Please Help: Suspected UARS, Problems with APAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
MaybeUARS
Posts: 2
Joined: Sat Jan 17, 2026 7:11 am

Please Help: Suspected UARS, Problems with APAP

Post by MaybeUARS » Sat Jan 17, 2026 7:59 am

Hi, I’m new to APAP and need some advice.

My story in short:
  • Increasingly poor sleep for the past two years
  • I can’t drive a car for more than one hour in the afternoon without having to take sleep breaks
  • Bad mood, constantly tired, irritable, depressive tendencies
  • Morning headaches, I never feel rested
  • I don’t snore; without APAP my mouth is usually closed
  • Very severe bruxism for many years
  • Constantly hungry
  • I finally had a sleep lab appointment scheduled for early January, but it was canceled shortly beforehand due to too many emergency patients (COVID and influenza)
  • My primary care doctor and my dentist suspect: no sleep apnea, but possible UARS
  • Because my level of suffering is very high and I can’t wait for months longer, I decided to buy and try the following on my own and at my own expense:
  • ResMed AirSense 11 AutoSet + HumidAir 11 + ClimateLineAir 11 + ResMed AirFit P30i nasal pillow mask + Viatom O2Ring S

Experiences without APAP, using only the O2 ring:
  • Few oxygen drops, never below 92%
  • Low baseline heart rate around 40 bpm
  • Frequent heart rate spikes above 55 bpm, more than 500 times per night
  • Heart rate spikes above 65 bpm: more than 40 times per night

Experiences with APAP during the first 3 nights:
  • AHI always < 1
  • Baseline heart rate slightly higher than without APAP, around 50 bpm
  • With pressure min = 6 and EPR level 3, I can sleep
  • With pressure min = 7 or with EPR turned off, my cheeks often puff up
  • At pressure min = 8, my mouth inevitably opens after a short time, air rushes out, and I wake up
  • Even mouth tape could not prevent this (it was not fully sealed tape, but one with a slit in the middle)

My questions:
  • Do you see any indications of UARS in the OSCAR charts?
  • What do you think about the detailed views / shape of my flow rate curve? Does it look healthy?
  • How should I proceed?
    A) Simply continue for several nights with the current setup (APAP mode, pressure min = 6 and EPR level 3, nasal pillow mask, no mouth tape)?
    B) Try tape that completely seals the mouth and test pressure min = 8 (but I assume my cheeks would still puff up)?
    C) Buy a chin strap and test pressure min = 8 (but I assume my cheeks would still puff up)?
    D) Switch to a full face mask? (Which model would you recommend?)
    E) Return the ResMed AirSense 11 AutoSet and switch to a bilevel AirCurve instead (which one)?
    F) Stop pursuing the UARS direction altogether – this is not UARS in my case?
    G) Any other ideas?
Thank you very much for your assessment and tips on how to proceed!

User avatar
Pugsy
Posts: 65190
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Please Help: Suspected UARS, Problems with APAP

Post by Pugsy » Sat Jan 17, 2026 9:07 am

MaybeUARS wrote:
Sat Jan 17, 2026 7:59 am
Do you see any indications of UARS in the OSCAR charts?

What do you think about the detailed views / shape of my flow rate curve? Does it look healthy?
Don't see any OSCAR reports and even if we did UARS doesn't really show up on the machine reported data because it doesn't collect the data needed to document UARS.
You would need a sleep study done with a Pes device for a for sure diagnosis.
Even if you do have UARS the cpap machine in auto/apap mode won't/can't treat UARS. Most people with UARS (documented by Pes device ) end up needing quite a bit more pressure than auto mode wants to deliver.

_________________
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MaybeUARS
Posts: 2
Joined: Sat Jan 17, 2026 7:11 am

Re: Please Help: Suspected UARS, Problems with APAP

Post by MaybeUARS » Sat Jan 17, 2026 9:21 am

Here come the images:

NIGHT 2 OVERVIEW:
https://imgur.com/ds3WGnJ

NIGHT 2 DETAIL (Are the marked tips of the curves too flat???):
https://imgur.com/ebE5JC0

NIGHT 3 OVERVIEW:
https://imgur.com/y4KibMa

FLOWRATE SPIKES EXAMPLE 1:
https://imgur.com/FjDyOyM

FLOWRATE SPIKES EXAMPLE 2:
https://imgur.com/7fiUTRY