AnnieLA wrote:Good day ladies and gentlemen!
I'm new here and to cpap in general. I'm sure I can learn a lot from your wisdom and experiences. So I decided to start a journal describing my attend at a better sleep (and better health).
Apparently I may suffer from Upper airway resistance syndrome, but I'm not sure (it's hard to find a consensus on what upper airway resistance syndrome really is!).
But here's my symptoms:
- Sleep bruxism
Fatigue all day long despite sleeping 8 to 9 hours
High blood pressure
Frequent awakening during the night
Keep in mind, I don't smoke nor drink. I'm fit, active physically and eat very healthy.
I bought a pulse oximeter and audio recorder to record my sleep. It turns out may times during the night, I get small drops in blood oxygen (from 98% to 95%). Then my jaw muscles and pulse would get activated. And five seconds later, I wake up, take a deep breath, change position and fall back asleep.
So far I have been using my auto cpap for three days. It did record about 2 apnea events per night at a pressure of 6. Is that good? Or do you consider a cpap treatment successful only when you get zero apnea event?
I know I have a lot of testing to do ahead of me, especially if my problem is not apnea event but upper airway resistance.
On a side note, I first bought the Quattro FX full face mask because I was normally breathing a lot from my mouth. But it turns out that with the cpap pressure, I'm now a nose breather! The resistance is gone. That's the good news.
The bad news is that the full mask was giving me a lot of pimples around my mouth and on my nose. I normally have oily skin on my face, and my guess is the added humidity and heat probably helped my skin to develop more pimples. And I got a bleeding bruise on my nose bridge on the third night!! Was it a pimple that got destroyed by the mask? I don't know but it sure makes wearing a full mask too painful now. Too bad, I slept very well on the first two nights.
But since I'm not using my mouth to breathe any more, I went ahead and bought the Swift FX nasal pillow today. I hope I won't open my mouth during sleep. Is there any easy way to detect if you opened your mouth while looking at cpap data on your PC?
Thanks for reading. I know it's a lot of questions, but hopefully one day I'll be able to answer yours.
Hi AnnieLA!
Upper Airway Resistance Syndrome (UARS) appears to me to be more about breathing effort and a fight against resistance than Apnea or Hypopnea, indeed you may never have an apnea or hypopnea and yet still have UARS.
Many mention a hyper-active nervous system. It does seem to be about nerves.
I am suspicious that carbon dioxide maintenance issues are also involved. When my nerves become over activated due to Post Tramatic Stress (PTS) I use EERS[1] to deal with the tendency to blow off too much carbon dioxide. There may be better treatments to come[2].
I have also found it useful to do the following:
1. Reduce the stress load in my life. Stress seems to be the major factor to cause the kind of ventilatory instability that causes the arousals and awakenings. It also seems to set my breathing reflexes (chemoreflexes) toward hypocapnic.
2. Raise the head of my bed a couple of inches. Tends to reduce swelling in the upper airway so less restriction to fight about. May help with acid reflux if that has a part in forming the obstructions. I think helps to prevent the rostral fluid shift often noticed with OSA.
3. Spend some quality time with my CPAP during the day. Time in bed learning to breath quietly. Time at the desk. Time listening to music. Time watching light TV. With being fully awake I think you build better breathing reflexes.
4. Move toward an active lifestyle. So far today I have walked 2214 steps (none aerobic yet) and have cycled about a mile. My goal is 10,000 for this day so will take a walk a bit later. I hope to start running since I read it is good for the brain. I think that the time I spend at 85% of my maximum heart rate is particularly good for developing good breathing reflexes, which I think are part of breathing well at night and so not breaking into ventilatory instability and its arousals.
5. Eat in an anti-inflammatory way.
Have a great week!
Todzo
[1]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link:
http://www.ncbi.nlm.nih.gov/pubmed/21206741
[2]: Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes
Yoseph Mebrate, Keith Willson, Charlotte H. Manisty, Resham Baruah, Jamil Mayet, Alun D. Hughes, Kim H. Parker and Darrel P. Francis
J Appl Physiol 107:696-706, 2009. First published 23 July 2009; doi: 10.1152/japplphysiol.90308.2008
Link:
http://www.ncbi.nlm.nih.gov/pubmed/19628721
