WHICH CPAP FOR SELF TITRATE WITH UARS?

Hi:

I don't even know how to write this post. I'll try to summarize so it's not that long. So, i'll probably miss some info.

I don't use CPAP. Don't tolerate it, neither does it make me sleep better. I had all sorts of problems with it. And although i've given it a try with sleep studies and doctors, i've never used it more than 3 months.

So a lot of years have passed with my untreated severe sleep apnea which is now triple, one doctor said, using only a customized dental appliance that pushes my lower jaw forward, together with the AVEO TSD, at the same time. Also an orthopedic neck and a foam wedge for both my acid reflux and sleep apnea. Oh and also Nexium and Pepsin sometimes, for they don't work either.

Now i've been properly diagnosed MMA surgery and I'm researching surgeons to get the surgery, which won't be until next year. Right now i'm pretty bad, with already the sleep apnea literature side effects of untreated sleep apnea. Overweight, high cholesterol, fatty liver, and beginnings of diabetes.

Without counting the terrible and debilitating other side effects like anxiety, depression, chronic acid reflux, chronic bloating, chronic insomnia, and even shortness of breath from the bloating.

Because I don't know if i haven't given CPAP a second chance or i haven't tried it hard enough and i feel like i'm going crazy and dying, i thought of trying it again, despite all the above. But i don't have a sleep apnea doctor or a cpap now. My machine broke i think.

I'm planning to go see Dr Krakow in Albuquerque, New Mexico, since he seems to be good and treats menthal health patients. I have chronic insomnia, don't sleep at night, but in the mornings and have to take sleep aids or i won't sleep at all.

I've been told i have this bad obstruction (triple severe). Both the images for the surgery and my DISE show that. I'm supposed to have UARS (not diagnosed). Lots of awakenings with short apneas or not long enough apneas to be apneas, and even Doctor Park diagnosed me having palatal collapse with exhalation. He says that's shy cpap hasn't worked for me. Oh and i also have a collapsed nose that also needs surgery. Lots of post nasal drip (from it or acid reflux or both?). I've also been told acid reflux and nose issues mess up cpap therapy. Plus the UARS thing makes me wake up extremely easily. It's like having a very hyper sensitive nervous system. I have this very light sleep all night. I think that's also why i don't tolerate cpap. That stimulus keeps me even more awake.

Having said all this, I still think I should make the effort to try cpap. Getting a sleep study here is out of the question. I already ran out of sleep clinics and doctors who have patience with me. I want to see Doctor Krakow soon, but I also want to at least own a cpap i can try whenever i can and try to self titrate like i've been advised by several experienced cpap users who have sort of understood my situation. I second hand cpap that i would get online. i don't know if you need a prescription for these ones. I guess you do.

So my question is: should i wait till i see Dr Krakow and let him prescribe me a cpap, or is there a type of machine for my case. You know, a difficult case/patient with UARS? Is there a specific type of cpap machine that works better for UARS or patients who haven't tolerated CPAP that i can second hand buy and try to self titrate with?

I've read his articles where he advices Bilevel and even the Resmed Servo machine for these patients. The broken cpap i had for years i didn't use is this same machine: the Resmed VPAP Adapt SV, cause the first sleep study i took in the US showed i have complex sleep apnea. I don't even know if this was accurate or not. The rest of the sleep studies, each showing a different thing, showed no central apneas. I have to use full face masks. My current one is the Simplus.

I'm male, i'm 40 years old, 40 lbs overweight but not obese, and i live in South America.

Thank you so much for bearing with me with this long post, understanding my situation and possibly giving me any help/advice.

John.

JohnnyBravo wrote:the first sleep study i took in the US showed i have complex sleep apnea. I don't even know if this was accurate or not. The rest of the sleep studies, each showing a different thing, showed no central apneas

Oh...I have no doubt about the accuracy of the first sleep study but situations can sometimes change when it comes to centrals....it all depends on why the centrals were happening in the first place.

Were the "rest of the studies that showed no centrals" with or without cpap machine and were they done in a sleep lab setting?

I read your story and had a machine in mind to suggest trying but the mention of your first machine being ASV and the centrals squashed that idea. I hate to recommend a machine that might be at worst potentially harmful and at least a waste of your money if you really need the specialized therapy for centrals.

The newer full efficacy data cpap/apap machines (ResMed and Respironcis) now do flag centrals so if you got one of those machines and used the software available (free and easy to use) you would know if centrals were still and issue or not. The problem being if they showed a truckload of centrals then that's the wrong machine and it could potentially be adding to the centrals which is potentially dangerous.

Now if we were just talking about UARs and plain OSA without the centrals ...I would suggest this machine because it has a special mode that might be useful (stress the MIGHT part) if UARS is the primary issue.
Doesn't sound like UARS is your primary issue though...sounds like it is a MAYBE issue.
https://www.cpap.com/productpage/resmed ... idair.html

In all honesty, without knowing the status of the centrals....I would suggest waiting until you see Dr Krakow.
If you just feel the need to try using a machine again...If it were me I would get another ASV machine (assuming a person don't have any known cardiac function issues) and then I could use it either like a cpap or apap (setting adjustments) or ASV mode to deal with any centrals if they are present. I would want a machine that covers all bases.
Since I would want centrals flagged totally separate so I could keep an eye on them I would look at this machine. The ResMed ASV type machines won't flag centrals totally separate.
https://www.cpap.com/productpage/pr-60- ... anced.html