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+--- Thread: ENT / Morning Sleep (/Thread-ENT-Morning-Sleep)
ENT / Morning Sleep - r4robin - 03-06-2024
I went to an ENT yesterday after having no success with Bilevel and APAP treatment.
The ENT said everything looks good, except my jaw is really far back, and he recommended going to the dentist to get a MAD. So my question stems, is there such a scenario where Bilevel and APAP don’t help but MAD would? I’ve never heard of this, from what I’ve seen most people who opt for MAD do it for the convince, or as a “worse” alternative to PAP treatment, so I am hesitant to go down this path.
Another completely random thing which makes me suspect it isn’t my jaw, is basically I sleep 11pm-8am, and I feel awful, but then if I sleep from 9am-11am the same day, I feel better. For some reason when I sleep a little in the morning I feel significantly better then a whole nights sleep, why would a jaw issue cause this? And I seriously do mean significantly better, as in if I sleep the whole night but don’t sleep the extra 2 hours in the morning my whole day is ruined, vs if I do I can at least function like a human.
Extra: Why do I think PAP treatment failed for me? I have another thread on dialling in those settings, I’ve tried basically everything and I’m still so far from being better I don’t think settings are the issue anymore. My OSCAR data looks super good, low flow limitation, normal respiratory rate, <1 AHI, yet still I feel almost as bad as no PAP. Also suspect UARS since sleep study showed 7AHI, but 25RDI.
RE: ENT / Morning Sleep - BoxcarPete - 03-06-2024
Did your ENT have you move your jaw around while he or she had a scope up your nose? Jaw position alone shouldn't be a clinical indication for MAD. I have used one and they can sometimes cause all sorts of other trouble with your jaw and bite; thankfully, a couple months after discontinuing use, my molars touch each other again. If you have low flow limitation and AHI already as well as good respiratory stats, I doubt that an MAD will do better than PAP, and it is unlikely that it's needed as a supplement either.
Can you post some of your OSCAR charts here for review? I'd like to see the tidal volume graph included in your overall daily chart, with that we can sometimes make an educated guess as to your sleep architecture and see if that's got something to do with the morning nap being such a help. If you're short on either REM or deep sleep that might be why.
RE: ENT / Morning Sleep - r4robin - 03-06-2024
Thanks for the response!
My ENT did not have me move my jaw around while he had a scope up my nose, he just said my jaw was far back and referred me to the dentist. I also guessed it had to do with REM sleep being worse because in my sleep study my AHI was like 2, but REM ahi was like 16 or something, same with RDI was way higher in REM.
I've attached some OSCAR charts.
The reason I think PAP treatment isn't working is because I feel so far off "good" that even when I test with super high pressure, low pressure, low PS, high PS, etc. I feel no difference once I get into REM / Deep Sleep and wake up I feel exhausted. Also at this point, AHI feels truly irrelevant to how I feel. I really have no clue where to go from here...
RE: ENT / Morning Sleep - BoxcarPete - 03-07-2024
I don't see any major red flags from your OSCAR charts. You got prescribed a PAP machine for a reason though, what was your sleep study result?
RE: ENT / Morning Sleep - r4robin - 03-07-2024
My sleep study showed high RDI and AHI especially in REM sleep. And as mentioned, I generally feel way worse after waking up from deep (or REM sleep).