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Your pillow could be killing you
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DeepBreathing Offline
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Sex: Male
Location: Perth, Western Australia

Post: #1
Your pillow could be killing you
In the days BCP (before CPAP) SWMBO often threatened to kill me with my pillow if I didn't stop snoring. Luckily that threat has receded, but I have found a new way the pillow could be killing me.

I was lying in bed the other night not able to sleep, just breathing along with my VPAP Adapt. I noticed the pressure kept going up really high for no apparent reason. I raised my head and it dropped back down to quite low. I realised that the shape of my pillow was causing my head to slump forward, chin to chest. This was obviously causing a narrowing of my airway and the machine responded appropriately. When I tilted my head back so the airway was clear, pressure returned to normal.

I use a duck feather pillow which I pummel into shape for maximum comfort. Now I make sure it holds my head in a chin-up position with fully open airway. Pressures are now much lower.

You might want to consider if your pillow is causing your head to slump forward - it could be killing you!

DeepBreathing
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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.
09-27-2014 08:00 PM
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surferdude2 Online

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Machine: ResMed S9 AutoSet
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Location: Mousetown, Southern Illinois

Post: #2
RE: Your pillow could be killing you
Hi Paul,

I recently covered that with a friend who has been on CPAP for more than 10 years. He had no idea that the position of the head was so important for maximizing therapy. The reason it came up was we were discussing how it is often said that a person could sleep in a half sitting position in a recliner and help control apnea. I said, "Not if their head is thrust forward by the usual extra padded area at the top of most recliners." It would be even worse if they used an additional pillow!

You can even ruin the benefits of side sleeping by inappropriately tilting your head down toward your chest as you position it on the pillow.

Thanks for bringing it up since there may be some here that haven't considered that before.
09-27-2014 08:13 PM
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Galactus Offline

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Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
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Post: #3
RE: Your pillow could be killing you
Do you guys entertain the possibility that too much focus is put on sleeping position when treatment is properly working? I mean let's face it, I missed sleeping on my back, till I got this machine. Now I can sleep that way again, and I don't want to give that up. So what if the machine pressurizes up a bit more to compensate? Point is it is working, and the morning data shows it is. I think far too much worry is put into sleeping position when the therapy is effective.

This is not say I don't agree that sleeping upright will reduce apnea, and side sleeping will reduce pressures, and everything else which I agree with. I just feel if it's working for us we should focus on that.

Just my 2 cents YMMV

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-27-2014 09:07 PM
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surferdude2 Online

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Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #4
RE: Your pillow could be killing you
You're just one of the lucky ones then. Some of the rest of the flock are having problems with all that pressure blowing them up like a balloon and keeping them from exhaling. Newbies especially have those problems in addition to mask leakage that they struggle with and unfortunately sometimes throw the cpap rig in the closet and forget the whole deal. Sad

It just make good ΒΆΒΆ to post some info that might help them. Smile
09-27-2014 09:15 PM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
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CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Perth, Western Australia

Post: #5
RE: Your pillow could be killing you
Hi Galactus. I think the point is that sleeping position can make life easier or harder, even though the machine is doing its thing. Like you I prefer to sleep on my back and I usually wake up with hip and leg pain if I sleep on my side. However, sleeping on your back is more likely to induce an obstructive apnea, simply due to gravity and the geometry of your airway. Sleeping on you back with your head slumped forward will induce flow limitations. Both these conditions cause the machine to jack the pressure up (in my case it goes up over 20, which is very uncomfortable).

If the machine can control your apnea with low or moderate pressures regardless of sleeping position, that's a good outcome. But if it needs to raise the pressure higher and more frequently, then your sleep quality won't be as good. I can't stay asleep with a pressure of 20, nor can I sleep with persistent leaks caused by higher pressures. Both these things interrupt my sleep just as much as the apnea. So I think we should worry about these peripheral issues as well: taking care of things like position can make your therapy more effective by achieving a low AHI at a consistently lower average pressure.

DeepBreathing
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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.
09-27-2014 09:23 PM
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Galactus Offline

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Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
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Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #6
RE: Your pillow could be killing you
Hi there DeepBreathing, and of course SD2, Good points indeed, I never did really look at it in that way before you expanded on it. My machine does jack me up to 19 or even higher at times. Coming from an 18 fixed brick with no ramp it didn't bother me as much till I got the BIPAP and got the pressures down. Now when it does happen I just sleep right through it. But you are correct, it does wake people up, and disturb some peoples sleep, as I do see that complained about here. Interesting points to bring up indeed, I just never thought of it in that light before. In that case even though the therapy is effective, they could still benefit from a positional change. I see your points, good information for those that are bothered by the pressure increases, and good all around information. Thanks for enlightening me to that.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-27-2014 09:30 PM
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retired_guy Offline

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Post: #7
RE: Your pillow could be killing you
I agree with all of the above.

