Need advice = UARS

[guest (tiredintenn)]

posted this on another board. i will make this one quicker. I have completed two sleep tests - both revealed UARS. Last one had a RERA index of 17. I have all the classic UARS symptoms with fatigue being the most debilitating. How do I treat this thing? I have tried XPAP, dental device, neither have worked at all. I am now looking at surgery. ENT wants to do UPPP + hyoid advancement. I am ok with the hyoid procedure since my exam shows very narrow behind the base of the tongue...but I dont want to do the UPPP. First, I dont snore so I dont think it is needed. Second, the pain sounds awful. Third, the side effects, albeit low are things I dont want to deal with. Finally, the long term success rates dont appear that great. Has anyone seen research on tongue based procedures alone when treating UARS. thanks

[ozij]

This is something you posted in January:

I posted this on another board but wanted to get thoughts on this board. thanks-

I was diagnosed with UARS / mild OSA (no apneas, just hypopneas with RDI = 11.6) in Sept 2010. The OSA came only after it was rescored. My first test showed only RERAs at 28.5/hr (I believe). My lowest oxygen desat was 95%. My symptoms are fatigue and headaches. Since then I have tried the dental appliance (TAP III - didnt work) and have been using APAP since mid Nov. Nothing has worked for me. I feel worse when I use PAP than not. PAP therapy appears to be more disruptive to my sleep than the UARS. I don't find the mask or pressure particularly bothersome, I just don't have restful sleep with PAP. I have heard it hypothesized (by Dr. Park and others) that UARS sufferers cant tolerate PAP because of an overactive nervous system. Perhaps the PAP prevents us from getting restorative sleep and creates arousals because our nervous system reacts negatively to the foreign object, pressure, etc. My sleep doctor seems to think things are working since my AHI is always below 1, but my body and mind beg to differ. I don't think he knows much about UARS. I have a few questions:
1. If my oxygen desat is lowest at 95% and the PAP is disrupting my sleep more than the UARS, then am I better off discontinuing PAP?
2. I know PAP works for OSA patients, but does it work for UARS sufferers?
3. Does surgery cure UARS and if so, what surgery?

UARS appears to be the red headed step child of sleep medicine.

If you want reliable info, why not contact Dr. Park - or search for some of his papers using "google scholar"? You may also want to ask a librarian to help you do the search.

[steverrt]

Hi, are you worse on your back.. did any of the sleep test document if you had more events on your back vs your side. If you are worse on your back , using a positional device like a rematee ( bumper belt which has pads built in that keeps you off your back) may help but only if you are worse on your back. Was the mask fit a major issue with your cpap trial? Or were you wearing cpap all night and not seing any difference. CPAP if titrated properly should still be of some benefit if you can wear it for most of your sleep phase...? Go to rematee.com , it was designed by a guy here in vancouver who couldn';t wear cpap or dental applinace. his ahi went down significantly when he stayed off his back.. good luck ... steve.

[tiredintenn]

It is worse on my back. I may try that. I didnt have a problem with the mask or pressure. I just woke up feeling as or more fatigued than before cpap.