Need help, suspect UARS. Want to try APAP - need advice and guidance.

[palerider]

Nothing wrong, if you have sleep apnea. But such leaks can be sleep disruptive for UARS.

No more than for sleep apnea.

[palerider]

I know people say using the Airsense 10 auto with EPR of 3 is close to BiPAP, did you ever try something similar? I do wonder if the Airsense 10 Auto + EP3 set to 3 is suffice for UARS or not.

EPR is exactly like bilevel, just limited to a ps of 3.

If you look at the pressure curve of an autoset at epr3 and the pressure curve of a bilevel at ps 3, they're the same.

Autoset on the top trace, vpap auto (bilevel machine) on the middle trace.

[musculus]

The for Her mode blows air while awake exactly like the regular mode.
If you had difficulty while awake with air movement and comfort....it was the congestion not the mode.

Ah, okay that's good to know - thanks pugs!

Current battle is fine tuning my diet to alleviate it enough to use it. So far today I've not had an anti-histamine, the pollent count is very high and currently my congestion is pretty low - so fingers crossed if that carries over to tonight I might have more luck.

Currently it looks like the soonest ENT appointment might be September, which is a bit dissapointing. Waiting to hear from another clinic to see if they can see me sooner.

You journey for conquerring UARS reminds me of my experience. (A visit to ENT was part of it, too). I was also given P10, which I, unlike some of our esteemed members, couldn't tolerate well for several period of attempts. I also had noticeable leaks and FLs.

I may not have that level knowledge of members posting here, but I have successfully taken my UARS under control (diagnosed with RDI 18)

Tan, good to hear that. what's your current RDI?

[palerider]

Good point. epr3 is close but not the same as Vpap with ps=3 in my config. VPAP has other settings (trigger and cycle, which I set to Very high). But APAP is good start. While looking for my pressure setting, I jacked up to 10/13 but I start having aerophagia with epap around 9 and above. So, I had to lower.

EPR certainly helped in my case. Other people switch it off.

And, just how do you think it's different?



If they weren't labeled, I'd challenge you to tell which was EPR and which was PS=3.

[musculus]

My other option is to pay £500-600 and go privately to see an ENT, which means I could see them next week. I do wonder if it's something like Polyps causing my nasal issues, I don't know if it's possible something like that could be the cause of my RDI of 15? Or if it's just preventing me using the mask if that's the case.

I think I need to ask some family members if I can look up their noses with a torch Looking up each nostril, it appears the airway opening does become MUCH smaller probably a centimeter or two up, which then looks like a narrow slit almost. I need to try and determine if that's normal, or something like a polyp!

A simpler solution is: buy Afrin at a pharmacy => clean the nostril and spray both nose just before sleep => wait and see if any difference in sleep quality.

If not much difference, the nasal congestion is not the root issue. Afrin will clear the nasal congestion for 8-10 hr

If lots of difference, then see an ENT specialized in nasal surgeries (assume no allergy)

[canyouhearmeaya]

My other option is to pay £500-600 and go privately to see an ENT, which means I could see them next week. I do wonder if it's something like Polyps causing my nasal issues, I don't know if it's possible something like that could be the cause of my RDI of 15? Or if it's just preventing me using the mask if that's the case.

I think I need to ask some family members if I can look up their noses with a torch Looking up each nostril, it appears the airway opening does become MUCH smaller probably a centimeter or two up, which then looks like a narrow slit almost. I need to try and determine if that's normal, or something like a polyp!

A simpler solution is: buy Afrin at a pharmacy => clean the nostril and spray both nose just before sleep => wait and see if any difference in sleep quality.

If not much difference, the nasal congestion is not the root issue. Afrin will clear the nasal congestion for 8-10 hr

If lots of difference, then see an ENT specialized in nasal surgeries (assume no allergy)

That's what I'm going to try tonight I think, then possibly Clarityn also. Although the only thing I'm not certain on is, if you're been having chronically disrupted sleep for months/years, is one night of 'good' sleep going to give you enough benefit to clearly know the difference?

To note: Afrin AFAIK is the same as 'Otrivine', the stuff I said I'd used a couple of times in the past week, which seems to clear up my sinuses like nothing else. I haven't yet tried doing it immediately before bed I don't think, hence I'll try that tonight.

[canyouhearmeaya]

What's also interesting to note is when I recorded my sleep a few times a couple of weeks ago, I noticed a few times throughout the night I was making that 'scratchy throat noise'. You know if you get an itchy throat and you scratch it, by like sucking your tongue to the roof of your mouth and and like clicking the air through the back of your throat.. Kind of sounds like a pig noise lol.

I hadn't been getting any notable allergies AFAIK during the day, and hadn't been doing that during the day, yet hear myself doing it quite a few times at night. Whether that was allergy related, or being caused for some other obscure reason I don't know.

