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Side vs. Back sleep - APAP tuning
#1
Hi all, I am fairly new to the task of improving on what has been generally degrading sleep quality. Sleep study indicated moderate obstructive. I was assigned a ResMed S9 autoset w/humidifier. Being a techie, I learned of the software and downloaded the ResMed scan software and began studying the detailed graphs, with emphasis on the actual breath volume time-graph. I can see where the tool bumps control pressure (auto ranged from 7 to 12 cm in my case) when breathing stops and sensed to be obstructive type.

I don't have data on this but I suspect that obstructive is only happening while sleeping on my back. During those moments between awakeness and sleep I have on occasion sensed my airway closing, like a valve would snap shut. Is this true or mostly true that obstructive apnea happens only on back sleep?

Be that the case, we would want an APAP algorithm that could adjust quickly to the breathing pattern changes as one shifts sleep positions. If on side, the PAP should be able to settle into the low limit setting an stay there. A transition to sleep on back - the tool should be able to ramp up rather quickly on the first or second event so as to minimize total obstructive events while sleeping on back.

Can an S9 Autoset pressure "gain" be adjusted (maybe maximized), so that when obstructive events start (move to sleep on back) the pressure will increase quickly to maximum limit? I think the decay rate of pressure might be adjustable too, when on events are happening in time.

Regis - Pleasanton, CA
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#2
I think the attack and decay rates are fixed in firmware. The S9 Autos are aggressive to raise pressure and slow to decay.
As for back versus side. For me, side is better.

One of the reasons for using an auto machine is to have it adjust to positional changes and other influences on apnea.

The main control one has is the pressure limit window. It should have a floor that is not too low, else it will take several pressure increments to get to control OSA. It should have a ceiling that controls under worst case conditions.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
Crw,
I'm new here myself but I can say that while Apnea events do tend for many folk, to be worse while sleeping on their backs, they are in no way, limited to that. I am nearly exclusively a side and stomach sleeper and I have moderate apnea with a diagnosed AHI of 26.6 on sleep study.

That said, it does help to not sleep on back and some use things like tennis balls sewn into back of pj's to keep one off the back.

The Manse Hen
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#4
Yes, I am familiar with the slamming shut (100% strangling) by something while sleeping on my back. That doesn't happen when I'm on my side since then I get smaller reductions over longer time spans. Everyone is different but most people will have many more breathing limitations while sleeping supine. My hope is to eventually be able to sleep on my back but my CPAP isn't sociable with that at this time.

I tested that as it applied to me and the following graph says it all:

[Image: 11kblhg.jpg]
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#5
Hi crwheelr,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and hang in there for more answers to your questions.
trish6hundred
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#6
Yes, studies show most tongue, soft palette, throat obstructions are much worst when the tongue weight is falling into the throat (back sleeping). There are other weight and size of clear throat area issues that complicate, but usually result in same thing, position that is the worst is usually on the back. nasal cavity obstructions may not follow the same course, as they do not relate to the tongue weight.

It is a very clever thought of doing some sort of detection and auto gain titration algorithm.

I am awarding you the very first Excellence Toward QALity in Sleep Award.

This idea ought to be easy to integrate into next generation ALLPAP machines! In a few years our data capable machines will be dinosaurs.

What will be necessary for the detection is a device that has multi-axis accelerometers allowing home detection of sleep position.

Now if only the detection device could also detect EEG info and transmit position and brain waves all to the ALLPAP wirelessly, and ...

if the ALLPAP was a learning device that correlated the position and EEG with the detected apneas, auto-deciding the appropriate up and down signals or jumps.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#7
Greetings,
I am a side sleeper, but now and then I like to sleep on my back. I was never able to sleep on my back prior to CPAP because I felt as if I were suffocating. We had to replace our bed this year, and deceided to purchase an adjustable bed. Yes, it was expensive, but worth it. I find that if I raise the head just a little, I can sleep on my back, and my AhI doesn't seem to be affected. I would guess that if I wre laying flat on my back, my readings would be high.
Bed
OpalRose
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#8
I have to sleep on my back. I try to sleep slightly inclined.

I've not done much real looking into the data except to note I have a lot more central events the nights I sleep on my side and few to none when I sleep on my back. Part of the Great Paula Plan is to start tracking my sleep position via journal and other means Feb 1. We are trying to decide if it is time for a hospital bed for me and my sleep of course plays a big part of it.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#9
Hi Paula,
I like your idea of a journal. I am going to start one today.
I pray you can find a way to purchase an adjustable bed or hospital bed. As I stated in another post, we were due to replace mattress anyway, and it just made sense to purchase an adjustable bed. I didn't think my better half would adjust to it, but he loves it too! But for you and me and anyone with Apnea, it will make a difference in your quality of sleep, and your worth it.
Best to You!
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#10
When you say, Paula02, that your centrals go up on your side, I can relate. I can look at my graphs and can tell when I roll over onto back, or side. Last night OA was under 2, but centrals were twice that. So, no real satisfaction patting myself on the back for low OA, sleeping on my side, when centrals were jacked, huh?
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