biPap pressures and UARS

I supposably got UARS. I sure got te symptoms. Daytime sleepiness. Slight occasional anxiety. Half the night I sleep deep then the second night I wake up few times expecially toward the last 2 hrs of sleep I wake up rather regularly "sleep maintanence insomnia". Sometimes when I get up from couch I have a slight increase in heart rate. Basic fatigue during the day

Got sleep study done showing I had 1 apnea (I was diagnosed 3 years ago with OSA ) it showed basically a lot of arousals during the night but no apnea.

Doctor "primary doc not a sleep specialist" said to do bloodworm for thyroid/testosterone/ect). Waiting results. He said I could have UaRS told me to try a bipap. But he didn't set pressures and th DmE set then on lowest the m series would go. 6 on IPap and 4 on epap. I feel slightly better since starting. Some days better and some days worse. Te second half of the night I still experience slight insomnia and multiple arousals on last 2 hrs of sleep


Should I talk to doc and dme to read the memory card and maybe raise the pressures? I'm on bipap auto. Max range 15

i have woken up with air leaking out of my mouth i guess i should get a chin strap but it seems like your mouth is trying to compensate if it comes open so fighting it with a chin strap means obstruction of compensation or am i an idiot for thinking that way?

Ruinednose wrote:i have woken up with air leaking out of my mouth i guess i should get a chin strap but it seems like your mouth is trying to compensate if it comes open so fighting it with a chin strap means obstruction of compensation or am i an idiot for thinking that way?

If your pressure is optimal there should be no need to breathe through the mouth unless the nose is congested to the point that you can't breathe well through it.
Most often (assuming we don't have nasal issues) the mouth opens out of habit. Habit learned maybe from past apnea events but not from current apnea events if the machine is set optimally.

Pugsy wrote:

Ruinednose wrote:i have woken up with air leaking out of my mouth i guess i should get a chin strap but it seems like your mouth is trying to compensate if it comes open so fighting it with a chin strap means obstruction of compensation or am i an idiot for thinking that way?

If your pressure is optimal there should be no need to breathe through the mouth unless the nose is congested to the point that you can't breathe well through it.
Most often (assuming we don't have nasal issues) the mouth opens out of habit. Habit learned maybe from past apnea events but not from current apnea events if the machine is set optimally.

Or if the tongue can't keep a seal with the back of the throat. It doesn't mean that the pressure is excessive, nor that the mouth is opening out of habit.

That said, in my case my jaw tends to naturally relax and open, which breaks the tongue-throat seal; on the other hand, I mouth-breath even with a chinstrap because my tongue can't keep a seal, so mouth taping or going for a FFM is the only option then.

echo wrote:mouth-breath even with a chinstrap because my tongue can't keep a seal, so mouth taping or going for a FFM is the only option then.

You know Rested Gal had the same issue I think. And if she didn't use a chin strap snug to keep cheeks from inflating because tongue wouldn't/couldn't keep a seal she would have chipmunk cheeks real bad because she taped along with using the chin strap.
She told me once she thought her tongue was too small because try as she could...she never could get that tongue to close the door completely even while awake and trying...much less when asleep.

ok it looks like i need to get my pressures optimal.

any way to address that to my doctor and get to a conclusion as i wrote above? because i was sent to DME to rent machine with no pressure prescribed. other then really just a range for the auto mode

Pugsy wrote:You know Rested Gal had the same issue I think. And if she didn't use a chin strap snug to keep cheeks from inflating because tongue wouldn't/couldn't keep a seal she would have chipmunk cheeks real bad because she taped along with using the chin strap.
She told me once she thought her tongue was too small because try as she could...she never could get that tongue to close the door completely even while awake and trying...much less when asleep.

Funny, I don't remember the chinstrap thing, but she was one of the people that led me to mouth-taping (and her awesome set of links! ). I didn't have this problem until I started losing weight (yeah, I know, what a thing to complain about ).

I have gotten my blood work results and the doctor said thyroid is good and everything other then my testosterone is kinda low.
Im 24 years old and so that should not be a problem

i went back to My DME and they raised my presssure from IPAP 6 raised to 8 and EPAP from 4 to 6. I never went past 10 on the machine yet. i had few flow limitations 3. on few occasions and my AHI index of 2.5 mainly consisting of HYPOPneas.

I still feel rather tired during the day. im a little better but not normal at all.

I may need to address my stomach stuff i figured it was aerophagia before using the cpap but now i have acid reflux quite frequently


ANOTHER symtom is after i lay down a while and i get up to move around i start burping and releasing air from my stomach when i stand up also heart rate slightly increased.

ANyone have any tips on what steps i need to further take?

please please help, im getting scared.

i guess i need to see a specialist other then my primary care doc. i have yet to go to a sleep doctor. or should i address it to some other type?

Yes, you should see a sleep doctor and go through an overnight sleep test. Since your primary care doctor thinks that you have UARS, you should try to see a sleep doctor whose specialty is pulmonology rather than neurology (you find both working as sleep doctors). If at all possible, you should also try to get one who has experience with testing for UARS, as opposed to obstructive sleep apnea. The difference is in the technology that they use for measuring the volume of air that you breathe. The sleep labs with more experience with UARS use more sensitive flow equipment that either uses a tube inserted through the nose and into the throat to measure pressure (esophageal pressure or Pes) or else they have very sensitive flow detectors that they place under your nose to measure flow rates. The labs that claim to measure flow rate using thermistors (a metallic sensor hooked to a wire) under the nose have been shown to not be as sensitive to the flow restrictions found with UARS.

You really should have an overnight study. And even that may not be the final answer. (I have UARS and was initially titrated at 7; an actual pulmonologist did the retitration and figured out it needed to be at least 11 and maybe up to 14, with the possibility of a bipap needed--once I could afford a bipap since I don't have DME coverage and self-pay, 2 months of tinkering on an auto bipap revealed I needed to be at 15/18.) Get a specialist, and talk your DME into renting an auto bipap.