[tan]

Nothing wrong, if you have sleep apnea. But such leaks can be sleep disruptive for UARS.

No more than for sleep apnea.

The palerider I knew:
1) wasn't a medical professional;
2) didn't have UARS, but sleep apnea;
3) tolerated P10 well;

Are you that same palerider? If you are, than how do you know, without either medical training or first-hand experience, whether leaks are least disruptive for UARS?

[tan]

Good point. epr3 is close but not the same as Vpap with ps=3 in my config. VPAP has other settings (trigger and cycle, which I set to Very high). But APAP is good start. While looking for my pressure setting, I jacked up to 10/13 but I start having aerophagia with epap around 9 and above. So, I had to lower.

EPR certainly helped in my case. Other people switch it off.

And, just how do you think it's different?



If they weren't labeled, I'd challenge you to tell which was EPR and which was PS=3.

Do you intentionally miss "in my config"? APAP (S9 at least) has no configuration for trigger/cycle.

[palerider]

, without either medical training or first-hand experience, whether leaks are least disruptive for UARS?

Because UARS isn't some sparkly magical unicorn. It's sleep disturbed breathing, leaks are leaks, if the leaks don't bother the OP, then they're not an issue, same as with anybody.

They're not "less disruptive", they're "same disruptive", and the OP's leaks are small.

[palerider]

Do you intentionally miss "in my config"? APAP (S9 at least) has no configuration for trigger/cycle.

Trigger/cycle, TiMin/TiMax has nothing to do with the actual pressure differences, and the way they're delivered.... the pressure changes are the exact same between PS and EPR, and that's the point.

Is a VPAP Auto/Vauto machine more customizeable... yes.

Is that what you said? no.

Does the customizeability make a difference in your special sparkly unicorn view of things? maybe. But the effect of the pressure changes is still the same. All trigger/cycle does is change the exact, precise moment that the pressure changes happen.

[tan]

The for Her mode blows air while awake exactly like the regular mode.
If you had difficulty while awake with air movement and comfort....it was the congestion not the mode.

Ah, okay that's good to know - thanks pugs!

Current battle is fine tuning my diet to alleviate it enough to use it. So far today I've not had an anti-histamine, the pollent count is very high and currently my congestion is pretty low - so fingers crossed if that carries over to tonight I might have more luck.

Currently it looks like the soonest ENT appointment might be September, which is a bit dissapointing. Waiting to hear from another clinic to see if they can see me sooner.

You journey for conquerring UARS reminds me of my experience. (A visit to ENT was part of it, too). I was also given P10, which I, unlike some of our esteemed members, couldn't tolerate well for several period of attempts. I also had noticeable leaks and FLs.

I may not have that level knowledge of members posting here, but I have successfully taken my UARS under control (diagnosed with RDI 18)

Tan, good to hear that. what's your current RDI?

There is no reliable way to measure RDI outside of the lab, is there? Machines has some software

So I measure my success by how I feel and that I feel great (refreshed and alert, not feeling sleepy during the day and evening) most of the times. However, sometimes, I have a bad night though. For example, yesterday, I tried to switch masks from Mirage -- which leaves pronounced marks on my face and everyone in our office is reminded that I am a CPAPer -- to AmaraView hybrid. SleepyHead shows an RDI or 0.0, as most of the nights, but I didn't feel well at all (tired and sleepy). The only difference between otherwise "perfect" pictures is noticeably higher leaks, which are within the "norm".

[tan]

, without either medical training or first-hand experience, whether leaks are least disruptive for UARS?

Because UARS isn't some sparkly magical unicorn. It's sleep disturbed breathing, leaks are leaks,

Didn't Sludge/Muffy/NotMuffy/StillAnotherGuest suggest that one way to overcome UARS is reducing the sensitivity threshold with some medication?

if the leaks don't bother the OP, then they're not an issue, same as with anybody.

How does he know that the leaks don't bother him? He may be just unaware of them. Isn't this UARS also about: not remembering one's frequent arousals/awakenings?

[canyouhearmeaya]

Is my logic right here: That UARS similar to OSA is often a collapse of the airway, and obviously CPAP keeps pressure up to prevent the airway collapsing..

Having impaired nasal airflow (congestion, polyps, deviated septum etc) causes reduced airflow and air pressure, therefor ALLOWING the airway to collapse/reduce, i.e. causing UARS. Therefor, potentially by fixing the restricted airflow (without CPAP) by whatever means (eg fixing congestion, removing polyps, whatever the restriction is), basically increasing the amount of air able to pass in and out of the nose, can effectively resolve the UARS?

Does that make any actual medical sense?

[OkyDoky]

There is no reliable way to measure RDI outside of the lab, is there?

In Sleepyhead you can change your events preference to RDI. Not the reliability of an EEG but could give you a good indication if your AHI is not the indicator that you need.