[Treatment] Possible UARS or is it something else?

[C.T.]

Hi there, I've been lurking this forum for a month or two now trying to figure out my sleep issues.

TL;DR Background: poor quality sleep since childhood, sleep study negative, CBT-I completed, sleep hygiene dialed in, doctors say I should be fine lol


- I am suspicious of UARS as my AHI is <2 but waking up frequently at night
- The 3 sleep studies I have had over the years all did not measure RDI, just looked at AHI and said I was fine
- I got a mandibular advancement device 4 months ago, very slight improvement, but still working my advancement mm up
- Recently got Airsense 11 Autoset and have self-titrated up to 10-12 range
- Flow rate graphs are confirming frequent spikes and flattening
- I have also recently tried combining my MAD with the CPAP
- I have no troubles getting to sleep, but I do not ever feel rested when I wake up, and I have many mini awakenings at night

I have been reading the wiki and looking at resources on apneaboard but I am not sure if I am missing something in my data. Is this UARS? Is there some other pattern I am not aware of?

This is probably on the better end night for me:

   

This is a typical sample of my flow rate graph:

   

This is a typical sample of the jumbles that show up throughout the night, with or without CA events flagged:

   



If anyone has any thoughts or something I could look into more, I would really, really appreciate it. I am at a loss for where to go from here. Upping the pressure didn't seem to help, it just blasted air in my mouth waking me up, or puffing it up like a baloon whenever I have tape / chin strap.

[PeaceLoveAndPizza]

First, please read the link in my signature “Formatting OSCAR Charts”. it describes the graphs we like to use to help folks.

What I see in the posted chart are arousal breaths. I would need to see more data to consider UARS.

As the calendar is obscuring the machine settings, I can only guess at what it is set to based on the graphs. Based on what I can see, I suggest trying the following.

Mode APAP
Min pressure 10
Max pressure 12
EPR 3 full-time
No ramp

I suspect you may have a bit of flow limitations going on even though it is not triggering the FL counter, but will know more if you give those settings a try for a few nights.