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UARS Mild Apnea sufferers what are your thoughts? - emos12 - 01-21-2018
Hi everyone !,
I am a student from the Netherlands and have gained a lot of knowledge thanks to this website and its great people!! After one year of chronic fatique and 2 sleep studies my sleep docter diagnosed me with mild apnea. RDI 12. See here RDI, is the same as AHI.
Sleep study results:
AHI:4,5/hour
RDI: 12/hour
ODI: 6,7/hour
The doctor told me that he had to revise my study to see that I had a lot of reras which they did not see in the lab. When I asked him if I had UARS, he said yes but he did not find it important beceause you treat it the same way as apnea he told me. I was very happy with the diagnosis because I knew something was definitely wrong with my sleep. Waking up frequently in the night, super dry mouth and just feeling awfull when I woke up as if I ran a marathon.
I have the MAD for 2 weeks, which is the first line of treatment for a AHI below 30. Right now I am really suffering beceause of my bad sleep. I have 0 concentration, super fatiqued and just an overall feeling of malaise whith headaches etc.
Are there any other UARS people that have such heavy symptoms and how is treatment working for you? Also, are there UARS sufferes with a MAD?
I look forward hearing from you
Emos
RE: UARS Mild Apnea sufferers what are your thoughts? - Cpapian - 01-21-2018
I can imagine those devices are uncomfortable. Not many here use MAD. you should go back to the dentist who provided the device. Perhaps they adjusted it too aggressively.
Some UARS people find sleeping on their stomach helpful, because gravity will help keep the tongue away from the back of the throat, to some degree.
RE: UARS Mild Apnea sufferers what are your thoughts? - Sleeprider - 01-21-2018
The problem with a MAD is that it targets one type of upper airway restriction, but doesn't resolve others. It can have the adverse side-effect of causing permanent jaw misalignment and temporomandibular jaw disorders (TMJ). Ironically a MAD can be more costly than CPAP, have adverse side effects, and is generally less effective. If possible, I recommend getting a copy of your sleep study, and especially the respiration wave-form chart. This will let you better understand your condition, and discuss concerns with your doctor.
Most UARS appears as an inspiratory flow limitation on the charts. This is where inhale begins normally with a rapid rise in flow, but the UARS sufferer ends up with a restriction that cuts-off the peak of the flow. The wave-form is flattened or downward sloping. This reduces the efficiency of respiration and can result in arousals and oxygen desaturation. This is a more technical discussion https://www.sciencedirect.com/science/article/pii/S0954611105003744
UARS can transition to moderate sleep apnea with age, weight gain or inflammation or illness. What shows up as UARS one day, may be something that qualifies for CPAP treatment another. It responds well to CPAP pressure and can avoid the arousals. The study cited above suggests that flow limitations associated with UARS, impost high negative swings of esophageal pressure. The study demonstrated that these periods have some adverse physiological consequences. Given the high pleural pressure swings occurring in these periods, it is conceivable that a hemodynamic workload is produced resolving the high pressures in the esophagus. This is the primary pathway by which sleep apnea is also associated with atrial fibrillation.
I guess my point is that you are under a doctor's care and receiving a treatment that may not be ideal. I hope you will continue to pursue the treatment that works best for you and makes you feel rested and prevents unhealthful side-effects. Welcome to the forum, and good luck with your treatment journey.
RE: UARS Mild Apnea sufferers what are your thoughts? - CB91710 - 01-21-2018
Agreed on the MAD. I tried one before moving to CPAP and it created a painful TMJ condition. I could not properly close my jaw to eat for several hours after getting up, and it did nothing to resolve my apnea.
Like you, my apnea was diagnosed as mild, AHI between 12 and 15 with O2 Sat dropping below 90%, but remaining above 85%.
RE: UARS Mild Apnea sufferers what are your thoughts? - emos12 - 01-21-2018
Thanks for the replies! How is treatment working for you now CB917?
Well, in my country healthcare is free so the MAD is insured. But there are also a lot of protocols and rules and dutch doctors always follow those very firmly. The first line of treatment here is a MAD for mild-moderate apnea. If it does not work you get a CPAP. But I think you are totally right, CPAP may be the a better solution without side effects. The dentist told me about the side effects and I was just like nah... just give me the device ! Tomorrow I have an appoitnment with the dentist, she will show me how to adjust it, for now it was just to get used to the strange thing in my mouth during the night.
I really feel as if I am breathing trhough a straw in the night. Nose is congested when I wake up and my throat actually hurts a bit
Maybe the MAD can allow for that little extra space in my airways to have a full inhale without limitation. Only thing is I have to wait for the MAD to work or not and then get assigned a CPAP. I was thinking about buying my own cpap as I know I have Apnea or UARS and start out with a low pressure. I was thinking about buying the philips dreamstation.
