Can’t treat my UARS — need suggestions

[Etirpsakdov]

A few sleep studies later, I’ve confirmed that I have UARS.

I’ve tried an APAP and now onto a BiPAP. Roughly 10 masks... nasal and full face. Can’t get more than a few hours of sleep without ripping it off, and that’s IF I even get to sleep in the first place with the mask. I wake up 1-2 hours after sleeping consistently with the CPAP. I guess getting an oral appliance is the next best option besides surgery, right?

My only issue is, my sleep study came back with a 0.0 AHI didn’t record RERAs. 

Is there some way I can get this study re-scored to show RDI so I could be covered by insurance for the mouthpiece? Everything else has been out of pocket for me but the mouthpieces are a bit more. 

Any suggestions would be greatly appreciated. I just don’t know the next step I should even be taking, but, I’ve got an apt with dentist coming up. Just worried I won’t even be covered for the mouth piece because my study doesn’t show RDI.

[weiss27md]

At home study? Most at home studys dont record RERAs. Have you tried the N20 or P10 masks? I've found better success using the slimline hose instead of the heated hose.

[Etirpsakdov]

Nope. 2 in lab and 1 at home.

I have a slimline I’ve never used. Interesting you say that. Why do you think it worked better than the heated one? (Which is what I use)

I have a P10 mask which is my favorite but hard to use when I have bad nasal congestion.

[weiss27md]

The heated one is too hot for me and heavy. Depends on your climate but the slimline one works good for me. My humidity now is set to 3. I used to have chronic nasal congestion too. Is yours due to swelling or mucus. Mine was swelling. Had turbinate reduction, balloon sinuplasty and septoplasty. This has helped a lot. I think correct tongue posture can eventually open up the nasal passages too. You can look up 'mewing'm, also look up 'buteyko method'. That's mostly about just breathing out of your nose. Maybe diet changes can help congestion too. Grains, dairy, sugar and alcohol can make congestion worse.

[Etirpsakdov]

Eating a gluten free diet has def helped my nasal congestion. Mine is def due to swelling and allergies. Should try cutting out dairy next. Did you change your diet as well?

Gonna try the slimline tonight. Just heard of the buteyko breathing today too I’ll look into that.

Do you still use the CPAP after surgery? I assume it makes it a lot easier to use lol.

[weiss27md]

I try to eat paleo / keto / carnivore but my diet is all over the place with having 2 kids. I know sugar is my biggest enemy, instant joint pain. I started using PAP just a couple weeks ago. I had my nasal surgery almost 4 months ago. It did help but I guess my apnea had nothing to do with my nasal congestion.

[SarcasticDave94]

That's similar to what many others post on Apnea Board. For whatever reason the patient tries some sort of mouthpiece or nose or throat surgery. Most will say it didn't help enough to eliminate CPAP.

[mper6794]

A few sleep studies later, I’ve confirmed that I have UARS......this is good!

I’ve tried an APAP and now onto a BiPAP......great machine, the best one for UARS, from what I have learned in my own case and observed in this Forum, even better than ASV, in my opinion.... Roughly 10 masks... nasal and full face.....I would insist on full face, maybe airfit f20 or f30.... Can’t get more than a few hours of sleep without ripping it off, and that’s IF I even get to sleep in the first place with the mask. I wake up 1-2 hours after sleeping consistently with the CPAP........my experience: I started 1 year ago; had many claustrophobic issues, worked out with minor doses of clonazepam until get acquainted with the machine. I guess getting an oral appliance is the next best option besides surgery, right?.....in my opinion , this would be the very last option; I think you would still have lot of room to go yet.....

My only issue is, my sleep study came back with a 0.0 AHI didn’t record RERAs. ....lower  AHI is one of the clinical diagnostic point to assure UARS presence.....flagged RERA is a rare thing, in my opinion; majoritty are unflagged. The metrics for UARS would be how many times you have arousal/awakenings, no AHI or flagged RERA's......

Is there some way I can get this study re-scored to show RDI so I could be covered by insurance for the mouthpiece? Everything else has been out of pocket for me but the mouthpieces are a bit more. .....in my modest opinion, you already have the best tool to treat UARS: the aircurce VAUTO.

y suggestions would be greatly appreciated. I just don’t know the next step I should even be taking, but, I’ve got an apt with dentist coming up. Just worried I won’t even be covered for the mouth piece because my study doesn’t show RDI.......

----- all I said above  is general statements; could be validate only after you post your chart here.

all the best

[Max Maker]

Since you are discussing masks here. Mine leaks a little bit at the top swivel connector on the minimalistic philips nasal mask. I think the same one as you have. Is that normal? When I hold my finger to it, I can hear hissing.

[SarcasticDave94]

Since you are discussing masks here. Mine leaks a little bit at the top swivel connector on the minimalistic philips nasal mask. I think the same one as you have. Is that normal? When I hold my finger to it, I can hear hissing.

It's probably best for you to get your answers by creating your own thread on questions about your mask or other therapy needs. Your question will get lost in the stack of stuff in someone else's thread.