UARS: Switch from APAP to BiPAP?

[lattie]

TLDR; Sleep specialist suggested APAP for UARS. No resolution of flow limitations, and still wake up wayyyyy too much. Still feeling quite lethargic, brain foggy, etc.

Hi yall!

(Attached last night's OSCAR for reference on settings, etc.)

Had a sleep study conducted which found I have UARS. They put me on a 2-week trial for an APAP which I found pretty meh and that's where they stopped providing me with support/advice. Went out and purchased my own APAP and have been fiddling with it for 2 months now, with the help of OSCAR. So while I wait to see a different sleep specialist (another 4-8 weeks), I'm kind of in this sh**ty limbo where my studies and relationships are all falling apart (

I've had a few nights where I've woken up feeling rested on the APAP, but for the most part, it's been sh*t.

I'm wondering if I should be considering trialling a BiPAP or ASV for UARS treatment as I've read they are way more effective. At this point, I'm even considering if an ASV machine might just be the hail mary to get all this sorted. Like I'd honestly be willing to pay any amount of money just to feel consistently rested in the morning.

[Gideon]

Your numbers are very good, but your flow limits are somewhat clustered implying a positional aspect.

Four possible solutions
1. Pillow modification to straighten your neck, 1 vs 2 pillows, flatter less firm.
2. A well fitted soft cervical collar, see my signature.
3. Increase pressure by +2 until FLs diminish
4. BiLevel such as Reed VAuto to try PS GT 3

Also look at Sleep Hygiene to improve your sleep habits.

[lattie]

Thank you Gideon.

It may have been pertinent to include that my sleep study identified REM-specific UARS events, which explains the clustered flow limitations. (Let me know if a copy of the original SS would be useful).

I've found with any higher min pressure I've started to see loads of CAs (associated with full arousals as well; again happy to post OSCAR for that if required). Do you think I still try with let's say 13-15 for a few nights to see if over time they will go away?

I'll try the pillow modification tonight and see how that works. I'll give the cervical collar a go in the next day or two (don't want to change too many things at once). Sleep hygiene is really strict atm so I'm doubtful that's impacting too much.

I'm hesitant to trial more and more machines tbh. Trialling for 2 weeks cost me $150 and at this point, if buying an ASV machine would be more likely to fix any issues id rather just buy outright. I'm in Aus so I'd have to buy my machine out of pocket anyways, regardless of the clinician's perscription.

[lattie]

Holy sh*t! Gideon. You changed my life. Soft cervical collar. I didn't know how much I needed this.