HI Barb, I agree — I have little doubt that those of us who have damaged veins and/or damaged valves at the base of the IJV, have more trouble when we are supine, because blood fills in those veins (as opposed to the vertebral veins). I recommend that most everyone sleep with the head of their bed slanted up about 3-4 inches, and when I become inflamed for whatever reason, I sometimes need to be almost completely vertical! I use a soft cervical collar (and now a posture brace) when I’m inflamed. HUGE HELP. In the upcoming trials, we’ll be addressing this, as I believe we need systemic treatment for this condition. It makes sense — why should our IJV’s be the only messed up veins in our bodies?! 🙂 Diana