Uars need help

This is last night on my titration settings my doctors aren’t very helpful or versed in UARS I’m finding out and it feels the are way off as I am still struggling.

In case you have something rigged to tell you about replies - you left off the settings here...

Jlcds2 wrote: ↑

Sun Sep 22, 2024 2:45 pm

This is last night on my titration settings my doctors aren’t very helpful or versed in UARS I’m finding out and it feels the are way off as I am still struggling.

Without knowing what machine you are using and what your pressure settings are we really can't say anything useful that would help you with your struggles.

Also it would help us help you if you could describe what exactly "feels way off" and how you are "still struggling".

Is it that there is too much air being blown into the mask to make your breathing comfortable?

Or is it that there is too little air being blown into the mask to make your breathing comfortable?

Or are you struggling because you keep waking up all night long, but breathing with the machine isn't really that big of an issue?

Or is it that you are simply still excessively sleepy during the daytime in spite of being able to sleep with the machine all night with a minimum number of middle of the night wakes?

I have trouble with exhale , I tried using higher pressure and it looks worse , lots of waking in rem, I bought vcom , cause there was a video about UARS, and it by Jason, It does solve some things but still crap sleep. I switched to a hybrid full face and try to exhale with mouth its not working, I have bad LPR and Gerd sometimes my nose just closes off and its a worse night I don't know why it closes off. I think I have soft platte collapse ,Theres pain when I yawn right side of throat, my jaws are small. I have learned to function off light sleep surprisingly well some times but I am so sick of fighting with idiot doctors.

Find the MD who's the least idiotic and get him to refer you to real specialists to deal with the LPR, gerd and whatever else is going on, maybe an ENT to deal with the throat thing etc... I know it's hard to keep running around, but you have to do something.

Jlcds2 wrote: ↑

Sun Sep 29, 2024 7:01 pm

I have trouble with exhale , I tried using higher pressure and it looks worse ,

Why did you increase the pressure? What problem were you hoping to solve with a higher pressure setting?

Note: Higher pressure settings can cause more problems with exhalation, even when EPR = 3.

lots of waking in rem,

How do you know the wakes/arousals are coming in REM? In other words, if you are trying to track your sleep stages, what equipment are you using for that?

I bought vcom , cause there was a video about UARS, and it by Jason, It does solve some things but still crap sleep.

What problems does the vcom solve? What problems were you hoping it would solve that it didn't solve?

I switched to a hybrid full face and try to exhale with mouth its not working,

What problem(s) are you trying to solve by switching to a hybrid full face mask?

Do you have a problem breathing through your nose? If so, does it only occur at night, or do you also have problems breathing through your nose during the day time? And what do you mean by "its not working"? Trying to inhale through your nose and exhale through your mouth?

So let's back up a bit: During the daytime do you breathe through your nose or mouth? Do you notice any particular problems with your breathing during the daytime? In particular, do you have any congestion problems during the daytime? If so, are they allergy related?

When you are lying down in bed while awake, do you have any breathing problems? If so, do they occur regardless of whether you are using the CPAP? Or are they worse with the CPAP? Or are they worse without the CPAP?

I have bad LPR and Gerd sometimes my nose just closes off and its a worse night I don't know why it closes off. I think I have soft platte collapse ,Theres pain when I yawn right side of throat, my jaws are small.

OK, you are conflating a whole bunch of issues that may or may not be related to each other.

You need to take care of the LPR and GERD issues. There's a good chance that those are not directly related to your suspected UARS/OSA or your CPAP use, but untreated LPR/GERD issues can make using a CPAP seem more miserable, particularly if you are trying to force yourself to sleep in a position that is not good for the GERD. So that brings up this question: What's your usual sleeping position when you are using the CPAP?

When you say your "nose just closes off and its worse at night", do you mean one nostril suddenly gets super stuffy and impossible to breathe through while the other one stays relatively clear? If so, you may just be so wound up while lying in bed trying to sleep that you are noticing a normal phenomenon called "the nasal cycle"---we typically breathe (mostly) through one nostril at a time and the dominant nostril switches every now and then. When we're awake and vertical we don't notice this. But if we're on our side and we're breathing out of the upper nostril and it then switches to the lower nostril that can feel like the nose is just closing off and it can trigger the need to roll over to the other side.

Congestion problems might also explain what you are feeling at night. And this could be true even if you don't perceive any significant congestion problems during the daytime. You have the humidifier set to 4. It could be your nose wants more humidity when it is breathing through the CPAP. Or it could be that your nose wants less humidity when it is breathing through the CPAP. When you are congested, what happens when you take a nice long steamy shower? Does that make the nose feel less congested or more congested? Answer that and you'll have an idea of whether you should consider increasing or decreasing the humidifier setting.

Soft palate collapse? That's a standard cause of OSA. And CPAP keeps it from collapsing. The data you post indicates your CPAP's pressure settings are sufficient to prevent your soft palate from collapsing. Also worth noting: The soft palate is not part of the nose and a soft palate collapse is not a plausible explanation of why you feel like your nose is closing up. If your soft palate is in fact collapsing, we ought to see more OAs and Hs being scored. Now you do have some flow limitations, but it's not clear whether those flow limitations are real (in the sense that your airway is at risk of collapsing) or if they're being caused by nasal congestion problems.

Small jaws? Well, that's a risk factor in OSA, but small jaws don't make your nose suddenly close. (I speak as someone with exceptionally small jaws.). The pain when you yawn? It might be a symptom of something going on with your tonsils, your adenoids, your eustachian tube, your middle ear, and/or your TMJ on that side of your head. Again, none of those are directly related to OSA, but if there is something going on with any of these things, that could mess with your sleep. (I say that as someone who has chronic TMJ issues and has had chronic ear infections.)

I have learned to function off light sleep surprisingly well some times but I am so sick of fighting with idiot doctors.

If I were you, I'd start with my PCP. Ask for a referral to a gastrologist for the LPR/GERD symptoms and a referral to an ENT for the pain when you yawn along with the nose problems.