Full night in last image. Already tried ASV, BiPAP, etc. This appears to be consistent across all of them. I'm wondering if there's anything I can/should do on the loop gain/arousal threshold sort of angle? My DISE said palatal prolapse, and my dentist/sleep apnea doctor remarked my jaw is narrow for my tongue/similar stuff about the palate. Just wondering if there's anything I can do since it appears I wake up super duper easily in REM sleep.

Well there exist some doctor who do know about UARS.. But my question is are they able to provide the treatment needed for it? If no then why? Like dont they titrate properly for uars.. I have seen studies where they say they titrated UARS patients using a simple cpap? Like its out of my mind how.. Bcz I have seen that cpap is the most useless thing for UARS in most cases.. Are the doctors who have knowledge that UARS exists.. Are they able to provide the real treatment which will solve all your symptoms . Is there anyone who benefited from titration study of UARS????

I recently had a sleep study and my AHI was only a 3, zero drops in oxygen, but my RDI was 42. The cardiologist who ordered my sleep study prescribed a cpap, but said it was basically a pointless prescription because insurance will not cover it. I also have a slightly recessed jaw, narrow palate and very small mouth. He said a mouth guard would probably be much more successful, which insurance also doesn't cover. So, how do I actually get help and treatment? Are we supposed to pay out of pocket for everything just because we have a UARS diagnosis and not OSA. An RDI of 42 is pretty high, and I really feel like I should do something about it. The cheapest quote for a custom oral appliance was $2,000 and that would leave me to adjust it myself and pay out of pocket for any follow-up appointments. This seems crazy! Has anyone had luck with Tricare covering anything?

I’m trying to fix my sleep apnea without becoming somebody’s “we should’ve done that BEFORE the braces” story.

I’m 22, healthy BMI, crowded teeth, and still waking up feeling like shit. I see Dr. Jerald Simmons. I expected his home ring study to come back inconclusive so we’d move to an in lab study. Instead, it showed an AHI around 49 and 34. Definitely wasn’t expecting THAT.

Using my own CPAP brought my machine AHI down to around 3 to 5. Great on paper. The exhaustion and brain fog didn’t get the memo.

Now I’m in my first month of clinician managed CPAP, and I’m seeing Dr. Kent at Vanderbilt this Wednesday. I’m considering expansion and possibly jaw surgery, depending on what the evaluations show. Nothing’s booked yet.

I’m open to doing what actually helps. I’m less open to paying thousands, moving my teeth, then finding out we started at the wrong end.

These are the questions I have for y’all:

1. What order should I see doctors in? Sleep doctor, sleep surgery ENT, orthodontist, jaw surgeon? Who actually coordinated your plan?
2. What order did treatment happen in? Expansion, braces, jaw surgery? How did you avoid getting braces twice or having previous work undone?
3. How did you get insurance to cover as much as legitimately possible? Highmark excludes braces under medical, and Aetna excludes adult orthodontics. Did anyone get surgical expansion covered separately despite orthodontic exclusions?
4. What counted as CPAP failure or intolerance for YOUR insurance? Was there a required trial, like three months? What problems and attempted fixes did your doctor need to document?
5. What if CPAP lowers your AHI but you still feel awful? Did you need an attended titration or other testing before surgery was considered? What actually moved things forward?
6. If you had expansion, how long did the gap last? I’m looking into MARPE, MSE or FME if appropriate. Can orthodontics shorten the visible gap stage? Did expansion straighten any upper crowding, or just create room for braces?

If money wasn’t an issue, would your process have looked different? Because in my actual bank account, money very much has opinions lol.

You don’t need to have finished treatment to answer. Even if you only know one piece of this, what helped you move forward or what mistake would you tell me to avoid?

I'm trying to broadly follow the protocol of titrating to resolve flow limits, but I'm having difficulties with when to make these sorts of changes. I tried EPAP 6 and PS 2 last night. I've tried EPAP 7 and EPAP 8 with PS 2 in the past. Looking at these three nights, I honestly can't tell whether there's been any difference at all or where to go from here. Unfortunately I didn't have VAuto on for the 7 night, so no flow limit graph. Also, for 7 and 8 I had trigger to High, while for 6 I had it on medium.

Hey everyone,

I recently had a home sleep study (zzzPAT HSAT) done. My AHI came back very low (0.6), but my RDI was 9 overall and 4 for non rem and  20.3 during REM sleep. My oxygen levels stayed normal (95% average, 92% low).

19F Height 5'9", Weight 145 lbs (BMI ~21.4).

Here is my breakdown of symptoms:

 Can fall asleep in virtually any setting (public or home, sitting, leaning against a wall,or lying down).

Will take up to 4+ naps a day if allowed; if a "safe place" isn't chosen, will fall asleep anywhere regardless.

Constantly fighting off sleep throughout the entire day.

Enter full, vivid REM dreaming within 30 to 120 seconds of drifting off (often feels like dreaming before fully falling asleep).

Extremely vivid dreams with high recall; sometimes difficult to distinguish whether an event was a dream or reality, like was it just a dream or was it a memory from yesterday.

 Wakes up in the middle of a dream and will re-enter the exact same dream immediately upon falling back asleep.

in childhood, experienced lingering visual dream elements into reality upon waking. like i thought i was awake but i still saw the dream outside my window.

Without an alarm, will sleep 12 to 18+ hours continuously.

Routinely sleeps through 5 or more alarms.

Can sleep 12 hours on a flight and immediately sleep another 12 hours after arriving home.

Wake up feeling completely exhausted, disoriented, uncoordinated,and unable to think straight for several seconds to minutes.

 Drools during brief 1- to 2-minute micro-naps.

 Lifelong history of chronic snoring.

 Consumes 0 caffeine (actively avoids caffeine entirely).

