Need help, suspect UARS. Want to try APAP - need advice and guidance.

Also, when you have pillows on, your mouth opens and the air leaks out of your mouth for a period of time, does that show as a 'clear airway' in Sleepyhead? Does that effectively CAUSE a central apnea, because the air is shooting in your nose and straight out your mouth? And will that in turn prompt pressure increases?

canyouhearmeaya wrote: ↑

Fri Jun 22, 2018 12:40 pm

Also, when you have pillows on, your mouth opens and the air leaks out of your mouth for a period of time, does that show as a 'clear airway' in Sleepyhead? Does that effectively CAUSE a central apnea, because the air is shooting in your nose and straight out your mouth? And will that in turn prompt pressure increases?

1. No. It shows as increased leak.

2. No. It may allow obstructive apneas because it is unable to maintain the therapeutic pressure level.

3. No. The flow, not the pressure, increase.

canyouhearmeaya wrote: ↑

Fri Jun 22, 2018 12:16 pm

My only concern is that exhaling a lot of the time with the P10 felt difficult, even with EPR set to 3.

For newbies, in 90%+ of the cases, this is "mental" not physical. I am quite a bit older than most of the members here, and I am a small person. But, I can breathe out gently and easily against pressures as high as 20 cm. Unless you have some difficult physical problem, I am sure you can do the same if you relax and fall asleep. It might surprise you how easily and gently you can breathe against high pressures when you are sleeping.

canyouhearmeaya wrote: ↑

Fri Jun 22, 2018 12:16 pm

What are the main benefits of FFM v Pillows?

FFMs are necessary for patients who are unable to keep their lips closed all night. The footprint of a FFM is larger than the footprint of a nasal mask. For this reason, a FFM may be harder to fit, adjust and use comfortably.

ChicagoGranny wrote: ↑

Fri Jun 22, 2018 1:22 pm

canyouhearmeaya wrote: ↑

Fri Jun 22, 2018 12:40 pm

Also, when you have pillows on, your mouth opens and the air leaks out of your mouth for a period of time, does that show as a 'clear airway' in Sleepyhead? Does that effectively CAUSE a central apnea, because the air is shooting in your nose and straight out your mouth? And will that in turn prompt pressure increases?

1. No. It shows as increased leak.

2. No. It may allow obstructive apneas because it is unable to maintain the therapeutic pressure level.

3. No. The flow, not the pressure, increase.

Ah okay. I just noticed that I had a few of them occur, on the couple of nights I tried CPAP. On my sleep study I'm fairly certain it indicated 0 central apneas all night, so wonder if the CPAP was causing it? Is that normal to happen?

Will having the mouth open at all cause leaks? Even if you're still nasal breathing? I just ask because the only time I could 'feel' the air coming out my mouth was when I ended up trying to mouth breathe whilst having the mask on, when you get the hurricane of air shooting straight out your mouth. But I wonder if I was possibly experiencing some minors leeks due to my mouth slipping open partially, without allowing the hurricane to occur lol. Maybe there would be more benefit to mouth taping than I realised.

ChicagoGranny wrote: ↑

Fri Jun 22, 2018 1:31 pm

For newbies, in 90%+ of the cases, this is "mental" not physical. I am quite a bit older than most of the members here, and I am a small person. But, I can breathe out gently and easily against pressures as high as 20 cm. Unless you have some difficult physical problem, I am sure you can do the same if you relax and fall asleep. It might surprise you how easily and gently you can breathe against high pressures when you are sleeping.

This is the bit I'm stuck on.. It seems there is a physical reason possibly, due to enlarged turbinates.. But equally, unless the pillows is exacerbating that issue, then I don't know if that's the cause, as I can still nose breathe WITHOUT cpap. I am wondering whether it was possibly more mental than I realised, in spite of the fact it certainly felt very real.

I also was using Benadryl (or Nytol as we call it here in the UK, diphenhydramine) on the few nights I tried CPAP, in order to try and help me doze off. I think it worked to some extent, as there were a few nights where I managed to keep it on for 3-5 hours, but equally I've heard diphenhydramine can actually cause more fragmentation to sleep architecture.. I do wonder if it was almost working against me in some ways.

I'm feeling so lost and frustrate with this whole situation, feel like I'm still not closer to a solution. I'd be interested to hear opinions on the following:

To re-haso for anyone that isnt' familiar, my sleep study showed AHI 1, RDI 15. So suggestive of UARS or other SDB, rather than SA.

For 10 years I was a mouth breather, simply as my nose was often congested. I still had the symptoms of poor sleep then. When I discovered that mouth breathing was bad, I made the transition to nasal breathing (by concious effort in the day, and mouth taping at night.) Since doing that, my allergies have definitely improved, and my nose is overall much clearer. I can still mouth tape and sleep through the night nose breathing only.

