How to train yourself to not sleep on your back

[ca_hosehead]

There seems to be some interest on how to train yourself not to sleep on your back so I thought I would write up some methods. This is sometimes referred to as "positional training".

Eliminating back sleeping is certainly no "cure" for apnea but for most people apneas are worst on their back and eliminating back sleeping means better sleep with lower pressure.

There are two basic methods to keep yourself off your back.

1.) BLT - "Big Lumpy Thing". You put something on your back that is so big that when you try to go onto your back it's not physically possible.

2.) SLT - "Small Lumpy Thing". You put something on your back that makes it possible to roll onto your back, but very uncomfortable when you do.


I'll start with the BLT method.

One device that I tried that didn't work for me was Dr. Parker's snore cushion.

http://www.comforthouse.com/snorerelief.html

This is an inflatable cushion that fits into a small backpack. If the straps were too tight they bothered me and if the were too loose then I would find the cushion pushed to one side and up towards the head. In this position I could lay on it comfortably and still sleep on my back.

There are some shirts that use the BLT principle.
http://www.antisnoreshirt.com/
http://www.stopsnoringshirt.com/

I don't like the shirt idea. They are pricey and when the shirt wears out you have to buy another one. Better to keep the shirt separate.

This is a BLT that straps onto your back:
http://www.zzomasleep.com/about.htm

This design looks pretty good. All of the BLT devices are more expensive and I don't know that they are more effective.


Now about SLT (Small Lumpy Thing)

An SLT normally takes the form of a ball. The size of the ball is important. You need something that will make you really uncomfortable when you lay on it.

You can use any of these:

Ping pong ball
Golf ball
Tennis ball
Wiffle ball
Wiffle soft ball (the nuclear option)

Start with a tennis ball and go up the list. I have a good memory foam mattress which adapts to lumps so I wound up with the wiffle softball. You just need one ball.

Position of the SLT is very important. Having it around the waist messed up my back. Mid-back didn't provide enough pressure because of the curve of the back. The right spot is right between the shoulder blades. If you slide it to one side there won't be much pressure on it and you'll be able to sleep on it. Be aware of where the device is when you wake up so you'll know if it is moving out of position.

I am clever when I am asleep. This surprised me, as I am not clever when I am awake. I used a video camera during this training and found I would "scoot" the device into a position that would allow me to sleep on my back. Most commonly I would scoot the device up near my head. In the case of a BLT I would "lean into" the device and move it to one side. A BLT or SLT under one shoulder can be laid on for hours. I know this.

Sewing the ball into the back of a nightshirt is commonly suggested. This didn't work for me, the ball slid up near my head very easily. It is the most commonly suggested method, perhaps it would work for less active sleepers or tighter nightshirts. If you want to try it out without doing all that sewing, start out with duct tape. (Don't duct the ball directly to the back, tape it to the shirt.)

I used the "peas" cold therapy pack from CVS pharmacy. You could use it or something similar:

http://www.cvs.com/CVSApp/catalog/shop_ ... navCount=3

Save the cold therapy pack, it's pretty nice. It took a little sewing to close the opening and secure the ball. You could use duct tape and twist ties if you don't sew.

Bring the belt up under the arms. This way it can't slide up. It doesn't move much side-to-side either.

You'll start sleeping off your back pretty quickly. It takes a few weeks to switch over completely. I read that you can use the device only once per week after a while but I haven't tried this yet.

You will need to change positions during the night and you will start doing that by transitioning on your stomach. Make any adjustments to your hose or mask to accomondate this.

Can you use your imagination as to what device will work for you. Anything that follows the basic BLT or SLT design will work. Rooster suggests a Camelback hydration backpack with an empty 20-ounce water bottle in it. I've heard of some people using a fanny pack with a ball in it.

[track]

Thanks for the post Andy/hosehead...

I thought you actually trained yourself without props...Oh Well...my mistaken assumption.

I have used a big backpack stuffed with towels,a waterpack stuffed with a large hard cover water jug,a soccer ball or hard 4 inch diameter slow pitch style softballs under a double layer of a size too small of underarmor compression shirts and a tennis balls. You don't need a video camera to know how you find a way to cheat or get on your back with each device. A little scutting here or there or just enduring the pain.
I am beginning to wonder if ones basic sleep architecture is not intefered with staying off ones back. Sure the numbers are much better on the side, but I wonder if it prevents REM sleep. I don't seem to feel any more rested staying off my back even though the AI numbers are significantly better. It's usually early in the morning when I reach my deepest REM and that's when I try the hardest to get on my back. Then there is also the discomfort of not being able to vary ones sleeping position which leads to back stiffness in the mornings.
If it wasn't for the aerophlagia I would just turn the pressure up to what ever it takes and forget all the tricks to stay off my back. I have noticed that aerophlagia is noticeably increased when on my side and noticeably decreased when on my back....so for me side sleeping actually increases aerophlagia.....but not as much at 7.6 pressure as 16-17 pressure necessary to deal with any back apnea. The bottom line is I can sleep on my side with a pressure of 7.6 with minimum aerophlagia and keep my AI around one. On my back it takes a pressure more than double that to maintain an AI of one or under. It's a trade off and usually the prevention of aerophlagia wins out. Waking up in the middle of the night blown up like a balloon is painful.

