit with an OA; and still breathing a small amount of air with an H; but 10 seconds like this qualifies as one apnea).
2. It is your choice what position you choose to sleep. Side seems to be a lot better for you personally though. BUT, a person can still chin tuck sleeping on their side. Chin tucking is when you tuck your chin to your chest and it cuts off your airway. Kinking your airway to the left or right can happen also - try to keep it as straight as possible).
3. The question about only needing cpap if you sleep on your back or not, I cannot answer that. You will have to decide for yourself. The medical industry considers an AHI under 5 as a normal person. Above 5 is mild apnea up to 15. 15 to 30 per hour is moderate. And above 30 is severe sleep apnea. So if you AHI was below 5 sleeping on your side, that is your choice to make. Obviously if you sleep on your back, you need it according to this home study.
Any other questions, just ask. If you can, it might be wise to recheck your O2 during sleep to see if those results are accurate or not. Oximeters can be searched for and purchased online (if you choose to). Wellue and Contect are 2 brands that come to mind. There are other brands also.
RE: New with Lots of Questions - MissDonna - 09-28-2023
Thank you so much for the information, Jay.
RE: New with Lots of Questions - Gideon - 09-28-2023
Your oxygen levels are questionable close to needing action. It is hard to read because of the curve in the paper when it was copied. The use of a CPAP will likely improve your oxygen sats. You should prove this with an recording pulse oximeter. We like the ones compatible with OSCAR.
See the marked up chart below.
Your chart shows events on your back, and both sides, with your back being the worst. The Positional I'm referring to I believe is cervical alignment, We see this pretty often, old school says to fix this with increased pressure, they are events and events are resolved with increased pressure. You show this on both sides in addition to your back. We frequently see that pressure does not resolve this, and we have examples with a soft cervical collar working. If possible a pillow adjustment. If not try to stay off your back AND keep your cervical alignment in mind.
Your positional changes are driven by what appears to be Arousals. It could easily be flow limitations driving this but would need a breath by breath view to confirm that.
[attachment=54607]