Whats with the wedge pillow??

[mghaner]

My doc has me using this wedge pillow to sleep on and is adamant about my using it when I sleep on my back. I have no other medical condition then the sleep apnea. This all came about when I was having problems with the bipap pressure of 20-14 and he lowered it to 16-10. This was all done over the phone so I was not able to ask about the need for the pillow and just went out and picked one up. I seem to sleep OK on it but don't understand the need for it. If anyone uses one and knows why I would love to know.

Thanks, //mike//

[kteague]

Elevation of upper body can make a difference in obstructive sleep apnea for some. I used a wedge for a while, but seemed I kept sliding down off of it and could only lay on my back on it, so I wasn't sure how much it was helping me. I found it felt more natural for me to roll up a comforter and put it between the mattress and box spring across the top of the bed. Some on here put objects (bricks, wood blocks, risers) under the top of the bed. The trick is to make it enough tobe of benefit but not so much as to make you slide down.

Your doc was probably trying to offset reducing your pressure with the elevation a wedge provides.

[socknitster]

There are actually many reasons why a wedge may help you. First and foremost, getting you in a more upright position relative to gravity is going to make gravity work in your favor. Just like when you are awake and upright breathing is easier, throat collapse is less likely when you are more upright--even a few degrees that a wedge provides can make a difference.

Having an enlarged abdomen myself right now (I'm 8.5 months pregnant) those with big bellies should breath easier on a wedge because in the supine position the belly can spread out more and put pressure on the airway and lungs. That may or may not describe you--I have no idea.

A third way a wedge can help with sleep (and I strongly suspect this may help you) is keeping stomach acid where it belongs--again with gravity's help. Those with extremely high pressures (this is my own personal opinion formed by reading here) tend to have problems with GERD--heartburn, but it can go unnoticed.

I had (and still have) what is termed silent GERD. I didn't experience heartburn during the day, but enough acid was coming up to damage my esophogus. My only symptom was a persistent glob of mucous in my throat that I cleared my throat agains all day long and tried to swallow down all day long. The mucous is there trying to protect your throat from the acid that is NOT SUPPOSED TO BE THERE. By the way, this damage to my esophogus was confirmed by an ENT with a special scope. I rarely to never experienced heartburn after a meal.

What the acid does is insidious and dangerous. It inflames the airway tissues. Inflamed airway tissue is more ridgid and therefore harder for a cpap to move out of the way--the reason I believe high pressures like yours are often indicative that some form of GERD is involved.

The GERD paired with apnea is particularly problematic. Each gasp for breath can aspirate the acid into the lungs or sinus areas too--leading to problems like athsma and COPD--and into the sinus causing havoc there as well. It also is simply a viciuos cycle--the gasps bring up more acid, causing more inflammation etc etc.

I took prilosec OTC for a while and that helped. But when I got pregnant, I had to swiitch to Zantac. It is shorter acting, but that makes it possible to only take it when needed. I only take it at night since heartburn doesn't pester me during the day when I'm upright. I find I actually prefer the Zantac to the prilosec now.

Heartburn/GERD is another reason why people have problems with aerophagia--tummies painfully full of air in the morning. The sphincter that is supposed to close off the stomach is swollen and doesn't work as well as it should. Working on GERD issues should help with that condition as well.

Addressing my GERD and having my tonsils out allowed me to lower my pressure needs a great deal (mostly it was the tonsilectomy) which has made my comfort on cpap far easier. My original diagnoses was 16/12 bipap. I am now comfortably using 10/6 bipap.

jen

[mghaner]

I am thinking that poster "kteague" nailed it. That makes sense to me. Thanks to both of you for your input. I am working on inching my pressure up to where it is supposed to be little by little now that I have learned to to change pressure myself (thanks to those of you that gave me the scoop on that) THis forum is totally awesome. What a great group of folks on here.

[Snoredog]

elevating your upper body is supposed to lessen the effects of OSA. Think of your upper body being a big ole water balloon swashing around, put it on a platform raise one end it sloshes to the opposite end.

however, I'm not a big fan of the wedge because I like side sleeping which can also lessen the effects of OSA. Your ole body doen't like to bend in them unnatural directions.

I have a Select Comfort adjustable foundation with vibrating massage etc., it elevates the head and bends the bed in similar fashion as the wedge, not too comfortable but on your back, okay for watching TV.

But if you want the same effect and still sleep on your side you place blocks under the headboard end and elevate the whole bed.

[Gipper]

Hello,

I have ben using a wedge pillow along with the TAP 2 dental appliance for 3 years now. I was able to use this combination to get off CPAP. I know this may not help anyone with really severe apnea, but well worth a try for someone with mild sleep apnea.

Gipper

[Catnapper]

For years before I knew I had sleep apnea, I used a wedge pillow because it made it easier to breathe while I slept. I did this on my own without the advice of a doctor. Finally I learned about OSA, and that answered why I needed the wedge. Now that I am successfully treating my OSA, I no longer need the pillow.

I bet it will help you a lot, and in time you may not need it.

By the way, I never sleep on my back, then or now. I learned to sleep on that wedge on my side or stomach. You can see I was struggling to breathe to the point that I would sleep better in that unnatural position than having apneas without it.

I also had the silent GERD, but never other heartburn symptoms. All better now.

[socknitster]

I, too, sleep on my side with a wedge pillow. My left side, to be exact. This is the best side for problems with acid reflux, as it keeps the contents of the stomach in the stomach where they belong a lot better than the right side (this is a well documented anatomy factoid). It also happens to be the best position to sleep in during pregnancy.

I don't find this position any more unnatural than any of the other contortions I used to get into for sleep. As a child I routinely slept on my stomach with my face hanging off the side of the bed so I could breathe.

Currently, I sleep with a wedge, cpap, and a pregnancy pillow to support my huge tummy. Sometimes when I am getting in bed I wonder if sleep could get any more complicated. But I no longer have trouble sleeping and sleep like a log. Compare that to a few years ago when i got up several times a night and some nights felt as though I never slept at all--I wouldn't go back for the world. My life, my health, alll so much better now. It is worth it.

Jen