UARS-- Best Machine? Help a newbie!

[jacksonm6]

After years of unrefreshing sleep, severe TMJ/chronic pain and a fibro label, I've finally been given a diagnosis of UARS. Sleep study was just below AHI but clinical presentation and exam of throat revealed I have very little space to breathe.

Long story short-- I need help! I do not have a formal diagnosis to go through insurance due to my sleep study so I am going to buy a CPAP out of pocket and use an app to monitor. What machine do you recommend? Would Bipap be better?

I turned down a dentist's offer for a 2k MAD and want to prioritize my TMJ issues so nothing that will aggravate my jaw.

Any advice welcome! Thank you in advance.

[Miss Emerita]

Hello! Can you post your full sleep study? That would probably help the experts advise you. Be sure to back out identifying information before you post.

[Pugsy]

Look at the AirSense 10 AutoSet for Her.
Can be made to sort of function like a little limited bilevel machine by using EPR (exhale relief).
It has 3 modes of operation
cpap fixed pressure mode
apap/auto adjusting mode
and a second special apap/auto adjusting mode with a different algorithm that might come in handy for some people.

Here's the manual so you can read up on it.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

UARS is a different beast and the data provided to help people evaluated therapy effectiveness from cpap isn't really going to be all that beneficial as markers to a UARS patient. You will have to go more on how you sleep and feel and not rely on numbers so much.
For OSA we watch the AHI a lot but for UARS people they already have a really low AHI since they didn't earn the OSA diagnosis.
So a low AHI from a UARS patient doesn't mean much.

[jacksonm6]

Thank you for your help. I am attaching my sleep study below... I have also had a clinical evaluation of my throat that showed limited space for breathing. I have all the symptoms of UARS: waking up but without classic sleep apnea arousals, unrefreshing sleep, chronic pain/"fibro", very poor circulation to the point of Raynauds diagnosis, low blood pressure...

Right now I am considering the Resmed Aircurve 10 Vauto based on recommendations from another site that reference Dr. Krakow. I am also curious about the AirSense 10 AutoSet for Her.

[jacksonm6]

Final two pages posted below...

[Pugsy]

Dr Krakow is big into using the high end bilevel machines that also treat centrals....the ASV bilevel machines...for dealing with UARS type of issues. He titrates to whatever is needed to stabilize breathing and reduce arousals. Expensive machines and to do what he does with them is hard to do unless you go to his sleep lab for the titration. Not impossible to DIY it but it's difficult enough even in his lab.

UARS involves Respiratory Event related arousals......if an arousal isn't related to the respiratory system and is caused by something else...we can't expect xpap to fix it.
Was there any mention to RDI or Respiratory Disturbance Index in any of your paperwork? I am sorry but I had trouble reading the images sideways. Normally it is something that is included in the overall findings though and I didn't see it there.

The VAuto will offer a lot of options for customization in an effort to get you as comfortable as possible so that your arousals (from whatever cause) can be reduced.
The only thing that the for Her AutoSet has to offer to beat the VAuto is that 3rd special auto algorithm designed for women in mind.
It was NOT designed necessarily for UARS....but a lot of people with UARS do seem to have the same sort of complaints that people have who that for Her algorithm was designed for. Logic tells us that it's a least something we should try if at all possible.

I have always said that I wished ResMed had added that special algorithm on the VAuto and it would be a perfect machine.
I am using that algorithm right now and I love it...but I have plain ordinary OSA that is worse in REM.
But I am planning to get an AirCurve 10 VAuto because I have used an older model of it and really liked it and I am trying to see if using the VAuto will pull off a miracle that it really isn't designed to do....help me stay asleep longer when the reason I wake up isn't related to apnea. It's a long shot I know but I have to try something.

[bernieb]

Is your hypothyroidism being treated? The medications listed on your sleep study included a few that have many side effects and some have unproven benefits. Ashwaghanda in particular can affect your thyroid function.

[jacksonm6]

Ashwaganda is an adaptogenic herb, as is rhodiola. Can you point me to a reference where you see either of these affecting thyroid function negatively?

[bernieb]

This is usually a reliable source of medical information.


https://www.webmd.com/vitamins/ai/ingre ... shwagandha

[slowriter]

Was there any mention to RDI or Respiratory Disturbance Index in any of your paperwork?.... Normally it is something that is included in the overall findings though and I didn't see it there.

Yes. I was recently diagnosed with UARS, based on my RDI number (and a high number of RERAs; both numbers included on my report).

For OP, I just recently got the "for hers" machine to treat this. Still too early to draw any conclusions, but am initially encouraged.

[Miss Emerita]

Pugsy, looks like 9 arousals over approx 6 hours, of which 3 were associated with a respiratory event.

[Pugsy]

Pugsy, looks like 9 arousals over approx 6 hours, of which 3 were associated with a respiratory event.

According to my math that would give us a rather low RDI. Certainly not classic UARS but all this UARS stuff is highly subjective anyway.

I do understand the desire to try something though. I would probably do the same thing.
In terms of which machine to try....I am on the fence about that one. I do think I would lean towards that for Her algorithm though...it's a maybe I know but at least it's a maybe. Use it with EPR at 3 and you have a bilevel with 3 PS.