c_doe wrote: ↑Thu Feb 07, 2019 2:49 am
Would you say, that in an healthy person, with no sleep apnea or breathing problems those flow limitations or resulting pressure raises wouldn't exist, or at least only on a minimal level? ... Just trying to figure out if my flow limitations could be an indicator for UARS, or not.
Not Okie but thought I would chime in here.
UARS is thought to be more of when someone has their sleep disturbed more often by flow limitations that the rest of us might simply sleep through and not be bothered by some relatively minor flow limitations. Some people just find that their sleep gets easily disrupted by the least little change in anything.
Everyone will have some minor flow limitations here and there. Everyone will have an occasional even real apnea event of some sort every now and then. Very few people will ever have totally perfect flow rate with zero anything happening. The problem with sleep apnea is when people have enough events to either disrupt sleep quality often or they have oxygen level drops that can cause problems.
UARS is a tricky diagnosis to make and is more often a diagnosis made by ruling out the other potential culprits.
There is a device that can be used to be more definitive that can be used but you have to have a sleep study with the device in your airway/esophagus to be sure. Not a lot of labs do it.
It's called a Pes device
http://www.sleepmedicinecenters.com/Sle ... ceSyndrome
It's really hard to try to diagnose UARS from the data we get from these machines in terms of flow rate. They are really designed to treat sleep apnea and not diagnose anything and not really designed to show us the very minor changes in flow rate that might be flow limitations optimally. We can usually spot arousal breathing but not always able to spot any changes in the flow rate that might be responsible for the arousal in the first place....and then there are spontaneous arousals that are unrelated to any breathing issues that can happen too.
People with UARS can't depend on the machine to always increase the pressure (when using auto adjusting pressures) enough to keep the airway open well enough to prevent those relatively minor flow limitations that might be disturbing sleep. The machine's auto algorithm is designed to fight obstructive sleep apnea events that meet certain criteria. Flow limitations are part of the criteria but there are varying degrees of flow limitations and it's entirely possible that a UARS patient simply doesn't have a flow limitation bad enough to cause the pressure to increase much...but its bad enough to disturb a UARS patient's sleep.
This is why we can't always rely on the data that the machines give us when deciding best course of action or pressures needed. UARS patients will typically have a relatively low AHI and not much of great excitement going on in any data point because most of those data points are for OSA stuff...not very minor flow limitation stuff.
People with UARS have to rely on their own subjective feelings more than any data the machine is giving them in determining how effective the therapy is. It's hard to do...go by how we feel and ignore the numbers. We want to rely on the graphs or numbers as validation that this therapy is working. It's how we all do with all these medical tests...go by numbers in the results to define normal vs abnormal. Blood sugar or thyroid or liver or heart or cholesterol or whatever...we base our care on the numbers.
It's been my experience from the people here with documented UARS that they had to simply keep trying more pressure above what the machine as okay AHI before they started noticing improvement in how they slept and felt. They couldn't rely on auto mode to do the job because the machine wouldn't increase the pressure enough because not enough OSA stuff was going on to cause them to increase the pressure. Auto mode can still be used but simply at a higher minimum starting point that what the machine might be saying was needed if going by the numbers. Remember the numbers in this situation when its UARS and not OSA don't really tell the whole story.
I may have to RISE but I refuse to SHINE.