Another question: My sleep doctor, who is a pulmonologist, told me that the he manually revised my sleep study AND then find out about my apnea+UARS. He even told me that in the lab they can "overlook" the inspiratory flow limitations. I was like what the hell?!? ITs strange beceause they should not miss those events right?
I hope we can share our knowledge and experiences here beceause I can not wait to feel better, reading all the success stories of everyone on the forum!
RE: UARS Mild Apnea sufferers what are your thoughts? - Kryogen - 01-21-2018
My numbers and situation are exactly the same as you. AHI 4-5 or so, RDI 12 or so.
I have been on cpap for 5 months. Still tired but better. less "bad days".
I have a 6 months old baby so that doesn't help also...
I have 30 micro-awakenings per hour but only 8 can be attributed to resp events they say, so my understanding is that I wake up 30 times per hour and 22 times out of 30, they don't know why. um.
Forget the MAD, get an APAP online...
RE: UARS Mild Apnea sufferers what are your thoughts? - emos12 - 01-21-2018
Kyrogen,
Well it is a good thing youre seeing some improvement and relief. Hopefully it gets better with the time. I can imagine having a baby is not the best thing when your being treated for a sleep disorder. I know it when I did nog even have this disorder my baby siter was crying frequently in the night. Only thing to do is wait until they grow a bit.
Yes I may buy one. How did you know your pressure beceause you cant really go with AHI with UARS right?
RE: UARS Mild Apnea sufferers what are your thoughts? - Sleeprider - 01-21-2018
(01-21-2018, 04:44 PM)emos12 Wrote: Kyrogen,
Well it is a good thing youre seeing some improvement and relief. Hopefully it gets better with the time. I can imagine having a baby is not the best thing when your being treated for a sleep disorder. I know it when I did nog even have this disorder my baby siter was crying frequently in the night. Only thing to do is wait until they grow a bit.
Yes I may buy one. How did you know your pressure beceause you cant really go with AHI with UARS right?
Not to speak for Kryogen, but the full-data auto CPAPs do record flow limitations and RERAs. This can help you to optimize the settings. While Kryogen is using a Dreamstation Auto, I think the Resmed Airsense 10 Autoset For Her is the most ideal unit for UARS. It is capable of providing more pressure relief during exhale, and providing the most appropriate response to increase pressure for flow limitations of any auto machine. It also limits that response so the machine pressure does not respond too aggressively to only flow limitations.
RE: UARS Mild Apnea sufferers what are your thoughts? - CB91710 - 01-21-2018
(01-21-2018, 02:33 PM)emos12 Wrote: Thanks for the replies! How is treatment working for you now CB917?Doing quite well.
I used to think I was just a "light sleeper", but it was actually my impression of waking up frequently and not realizing it.
On CPAP, someone could fire off a missile outside of my bedroom and I would probably not notice. I wake up in exactly the same position I went to sleep unless I intentionally roll over.
My AHI is effectively zero... at least 50% of the time I'm at 0.0, and the rest of the time I run between 0.1 and 0.4.
RE: UARS Mild Apnea sufferers what are your thoughts? - Kryogen - 01-21-2018
nasal mask kept ahi higher with lots of leaks
amara view FF lowered ahi quite a bit, but hurts and still get leakage.
airfit F20 on order tomorrow I guess, will report asap.
Regarding my improvement:
It's a little hard to explain. Before CPAP, I was constantly tired, and I had a lot of bad days where I just got up in the morning feeling like a zombie with a headache, and it just didn't really improve all day, so I didn't do much all day and just tried to get to the end of the day.
With cpap, I am still tired often, but I get MUCH less bad days, I can go through my days, and I wake up MUCH less often with a headache feeling like crap.
If you ask me, I didn't notice it much, I still feel tired. But my wife said that it's a huge difference, that I am way better, that I complain much less about everything (tiredness, pain, headaches, dizzyness, etc). My assistant at work also noticed that I complain much less about being tired. Before that I complained almost every day that I was so tired that I could sleep on the floor.
Oh well, so I guess it works.
I started with 6-12 and PS 3
I found that the best for me is 8-12 PS off
less than 8 I feel like I need more air
above 8 I swallow too much air
PS off lowered my AHI, keeps the airway more open I guess, and I can breathe against 8 anyway so it's ok.
Plus, the amara view pumps horribly with PS, so I would rather just have it stay the same and not inflate and deflate all the time.
Wil probably be the same with the airfit, same kind of mask.