https://clinicaltrials.gov/ct2/show/NCT02264353Pugsy wrote:Maybe if I explain how the brain is involved it will help you understand it a little easier.WearyOne wrote: But I still don't see where it has anything to do with the brain.
I use a little different wording but the content really means essentially the same as someguy34 was trying to say...or at least what I think he was trying to say.
The brain in UARS patients tends to over react, for lack of a better term, to things that those of us without UARS might just sleep through. UARS patients are often what I might call hyper sensitive. The least little thing can bug them because the brain is always on high alert and trying to help by poking you (that arousal) to alert you to the fact that something is going on that it doesn't like or scares him. Problem ends up being that the arousal causes more problems than the ever so slight reduction in breathing might cause.
So it's not like where the brain is involved with central apneas and it just forgets to send the "breathe stupid" signal...it's more like the brain is standing guard and being over diligent when warning you that something seems to be happening that it doesn't like.
I have also read that most people with OSA also have some degree of UARS.. Makes sense if we think about it....start out with little air flow reductions that morph into full grown OSA. Might also explain why some people just don't feel rested despite what should appear to be adequate cpap therapy and adequate sleep quality/quantity. Maybe the sleep quality isn't quite as good as they might think. Might also explain why some people say they feel better using higher pressures (higher than what gives acceptable results on paper anyway). I have no proof to any of these thoughts. Just that it wouldn't be impossible at least in my mind when looking at things from a logical point of view.
UARS isn't that hard to treat but it is hard to diagnose (mainly because a lot of doctors and labs don't test for it) and the usual standards that we use to measure effectiveness are zero help when UARS is involved. We tend to want to measure therapy by the "numbers" given us by our machines and these machines don't really measure UARS stuff...at least reliably. Even the RERA stuff isn't absolute but it's the best we have. UARS patients that elect to try cpap therapy have to try to rely on subjective feelings and not the numbers....and in a numbers based society when it comes to evaluating medical stuff people want to validate with numbers.
For me...I would much rather have the OSA diagnosis because it is more easily measured. I am just like everyone else...like those good numbers to validate my therapy. Unfortunately it isn't always that simple and just like I talk about in my "when you don't feel the good numbers" thread....there's so much more to feeling those good numbers than just getting them. UARS patients typically start out with "good numbers" except for the arousal numbers. Makes any sort of measurement by the normal standards extremely difficult. We don't do well with "subjective" evaluations.
Good quality sleep is a very fragile commodity for a lot of people for any number of reasons.
I am thankful that the medical community is now coming around to the fact that UARS is a real problem worthy of real work and real solutions.
They are a little bit late to the parade but they are trying to catch up. No, it's not perfect but nothing ever is when it comes to medicine.
Doesn't mean we give up though....just means we have to work harder and think outside the box more and find medical professionals with an open mind who can do the same.
I have worked with many, many doctors over the years...there are good ones and bad ones and the good ones are often very hard to find.
It is called arousal threshold.
UARS sufferers have a low arousal threshold (ie they wake up or arouse too easily to events that normal subjects would not wake up to). They are typically light sleepers. So while there is a resistance in the airway there is a brain that is doing more than it should and identifying a problem that may not be a problem. This is why for many cpap and dental appliances are very difficult. Brain reacts to these as well.