UARS but normal AHI RDI but Many spontaneous arousals

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
johnny922
Posts: 1
Joined: Sun Mar 25, 2018 9:27 pm
Location: Hong Kong SAR, China

UARS but normal AHI RDI but Many spontaneous arousals

Post by johnny922 » Sun Apr 01, 2018 11:10 pm

My story on my OSAS & CPAP journey is a bit long and it's full of frustration. until now , i still don't know why cpap fails to help me.
you can jump to the questions in the last part if you don't have time to read through the whole passage.


I was diagnosed with mild OSAS 10 years ago in my 20s. I am thin with ideal BMI. My sleep PSG study show AHI = 11, but spontaneous arousal is > 20 per hour. The DISE showed that I had collapse at multiple locations (at palate, tongue base and with a loose epiglottis that would fold together when I inhaled). My CPAP usage report was very good (AHI <5), but I still woke up very tired.

Later, my ENT doctor performed a UPPP and hyoid suspension to me. Unfortunately, the surgeries seemed to help nothing. I still woke up with tiredness, even with CPAP.
In the next year, I saw another doctor and he said CPAP compliance issue might be due to my congested nose. He later performed a inferior turbinoplasty to me. But the outcome was also insignificant.

For years I have been struggling in different kinds of therapy to help me sleep better such as dental appliances, or the Provert therapy but none of them are consistently effective on consistent improvement on my sleep.

My recent sleep study performed in Feb-2018 shows that my AHI =3.7 , RDI = 5.2, but arousal index = 24 , while 85% of all arousal are spontaneous arousal.
My doctor cannot explain what causes the spontaneous arousal. He said if any respiratory related arousal can be reported in RERA so my problem is not related to respiratory. He has refereed me to a psychiatrist.


Questions:

1. Is it common to see UARS patients with very normal AHI, RDI , RERA, SPO2, but many spontaneous arousal in their non-cpap Sleep PSG result ??

2. I read some articles saying that floppy epiglottis could possibly cause intolerance of CPAP. Could this problem be indicated by the CPAP report ? I wonder if the cpap machine would report a very bad AHI.