I have discovered certain mattresses allow those back preventing techniques to work better. In motels and hotels they work like a charm...on firm non pillow top mattresses. Our mattress at home has a nice thick pillow top which works against such techniques as the hardness of each item or the size can be neutralized by the pillow top.

Thanks for the informative post. It turns out I have done all that stuff over the last 1.5 years but I was not aware you could buy those specific items. Most of my stuff is homemade.

[Section1]

Hmm, thanks for the info. I had thought that sleeping on my back would be the best thing I could do. I guess I assumed in that position your neck would be straighter and easier to breath that way. Thanks for bringing this up.

[UARS-girl]

My sleep apnea got bad enough to effect me when I started training myself to sleep ON my back. (I didn't know I had apnea/uars, and I was getting wrinkles. Lame, but there you have it.) I used the same technique once I was diagnosed to start sleeping on my stomach/side. I simply spent the last few minutes before bed thinking about sleeping on my side, how comfortable it is, how my health will improve, etc. I haven't video taped myself, but my husband says I never sleep on my back anymore.

[ca_hosehead]

My sleep apnea got bad enough to effect me when I started training myself to sleep ON my back. (I didn't know I had apnea/uars, and I was getting wrinkles. Lame, but there you have it.) I used the same technique once I was diagnosed to start sleeping on my stomach/side. I simply spent the last few minutes before bed thinking about sleeping on my side, how comfortable it is, how my health will improve, etc. I haven't video taped myself, but my husband says I never sleep on my back anymore.

Wrinkles are cute. Don't worry about them.

I tried the setting the idea of sleeping on my side in my mind before going to bed, but it didn't seem to have an effect. Perhaps if I had been more patient it would have done the trick.

You don't need the video tape to know if it's working, just keep track of your sleeping position when you wake up.

[sheltie]

Whats wrong with sleeping on your back????

[roster]

......

You don't need the video tape to know if it's working, just keep track of your sleeping position when you wake up.

Many people are not cognizant of and/or are not able to remember what positions they slept on. I slept five hours in my very first sleep study and swore I slept all five hours on my back. The sleep doc showed me the study and I had spent four hours on my back and one hour on my side. I have talked with other patients who said similar things.

Now I have a way to tell if I sleep on my back. If I look at the detailed report and see a period where the AHI was 32 or higher, I know I rolled onto my back. That is why I wear a backpack to force sidesleeping most of the night.

[bdlngton]

So are those of you who are trying to force yourself to sleep on your side not using the CPAP at all or are you using it as a lower pressure? I don't have a CPAP yet (and really don't want one if not necessary) so I hope that's the right terminology. Educate me, please.

Susan

[roster]

So are those of you who are trying to force yourself to sleep on your side not using the CPAP at all or are you using it as a lower pressure? I don't have a CPAP yet (and really don't want one if not necessary) so I hope that's the right terminology. Educate me, please.

Susan

I am using cpap. Pressure requirements on my side are 8.5 cm and on my back 19 cm (!). 19 is a difficult pressure to tolerate.

[track]

It's my understanding that about 50% of the population on cpap are position sensitive. In other words there is no guarantee that sleeping on ones side will prevent or lower ones apnea. It works for me but it doesn't completely eliminate apnea events. It makes the number less and duration much shorter...duration of each event is the main benefit.

[sheltie]

For as many years as I've had a CPAP, it's amazing at how little I apparently know. I have no idea what my "numbers" are or what they signify. I just put whatever mask on that I feel like using that night and go to sleep. All I care about is that the mask doesn't leak (they frequently do) and they are comfortable (that won't happen!). I suspect that if I had a supplier that was reasonably close to where I live, and knew what they were doing, it might make a difference. In the meantime, I guess I'll just keep plodding along. It sure woud be nice to have a comfortable, non-leaking mask though. I thought nasal pillows would be the trick but they were even worse for me than the masks. Oh well, if I wake up dead one morning I'll never know anyway!

[Ms Piggy]

Hi, I use a stocking leg tied around the hose that holds my nasal pillows-, this is stocking leg is tied in a knot at the back of my head and wakes me up if I turn onto my back. I do not know how quickly it does so though but Ido find it very uncomfortable to lie on.

[ca_hosehead]

It's my understanding that about 50% of the population on cpap are position sensitive. In other words there is no guarantee that sleeping on ones side will prevent or lower ones apnea. It works for me but it doesn't completely eliminate apnea events. It makes the number less and duration much shorter...duration of each event is the main benefit.

I used video to determine sleeping position and then marked the position on the Encore Pro report. Once I saw that about 90% of my events were on my back I decided to retrain myself. Staying off my back didn't eliminate 90% of my apnea events, more like 50%.

So are those of you who are trying to force yourself to sleep on your side not using the CPAP at all or are you using it as a lower pressure? I don't have a CPAP yet (and really don't want one if not necessary) so I hope that's the right terminology. Educate me, please.

I don't think anyone should look at this as a "cure" or a substitute for a CPAP, but it can be a good tool to improve sleep and reduce required pressures. It's cheap and has no side effects. If you been diagnosed with sleep apnea and given a prescription for a machine, get one that is data capable and will give you nightly reports on how you are doing. You can also look at the copy of the sleep study. Usually they list the number of apnea events on your back (referred to as "supine") as opposed to "non supine" events. This will tell you if events are worse on your back or not.