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+--- Thread: UARS (/Thread-UARS--26783)
RE: UARS - jomama - 02-16-2020
It's so great that you are sleeping better! Couple questions:
1. Have you experimented with sleeping without any PAP machine for a few days, to see if it's the surgery that has made the difference?
2. With a PS of 3.4 on your BiPAP, that's very close to a setting of EPR 3 on your Autoset. I wonder if you really need BiPAP, after all. I'd be curious to see if you switched back and forth if you notice any difference at this point.
RE: UARS - tarah - 02-16-2020
Well, the sleeping has gotten better, but I wouldn't say it's fantastic. I still wake up at least 4-5 times a night, and have significant troubles once a week, like waking at 4 and being unable to go back to sleep. We will see how it gets better with time. The insomnia was so brutal before PAP (only sleeping a few hours at night and severe depression and anxiety from that), that yes, it is much better. But I guess my goal is feeling good and sleeping well every day.
RE: UARS - tarah - 02-19-2020
I will continue to post what is happening, in hopes, it can help someone else.
In May 2019, I was waking up hundreds of times with APAP. Tried BiPAP and higher PS still wasn't enough to overcome the difficulties. I was barely functioning as a human being.
Three months after extensive nasal surgery, I am currently sleeping ~8 hours per night, with several brief wakeups. The difference is HUGE. No amount PS could overcome severe nasal obstruction. Breathing through your mouth is just not good enough for most people. My story is not over by a long stretch. I will continue to address nasal congestion as it worsens (which is almost certainly will, requiring further procedures), following strict sleep hygiene, *maybe* one day possibly reducing my sleep medicine.
RE: UARS - slowriter - 02-19-2020
Looks like good progress.
RE: UARS - Geer1 - 02-19-2020
That is good to hear the surgery has made quite a difference. Have you been feeling like you are getting good sleep now or that the sleep seems to keep slowly improving?
I am scheduled for septoplasty and turbinate reduction but could take up to a year thanks to our medical system... I have theorized that the main advantage I get from cpap is that it helps keep mucous from plugging up airway. I get better sleep with it but like you say not ideal yet and at times cpap or not I just get more plugged up.
My issue is nonallergic rhinitis and a slightly deviated septum. Vasomotor rhinitis (the form my ENT believes I have) doesnt respond well to medications etc. Dymista works best due primarily to the antihistamine in it(which actually acts as an anti inflammatory in this case not to treat allergic style reactions). ENT says for vasomotor rhinitis turbinate reduction is about all you can do and yes every so often might need to get it redone(sounds like 5 + years though).
I myself am considering a Vauto to get a bit more treatment capability but I wont be stepping up the PS too high. I think it can create it's own form of rhinitis just as the humidity settings can. With the autoset I cant sleep with EPR less than 3 so I already have this machine maxed out and changing pressures etc doesnt seem to help. I am hoping PS of 4 and ability to manipulate Ticontrols, sensitivity triggers and maybe rise time in S mode will help.
Turbinates are a strange thing and more complicated then most probably realize. They both sense the air and try to adjust to it, if they are malfunctioning like they do in those of us with vasomotor rhinitis then I think they likely add a complicated variable to cpap use that is different for everyone.
RE: UARS - tarah - 02-19-2020
Moving from an APAP to BiPAP and increasing PS definitely did help. It is worth a shot because, as I'm sure you are aware of, surgery in your nose is a tricky thing. I know someone who ended up with empty nose syndrome from surgery, and it was a HUGE concern of mine. Empty nose syndrome is basically when too efficient of the breathing is created (like too much pressure support), but there's no setting to turn down! I went to speak with the ENT about it repeatedly, asking every possible question, and ultimately, just trying to determine if she was bringing an ego to the operating room and whether she was going to listen to my requests to be conservative in her surgical approach.
A year is a disturbingly long amount of time to wait. I scheduled mine 3 weeks out.
RE: UARS - Geer1 - 02-19-2020
Yup that is the one downside of our Canadian medical system. Low priority surgeries like this can take a long time to get done. I probably could get it faster with a different surgeon but I know the guy I am scheduled for is highly regarded and as you mentioned I want someone good not just someone that will get it done sooner. I am on short notice list so hopefully it wont take near that long.
RE: UARS - tarah - 02-21-2020
Sleep, in general, continues to improve. There are still some nights that are SO rough. I felt like I barely slept last night, and the anxiety is so bad today.
Breathing looks nice and regular for large portions of the night, and then just sort of falls apart during other times. Are there any further changes I should be making to my therapy?
RE: UARS - geauxdbl - 02-22-2020
Glad to hear you're improving. For what it's worth, I recently switched to VPAP-S mode and reduced EPAP, and found, surprisingly, that my anxiety started disappearing. You might consider the same thing, since you're experiencing minimal obstructive events and the one OA could have been just from you tossing and turning.
It makes sense, as I find the extra air from my IPAP of 11 comforting, and at an EPAP of 6 I feel like I'm not exhaling against anything. And since there are no changes overnight, my nervous system doesn't have to process anything extra there.
The tradeoff is that you lose flow limit graphing - but at this point, I view that as an acceptable compromise. I'm really becoming a different person. Still tired at times, but... a content and happy tired, not rage mode tired.
RE: UARS - slowriter - 02-22-2020
(02-22-2020, 02:24 PM)geauxdbl Wrote: The tradeoff is that you lose flow limit graphing - but at this point, I view that as an acceptable compromise. I'm really becoming a different person. Still tired at times, but... a content and happy tired, not rage mode tired.
Change back to VAuto mode and set max IPAP to min EPAP + PS, and you have the best of both.