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Forcing sleep position
#1
Forcing sleep position
Hi folks

Sorry -- this is not really a CPCP/apnea issue at all; but I suspect that some folks here are dealing with similar problems.

I've recently discovered that my poor oxygen saturation has more to do with a right-to-left intracardiac shunt, than it has with sleep apnea. In order for my oxygen saturation to stay over 90%, I must sleep entirely on my right-hand side. That's just the effect of gravity -- I have to discourage right-to-left blood flow through the defect in my heart. I'm considering having the defect surgically closed, but that's another story.

When I say that I have to sleep on my right-hand side, I mean that my shoulder blades have to be perpendicular to the bed. Even a slight lean towards sleeping on my back is problematic.

The only way I can think of the force myself to sleep in the "proper" position is to somehow attach my left wrist to the bed frame, so I can't roll away at all.

Surely there's a better way? I can prevent myself sleeping on my back, but I need to prevent myself sleeping anywhere near on my back.

Suggestions welcome.

Best wishes, DS
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#2
RE: Forcing sleep position
This post has a link to what worked for me. The light canvas item was apparently a surveyor's vest. I was blessed to find it in a random visit to a thrift store when looking for a heavy denim cowboy jacket to convert into such a vest. 

One caveat, there was sufficient slack for me to roll toward and get within about 30 degrees of supine. 
Slack came from by my girth a bit less than that of the vest and the surveyors' pocket being a bit larger than my boxes. Both could have been tightened but wasn't necessary.

I never rolled over in sleep with that block on. Eventually--for similarly motivated readers of your thread--I shed that block arrangement after reluctantly discovering that I could tolerate a 4 inch cervical collar I had acquired but, fussily, had not used. No need for the block, I sleep supine some, AHI and FL remain low as before.  

How to stop rolling onto my back? | Apnea Board
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  (Disclaimer use permitted by sheepless)

 
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#3
RE: Forcing sleep position
My bed has been placed against a wall lengthwise. For some reason, it was easier to get in bed this way, with my very bad back pain.

To your question; I've used this lengthwise positioning along the wall to my advantage, by placing 4 extra long pillows stacked 2x2 next to the wall to create a pillow wall to lean back on to prevent back sleeping.
Dave

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#4
RE: Forcing sleep position
As ridiculous as it sounds, you probably already have a solution you could trial.

Wearing a backpack, preferably one of those multi-pocket ones that expands outwards if you fill all the pockets, may help keep you on your side.
Stuff it with towels, old T-shirts and other material items until it sticks out backwards behind you.

One that also has a waist strap would probably hold in place best.

A long foam block behind you would possibly be another thing to try, but in your sleep you are likely to still roll on to your back to some extent.
- They are not spelling/grammar errors.. I live in Australia, we do it differently Down Under  Big Grin -
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#5
RE: Forcing sleep position
Maybe just adding Supplemental oxygen would be easier. A oxygen Concentrator could be paid by insurance if your saturation is low enough.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: Forcing sleep position
Trying to sleep on your side for the rest of your life is sure to cause numerous skeletal and muscle problems that could become more of an issue than these minor oxygen desaturations.

Surgery, supplemental oxygen, bilevel or something else seem like better, more realistic long term solutions.
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#7
RE: Forcing sleep position
(01-23-2022, 11:36 PM)Geer1 Wrote: Trying to sleep on your side for the rest of your life is sure to cause numerous skeletal and muscle problems that could become more of an issue than these minor oxygen desaturations.

Well, that's the problem -- I have no idea how much of an issue the desaturation is. When I sleep on my right, my SpO2 swings through 5-6 percentage points every minute or so -- sometimes much more (see attached). It does that constantly, with the overall level heading gradually downwards. These SpO2 swings are with clear airways (as reported by ResMed). There's just that weird periodic breathing, that I've shown in other threads. I don't know how low my SpO2 will go because, when it gets down to 90%-ish, I wake up and roll over.

I don't know if this is a problem, and my doctors have no idea either.

My recollection is that supplemental oxygen does not help when the poor oxygen saturation is the result of an intra-cardiac shunt. Even if blood returning from the lungs is 100% saturated, it's getting mixed with deoxygenated, venous blood.

Sorry -- I'm trying not to pollute another thread with my moaning, but I can see I've failed. I guess I'll try the backpack method for now, if I can't train myself to sleep in one position.

BW, DS


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#8
RE: Forcing sleep position
I think you need to find a different cardiologist to help understand what is going on and what should be done about it. It doesn't appear you trust the one you are currently dealing with (either you don't trust him or don't think he knows enough to do his job fully aka explain what you are going through and if these desaturations are an issue or not etc).
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#9
RE: Forcing sleep position
(01-24-2022, 11:28 PM)Geer1 Wrote: I think you need to find a different cardiologist to help understand what is going on and what should be done about it. It doesn't appear you trust the one you are currently dealing with [...]

I've already seen two different cardiologists, and I've consulted a couple of others (friends of friends) informally. None has any idea what's going on, or what its significance is. None will hazard more than a vague guess that my cardiac problems are related to oxygen, or breathing, but none will say definitely that they aren't. It seems that my case is genuinely obscure. Any one of them will happily close my atrial septal defect if they're paid to do so, but none seems very confident that it will make much difference.

I've already spent enough of my pension fund on doctors, tests, and equipment to have to delay my retirement. 

Frankly, I think I'm on my own here.

BW, DW
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#10
RE: Forcing sleep position
My understanding is that you have/had a doctor that prescribed you CPAP because of heart arrhythmia and that no other symptoms were present.

Am I correct in saying at some point you started using an oximeter to track either heart rate or oxygen levels and you noticed that you were having these desaturations and now you are wondering/worried if these desaturations are an issue that need to be addressed?

Am I also correct in saying you wondered if these desaturations were being caused by CPAP (hence the questions regarding TECSA) but now you believe they are caused by your right to left shunt?

The main trouble I am having is understanding what you believe the problem is and why it needs to be addressed? What is it you are worried about and trying to treat?

Edit: My best guess is you are trying to treat the arrhythmias and you aren't sure if these desaturations are causing them so you are trying to treat these desaturations in the hopes it will help the arrhythmias?
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