The sleep study I did was 3 months ago, AFTER moving to nose breathing, so I have no idea what my scores looked like prior to that. However, it does seem to me, that since I started nose breathing, i've started to feel worse. As mentioned previously, the ENT last week observed my septum was *slightly* deviated and my turbinates were fairly large (and that day I was not suffering from allergies, and relatively speaking for me, my nose actually felt very clear), he said if that was a good day for me, then they were on the large side. But ofc he said, he couldn't be sure if reducing my turbinates and straightening up my septum would or wouldnt help/fix my sleep.

Now initally I thought, surgery should be kept as a last resort. But given that I am dealin with UARS, not Sleep Apnea, I keep wondering if maybe I should pursue that option.

Here's my dillema: Given that it feels like I've got worse SINCE then nasal breathing, it leads me to believe that infact opening my nasal airways would probably help my sleep. Where I come unstuck is, my sleep still didn't feel good when I was a mouth breather. But equally, mouth breathing I understand is supposed to be bad for sleep? (That was one of the things that really encouraged me to learn to nose breathe, hoping my sleep would improve.)

Is it possible that in the previous 10 years, my sleep was simply bad BECAUSE I was mouth breathing, rather than it being UARS etc? And that now I'm nose breating, it's got worse BECAUSE of the nasal obstruction?

I keep telling myself 'If your nose was the sole problem, then why was your sleep bad when you were mouth breathing?'. But I don't know if that's a false logic.

I know that often people don't find much relief from SA from Turbinate reductions, but I wonder if UARS could be? Has anyone heard of any success stories, or had any themselves?

I guess my thinking is: If I can find a solution that DOESN'T require me to spend the rest of my life using a machine to breathe, that would be ideal.

What does everyone think about the surgery route?

canyouhearmeaya wrote: ↑

Sat Jun 23, 2018 8:39 am

What does everyone think about the surgery route?

More importantly, what is the opinion of two trusted ENTs.

ChicagoGranny wrote: ↑

Sat Jun 23, 2018 8:50 am

canyouhearmeaya wrote: ↑

Sat Jun 23, 2018 8:39 am

What does everyone think about the surgery route?

More importantly, what is the opinion of two trusted ENTs.

Who are the two trusted ENTs?

Granny has them locked in her basement and will not let them out for anyone.

Hang Fire wrote: ↑

Sat Jun 23, 2018 11:21 am

Granny has them locked in her basement and will not let them out for anyone.

Has anyone ever tried the tongue and mouth exercises as discussed by Steven Park and Janet Bennet?
Can listen to the talk here: https://www.mixcloud.com/breathebetters ... t-bennett/

I think I might give these a go.. nothing to lose

Can someone clarify for me:

To my understanding, Apneas and Hypopneas have to meet a certain criteria. RERAs are the breathing episodes that don't meet this criteria.

My sleep study was done with a WATCHPAT-200. Which showed RDI 15 (24 in REM v 12 in nREM) and an AHI of 1.

From a physiological standpoint, is it not quite likely that RERAs are caused by the same thing as apneas/hypopneas, they just don't reach the same severity?

According to the way WATCHPAT detects: "A RERA is an arousal from sleep that follows 10 seconds or more of increased respiratory effort but does not meet the criteria for apnea or hypopnea."

Is this not likely caused by the same physiological reason, just to a lesser severity? (I.e. there is a closure in the airway much the same as 'OSA', just to a lesser extent, or the closure doesn't result in the oxygen desat.)

Surely you could have someone diagnosed with 'severe' OSA, and someone diagnosed with 'no OSA' ( and thus not be given CPAP), that actually could both virtually have the same condition, seperated by only a very minor difference? (I.e. the severe has desats that go 1% further each time, or breathing that stops for 1 second longer, rendering their score as qualifying for AHI where as the other person could have just as many events, but if you just missed that 'qualification line' for an event, it's not registered.)

What i'm assuming is, that effectively what the WATCHPAT-200 detects as RERAS is what i'm discussing above? Likely breathing/respiratory difficult that occurs for the same reason as regular OSA, but just doesn't quite meet the critiera.

Ofc some people define this as 'UARS', and then doctors claim 'UARS' can develop into 'OSA', surely this is often exactly the same thing, just not quite to the same extent (even though it could seemingly be SO borderline)?

So for me for example: I'm 26, Male, Not Overweight. I have an RDI of 15 and an AHI of 1.

