Pressure range for UARS?

[Kokopod]

Hi everyone, I have a couple of questions about UARS which I have tried to find answers for and failed.

Firstly, what sort of air pressure range should an UARS sufferer be on? For the past year I have been on pressures ranging from 4 to 8, but have seen no difference in my fatigue. Is 4 to 8 about right?

Also, are there any XPAP machines that are sensitive enough to detect airway resistance episodes? This forum talks about the importance of having a data capable machine so as to monitor the amount of episodes you have per night, but I don't think the data capable machine I used to have (the ResMed S9 AutoSet ) recorded my airway restrictions. (At the moment I am on an S9 Escape, which I know is appalling in terms of data, but the NHS refuse to give me anything else.)

Sorry if these are silly questions!

[Wulfman...]

Hi everyone, I have a couple of questions about UARS which I have tried to find answers for and failed.

Firstly, what sort of air pressure range should an UARS sufferer be on? For the past year I have been on pressures ranging from 4 to 8, but have seen no difference in my fatigue. Is 4 to 8 about right?

Also, are there any XPAP machines that are sensitive enough to detect airway resistance episodes? This forum talks about the importance of having a data capable machine so as to monitor the amount of episodes you have per night, but I don't think the data capable machine I used to have (the ResMed S9 AutoSet ) recorded my airway restrictions. (At the moment I am on an S9 Escape, which I know is appalling in terms of data, but the NHS refuse to give me anything else.)

Sorry if these are silly questions!

Which "Escape"? The plain Escape or the Escape Auto?
Neither one will tell you the information you NEED to know. How are you going to be able to determine your therapy effectiveness?
And, if it's the plain Escape, it won't do a pressure range......except to start at a Ramp pressure (like 4 cm.) and move up to a fixed pressure (like 8 cm.). That machine won't actually change pressures to respond to events. And, then you have the problem of the fact that you can't "see" the events because the machine doesn't record them.

Why do you no longer have the S9 Autoset? It collected a lot more data than the one you have now. And, it MAY have been able to tell you "something".

There are lots of reasons you didn't see any difference in your fatigue. But, without analyzing the data, you won't know.


Den

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[kaiasgram]

The Autoset does record -- and respond to -- flow limitation. Not perfect but way better than having no data at all.

As far as I know there is no one pressure or pressure range for treating UARS. I think it's as individual a treatment as in any other sleep disordered breathing condition. Which is why a data capable machine is needed if you're trying to optimize your therapy.

[tan]

Hi everyone, I have a couple of questions about UARS which I have tried to find answers for and failed.

Firstly, what sort of air pressure range should an UARS sufferer be on? For the past year I have been on pressures ranging from 4 to 8, but have seen no difference in my fatigue. Is 4 to 8 about right?

Dont know whether I have UARS or not, but an ENT doctor advised me to have all sort of surgeries: turbinate reduction, deviated septum, rhinoplasty (for flimsy nostrils), UPPP (for overgrown tissue in my throat)...

Having said that, pressures 5-9 are clearly inadequate in my case, I feel much better with upper pressure practically not restricted. In looking in my BiPAP log with SleepyHead, my pressure values occasionally peak at 11...14 during different nights

[Pugsy]

Unfortunately there is not predetermined range of pressures that is well known to work with UARS.
It's all about the airway tissue itself and some people need a lot to hold it open and some people need very little.

If it were me and I even remotely thought I had UARS and was looking for a new machine...I would get the latest ResMed AirSense 10 AutoSet for Her and I would make sure I got the "for Her" model even if I was a guy because it has a special mode that while they are touting it for women...they are implying that women are more likely to have UARS (which is a crock) but the for Her model has 2 APAP modes available in addition to regular cpap mode and one of those APAP modes flags RERAs Respiratory Event Related Arousals which some people think might point to a UARS type of situation. It isn't set in concrete though....this UARS thing is in it infancy in terms of recognition and therapy.

The AirSense 10 AutoSet for Her is a full data machine...software is available..Sleepyhead's latest version works with it as does ResScan's latest version.
this should get you started..there's more out there
http://www.resmed.com/us/en/commercial- ... r-her.html

It was just released mid Aug...a few forum members have one. see this thread for more discussion about that algorithm and the data it gathers.
viewtopic.php?f=1&t=99984&st=0&sk=t&sd= ... e+released

You won't ever get NHS to spring for it though. You would have to buy it on your own I am sure.

Will it help you with your issues/symptoms? Now that I don't know but it would stand the greatest chance of maybe helping you isolate things. It's very possible that whatever symptoms you are having are totally unrelated to UARS or sleep apnea and the best machine in the world can't fix a problem that is unrelated to what it is designed to fix.

[Kokopod]

Thank you for all the replies!

I don't think I worded my question very well. What I meant by 'range' was 'is a fixed pressure somewhere between 4 and 8 about right for UARS?'

I know the Auto responds to flow limitation. I had it on APAP for a while but it unfortunately did not help me.

Could someone please clarify how the data from a machine like the Auto could help me?

Den: I had a plain Escape. Why I no longer have the Auto is a long story. But they have made it quite clear that I will not be getting it back. And I know neither will tell me what I need to know - could someone please signpost me towards what will?

tan: thank you, I will suggest to my sleep clinicians that I try a higher pressure

Pugsy: it's good to know that CPAP technology is moving forward. As much as these new ResMed machines look good I will unfortunately not be able to afford one! Thank you anyway.

[kaiasgram]

wiki/index.php/Upper_Airway_Resistance_Syndrome

[Wulfman...]

Thank you for all the replies!

I don't think I worded my question very well. What I meant by 'range' was 'is a fixed pressure somewhere between 4 and 8 about right for UARS?'

