A friend's sleep study ... combo of OSA and UARS

A friend of mine recently went for an overnight sleep study and the result is nothing like I have ever heard of before. (or if I have, I have forgotten! )

She has moderate OSA (AHI 16.1) and severe UARS (RERA index 60). Lowest blood oxygen level 84%.

She went for a sleep study because she snores and has been experiencing fragmented sleep. She has just turned 60.

She has perfectly fine blood pressure (on the low side), and no co-morbidities. Not overweight. She doesn't experience daytime sleepiness … despite an RDI of over 60.

I am actually quite amazed at how well she is doing.

With my AHI of 16.2 and lowest blood oxygen level of 87%, I was experiencing arrhythmias and constant night sweats. Obviously It isn't just about the number of events!

I am wondering how treatment will be for her with the combination of OSA and UARS? Much the same as plain old OSA or a bit different?

One school of thought is that once the increase in upper airway resistance is high enough in any given patient for that patient to have met the diagnostic criteria for obstructive sleep apnea, the diagnosis is OSA. Period. Then fix sleep. It isn't about the name given to the problem; it is about using what it takes to fix sleep in each individual.

If less-than-hypopnea events continue to disturb sleep after PAP, though, then PAP may need to be modified to reach and sustain pressures higher than an APAP might provide moment-to-moment, so that increased stability of the airway can be maintained beyond that needed for the average OSA patient. Then the trick is balancing comfort and airway stability.

No one school of thought has cornered the market on UARS approaches or on approaches for those for whom PAP does not sufficiently treat lack of sleep consolidation. Thus the likes of Dr. K and others who specialize in broad-spectrum and varied approaches for individual sleep issues, especially those involving nonresolving sensitivities to disturbances.

Thanks JNK.

She is very motivated to treat this because her best friend has OSA and has been using CPAP now for about 2 years and has had excellent results. She also is very aware of how CPAP has helped me so she is embarking on this with optimism and a lot of support.

If she has any problems I will refer her to this forum for advice.