Surely it's quite possible, that actually, if I were to go and put on 30lbs (don't worry, I don't plan to do this ) and thus increase my neck circumference, I could quite likely then have an RDI of 15, and an AHI of 15, because at the moment my airway isn't closing enough to meet the AHI requirement, but by putting that extra strain on my airway from the weight/neck circumference, those RERAs would not reach the severity to classify as an 'AHI' rather than just 'RERAs'.

Surely what a lot of people are calling 'UARS' is actually just 'pre-OSA'. Maybe we're all throwing UARS around incorrectly, but regardless of what you call it, surely if you show an RDI similar to that of someone with OSA, but an AHI lower, that's actually likely the same thing, just not to the same severity?

canyouhearmeaya wrote: ↑

Sun Jul 01, 2018 4:15 am

Can someone clarify for me:

To my understanding, Apneas and Hypopneas have to meet a certain criteria. RERAs are the breathing episodes that don't meet this criteria.

My sleep study was done with a WATCHPAT-200. Which showed RDI 15 (24 in REM v 12 in nREM) and an AHI of 1.

From a physiological standpoint, is it not quite likely that RERAs are caused by the same thing as apneas/hypopneas, they just don't reach the same severity?

According to the way WATCHPAT detects: "A RERA is an arousal from sleep that follows 10 seconds or more of increased respiratory effort but does not meet the criteria for apnea or hypopnea."

Is this not likely caused by the same physiological reason, just to a lesser severity? (I.e. there is a closure in the airway much the same as 'OSA', just to a lesser extent, or the closure doesn't result in the oxygen desat.)

Surely you could have someone diagnosed with 'severe' OSA, and someone diagnosed with 'no OSA' ( and thus not be given CPAP), that actually could both virtually have the same condition, seperated by only a very minor difference? (I.e. the severe has desats that go 1% further each time, or breathing that stops for 1 second longer, rendering their score as qualifying for AHI where as the other person could have just as many events, but if you just missed that 'qualification line' for an event, it's not registered.)

What i'm assuming is, that effectively what the WATCHPAT-200 detects as RERAS is what i'm discussing above? Likely breathing/respiratory difficult that occurs for the same reason as regular OSA, but just doesn't quite meet the critiera.

Ofc some people define this as 'UARS', and then doctors claim 'UARS' can develop into 'OSA', surely this is often exactly the same thing, just not quite to the same extent (even though it could seemingly be SO borderline)?

So for me for example: I'm 26, Male, Not Overweight. I have an RDI of 15 and an AHI of 1.

Surely it's quite possible, that actually, if I were to go and put on 30lbs (don't worry, I don't plan to do this ) and thus increase my neck circumference, I could quite likely then have an RDI of 15, and an AHI of 15, because at the moment my airway isn't closing enough to meet the AHI requirement, but by putting that extra strain on my airway from the weight/neck circumference, those RERAs would not reach the severity to classify as an 'AHI' rather than just 'RERAs'.

Surely what a lot of people are calling 'UARS' is actually just 'pre-OSA'. Maybe we're all throwing UARS around incorrectly, but regardless of what you call it, surely if you show an RDI similar to that of someone with OSA, but an AHI lower, that's actually likely the same thing, just not to the same severity?

Hi how are you doing now? I believe I have UARS or sleep apnea and would like to try CPAP too. I will start a new thread but in the meantime how has this journey been for you?

Sleep-disordered breathing (SDB) forms a continuum ranging from benign snoring to upper airway resistance syndrome to severe obstructive sleep apnea.

If you are asking whether a high RDI with no hypopneas and no frank apneas can make a person very ill, the answer is YES!!! (Furthermore, appropriate CPAP treatment can effectively treat most cases of UARS.)

canyouhearmeaya wrote: ↑

Sun Jul 01, 2018 4:15 am

Which showed RDI 15 (24 in REM v 12 in nREM) and an AHI of 1.

Sorry, if I have said this before. How do you think a person would feel if he were awakened by a banging in the next apartment 15 times an hour, all night, every night? Wouldn't he eventually be a limp mess?

canyouhearmeaya wrote: ↑

Sun Jul 01, 2018 4:15 am

From a physiological standpoint, is it not quite likely that RERAs are caused by the same thing as apneas/hypopneas, they just don't reach the same severity?

Evolution caused trouble in the airway. We have one passage through which to breathe, drink, eat and speak. A design for disaster. Except for central sleep apnea, this design is the root problem of all SDB.

ChicagoGranny wrote: ↑

Sun Jul 01, 2018 12:24 pm

benign snoring

Even snoring isn't all that benign, it increases breathing effort, and thus reduces rest... (without even counting the disturbance to one's bed partner, housemates, neighbors... etc).