I know the Auto responds to flow limitation. I had it on APAP for a while but it unfortunately did not help me.

Could someone please clarify how the data from a machine like the Auto could help me?

Den: I had a plain Escape. Why I no longer have the Auto is a long story. But they have made it quite clear that I will not be getting it back. And I know neither will tell me what I need to know - could someone please signpost me towards what will?

tan: thank you, I will suggest to my sleep clinicians that I try a higher pressure

Pugsy: it's good to know that CPAP technology is moving forward. As much as these new ResMed machines look good I will unfortunately not be able to afford one! Thank you anyway.

I DID think that as a possibility for your description......but wasn't sure and felt I needed to get a clarification.

Again, the problem is that without "DATA", you won't know.......other than "how you're feeling".......which is always a component to therapy, it's just that seeing the reports helps to confirm some things.

As a side note and story, in the last couple of years, my wife and I have taken some "road trips" to visit our families. I took extra data cards so I could switch them out so I wouldn't lose ANY detailed data. So, during the couple of week trips, I wasn't able to see any data......until I got home and downloaded the cards. I was somewhat shocked to see how much leakage and variations of data I was having......sleeping in different beds, temperatures and other surroundings. Did I "feel" any different?......not really for those short periods of time, but it just reinforced to me how important the data really is.


Den

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[Julie]

A pressure range of 4 to 8, while on the low side for anyone with similar problems (OSA, UARS, etc.) is no more going to be 'right' for you than anyone else... you need to understand that regardless of your diagnosis or its supposed severity (caused on by either neurological or respiratory issues), they have almost nothing to do with the fact that each person's anatomy is different, and the amount of air pressure needed to keep that individual's airway wide enough to be 'therapy' will be different. Which is why we can't recommend what'll work for you... it's not that we're being careful, we just have no way of knowing.

And the 'data' you'd see from a good machine details features like flow rate, leak rate, mask fit (on some machines), and a whole bunch of other details that can contribute to your problem alone, so you can adjust the machine on a daily/weekly basis to respond to a low or too high reading of an individual parameter, something you have no control over without data to point the way, to show you what's not working or what is.

[Pugsy]

Hey guys and gals...OP here mentioned NHS...that's normally England or something in that neck of the woods.
Typically OSA patients are given APAPs to self titrate and then they come up with a pressure and NHS takes back the nice APAP and gives them a brick...cheapest possible and there is no negotiating with NHS...and they don't want patients touching the settings and have been known to repossess said machine if patient doesn't do things exactly they way they dictate it. Need I say Gestapo? Well that's what they do...it's all free (if you don't count the high income tax there) and that's what you get unless you go out on your own.
Buying out of pocket in England is extremely pricey from line sellers in Europe.

[Wulfman...]

Hey guys and gals...OP here mentioned NHS...that's normally England or something in that neck of the woods.
Typically OSA patients are given APAPs to self titrate and then they come up with a pressure and NHS takes back the nice APAP and gives them a brick...cheapest possible and there is no negotiating with NHS...and they don't want patients touching the settings and have been known to repossess said machine if patient doesn't do things exactly they way they dictate it. Need I say Gestapo? Well that's what they do...it's all free (if you don't count the high income tax there) and that's what you get unless you go out on your own.
Buying out of pocket in England is extremely pricey from line sellers in Europe.

Right! But, that still won't change any of my responses or the reasoning behind them.

Are you trying to insinuate that that's what our "AFFORDABLE CARE ACT" is heading toward?

(OK, I was stretching things a little.)


Den (goosestepping away)

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[palerider]

Are you trying to insinuate that that's what our "AFFORDABLE CARE ACT" is heading toward?

(OK, I was stretching things a little.)


Den (goosestepping away)

I wish... with what I save on premiums for crappy insurance, I could buy myself several APAPs every year.

[Kokopod]

Thanks again for all the responses. I guess I'll just have to resort to begging the NHS for a data-capable machine... Or buy my own.

Hey guys and gals...OP here mentioned NHS...that's normally England or something in that neck of the woods.
Typically OSA patients are given APAPs to self titrate and then they come up with a pressure and NHS takes back the nice APAP and gives them a brick...cheapest possible and there is no negotiating with NHS...and they don't want patients touching the settings and have been known to repossess said machine if patient doesn't do things exactly they way they dictate it. Need I say Gestapo? Well that's what they do...it's all free (if you don't count the high income tax there) and that's what you get unless you go out on your own.
Buying out of pocket in England is extremely pricey from line sellers in Europe.

This ^ is so accurate. That's exactly what happened to me. As for the price of xPAP machines, over here they basically substitute the dollar sign for a pound sign and reduce the price by about 10-15% . So we pay about 1.5 times what patients in America would have to for the same thing. They call Britain treasure island for a reason! (Rant over)

[Pugsy]

Are you trying to insinuate that that's what our "AFFORDABLE CARE ACT" is heading toward?

Nope...that thought hadn't crossed my mind but now that you mention it....hmmm maybe I should have.

To everyone else:
I said what I said so that other people wouldn't be coming here and tell him to take it back to his DME and stand his ground and all the normal stuff we tell people here in the US when they get a brick.
It was mainly to save a bunch of other people from bruising their fingers typing the same old same old replies...and it doesn't doesn't work that way with the NHS. NHS is the only supplier of "free" equipment available. Can't play one DME against the other in this situation. It's their way or the highway...and getting them to budge off of it isn't very easy.
Worth trying though...if you don't ask the answer is always "no".

Most cpap users in England (and I know a few) pretty much told the NHS "up yours" and got their own equipment and I haven't heard one regret.