Like Galactus, one of my great joys is being able to sleep on my back. When I had my sleep test, I was diagnosed as "Yeah, so what's the problem?" when sleeping on my side, and "don't even think about it" when sleeping on my back. (those are technical descriptions.) But with the machine I can sleep sideways, on the back, inside out, whatever I want to do, and I'm loving it. Sometimes I spend most of the night on my side, and sometimes most of the night on my back. Last night was a back night. My pressures were the same as they always are, my leak rates were great, and my ahi was 0. So in my ever so humble opinion it's about maximizing the therapy to the best ability of the person receiving the therapy. Notice I do not use the term "patient." That implies someone dependent on someone else, and I don't accept that. It is all about personal responsibility effort, and education.

So I like the idea of helping people to understand that it may be more difficult for them on their back, or flat versus inclined a bit, or whatever. But I like it when someone works with their therapy and gets to a point that sleeping position is about comfort, not necessity. I think it's a lot like "mouth breathers." It often seems to me everyone can only breath through there mouth until they actually try a different approach and find out "by gum, nose works!"

........and yes, I know the drill of "everyone's different." But I don't necessarily buy into that either. Yes, everyone's different, but I'm not. I'm the same. And since I'm the same, everyone else must be the same too. Ergo no one's different because we are all the same. Except me. I'm different.
09-27-2014 09:44 PM
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Galactus Offline

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Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #8
RE: Your pillow could be killing you
I'd like to add to what RG says in regards to what we can and can't do, and in regards to mouth breathing.

Firstly, I have found in all walks of life, not just CPAP therapy that whether you say you can or you can't you will be right. Just the basis of saying it will most often make it so. So many people I know have failed to get therapy simply because "they could never sleep with that thing", yet somehow they can smoke 2 packs a day, drink till they pass out, and a myriad of other things they have conditioned their bodies to do. And yet they draw the line of can't at CPAP therapy. Truly amazes me.

Secondly, this mouth breathing thing, I find much of this begins at the sleep study, I have found it interesting to note that almost every patient through the sleep study is "diagnosed" as a "mouth breather".... Isn't that interesting? I have taken some time to contemplate this, and it seems to me that OSA pretty much defines us at the sleep study, and because we can't breathe the body in trying to get air immediately opens the mouth and tries to breathe in, I think it is almost a gasp reflex, so of course they all say "oh you are a mouth breather". I have found in my life that the body is a pretty amazing thing, and it seemed to me that if the body was breathing through the nose, why in tarnation would it open your mouth for no reason? Not very scientific I know, but just my thoughts. So when they put this divers mask on me at my sleep study because I was a "mouth breather" I complained, and I said no I want to try a different mask, and they had to go get one because amazingly everyone is a mouth breather. So they had no other masks.... go figure. They got one for me, and I did just fine. I had pretty much the same argument again when I saw nasal pillows, and was told "no way", and was like "way", and they were "no way" you won't be happy and this and that and lo and behold here I am with a P10 and I am ecstatic.

In conclusion, and imho, maybe if everyone including ourselves stop telling us what we couldn't do, or can't do we'd be too busy doing it to worry about it.....

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
(This post was last modified: 09-27-2014 10:04 PM by Galactus.)
09-27-2014 10:00 PM
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OMyMyOHellYes Offline

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Post: #9
RE: Your pillow could be killing you
I switched over to buckwheat hull pillow a couple of years ago, primarily because it was cooler and I could sculpt its shape better. for the most part, if I don't move too much overnight, it maintains its shape and supports my neck while tipping my chin up, rolling my head back slightly which also helps in keeping airway open while on my back.

OMM
09-28-2014 09:28 PM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
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Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
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CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #10
RE: Your pillow could be killing you
(09-28-2014 09:28 PM)OMyMyOHellYes Wrote:  I switched over to buckwheat hull pillow a couple of years ago, primarily because it was cooler and I could sculpt its shape better. for the most part, if I don't move too much overnight, it maintains its shape and supports my neck while tipping my chin up, rolling my head back slightly which also helps in keeping airway open while on my back.

OMM

I hadn't heard of that type of pillow before but I see they are available here in Oz. My duck feather type has been pretty good at retaining its shape once I get it right, but it's a few years old now and probably due for replacement. I might try the buckwheat next time - thanks for the tip!

DeepBreathing
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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.
09-29-2014 12:16 AM
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