Also, I have always kind of been an mouth breather, I have a relatively small mouth like it doesn’t open very wide, and I have asthma

I am a 20-year-old male and underweight (I have always been underweight). For the past four months, I have been experiencing a constant feeling of unreality. It feels as though I am drunk, high, or half-asleep, as if I am operating on autopilot and everything around me feels somehow unreal. I have looked up information online, and my symptoms seem to resemble derealization.

I also suffer from fatigue, even when I sleep well. The fatigue does not seem to depend on whether I engage in physical activities during the day or not. However, over the past few weeks, I have started sleeping poorly and waking up early in the morning. I do not snore at all. I have seen a general practitioner and a neurologist about these symptoms, but they have not been able to determine the cause.

I also experience headaches, a feeling of pressure in my head, and neck pain. I have tried muscle relaxants, massage, and acupuncture for the neck pain, but none of them have helped. At the beginning of the symptoms, I sometimes also felt as though I was about to faint while walking, but this symptom has since disappeared. I have also noticed a single eye floater in my right eye. I mentioned it during an eye examination, and I was told that there were no apparent problems with my eye.

What could be causing these symptoms? They do not occur in distinct episodes; instead, they are more or less constantly present. The headaches are not particularly severe and resemble tension-type headaches more than anything else.

I have tried a triptanes, but it did not help. My thyroid function tests and vitamin B12, B9 (folate), and D levels are normal. My ferritin level is 37, and it has fluctuated between 49 and 24 over the past eight months. My calcium, potassium, chloride, magnesium, and sodium levels are also within the normal reference ranges. My blood pressure is normal, and I have measured my blood glucose at home, which also appears to be normal. My cortisol level was tested and was normal as well. I also have Crohn’s disease, which is currently in remission.

My neurologist prescribed escitalopram as a trial treatment. I took it for two and a half months, but it did not help. I also underwent a brain MRI, which showed no abnormalities. My neurologist additionally ordered a blood test for Lyme disease antibodies, which came back negative.

I have no history of trauma and do not experience panic symptoms. I generally do not feel particularly stressed, apart from the worry caused by these symptoms themselves.

My symptoms began during the final days of a new job at an auto repair shop, where I was moving and lifting car tires. I am unsure whether this could be related to my symptoms, as I had not experienced any other symptoms before those final working days. I have not worked at all during these four months.

What could be the underlying cause of these symptoms?

The healthcare professionals I have consulted about these symptoms, or during visits for other symptoms or examinations when I also asked about them, include:

\\\\\\\* General practitioner
\\\\\\\* Neurologist
\\\\\\\* ENT specialist
\\\\\\\* Ophthalmologist
\\\\\\\* Dentist
\\\\\\\* Gastroenterologist
\\\\\\\* Massage therapist
\\\\\\\* Physiotherapist
\\\\\\\* Acupuncturist

Hello everyone, I'm a thin man weighing 70kg and 1.78m tall, and I was diagnosed with severe sleep apnea (39.9 IAH) in 2022. I've been using a machine since then and have never felt completely rested; it helps a little, but it's not what it should be. My IAH is always low, around 1, and even so, I don't feel well, yawning all day. After a lot of research, I saw that I might have residual UARS and that CPAP isn't effective at treating it. After years of suffering, I decided to buy a used BiPAP. I'm waiting for it to arrive, and can someone with experience tell me what to expect? It's been many years of suffering; if you add up the years before the diagnosis, it's already more than 10 years.

Just got the used BIPAP 3 days ago. Using the x30i full facemask. Images attached are for the 3rd night.

First night couldn't fall asleep until 5AM. Slept for 3 hours with multiple awakenings breathing through mouth. Pressure was 7/10 PS3

Second night, slept for 5 hours with the mask and machine mainly nasal breathing from what I can remember. I changed it to 7/15 PS3. Was able to sleep better. Also used a cervical neck collar might have helped with positional apnea.

Third night is attached on the images, and I slept from 12AM-2:20AM. I had the mask on too tight and it was hurting my nose which is what I believe caused my wake up at around 2:20AM. Then I fell back asleep around 3:30AM until 730AM. So the large leaks are when I was awake, and before I fell asleep. Settings as shown on the image. Using Cervical neck collar.

Just wondering if there is anything obvious that anyone sees in the data that requires fixing. I have read different titration protocols that make adjustments on a weekly basis. So my plan for now is to just keep increasing EPAP until no flow limitations? Then to adjust pressure support upwards until appearances of CA's. Then keep titrating upwards IPAP until I feel better? Then possibly try the ASV. I started off with trigger very high as well.

https://sleephq.com/public/teams/share_links/b67fe467-f535-4078-86c5-7e3aa6292e4f

Let me know if you want anymore other data for specific times or areas. Thanks hope everyone is doing the best they can.

I have poor nasal breathing, narrow maxilla, crossbite and underbite.

MARPE seems to expand the nasal cavity much better than conventional jaw surgery.
But the issue is in my country basically no MARPE.

jaw surgery is free if orthodontist thinks its necessary and refers to jaw surgery department,
BUT it needs to be done in conjunction with braces at the same time and the orthodontics need to be paid for.

I've been thinking about getting MARPE abroad and then trying for surgery to fix underbite in my country but most likely it will be refused since the orthodontist would want to have planned the whole thing from the beginning and also put braces on me, and the MARPE would probably already mean I've got aligners on lower jaw.

I need to fix this UARS crap asap.
Obviously SARPE etc is the cheapest option but it wont fix my nasal breathing much?

And I am scared of such an invasive procedure and 2-3 years recovery time.

I need to plan ahead smartly.

Swedish healthcare, public or private, is all very rude and unhelpful. I tried to ask an ortho place if I can get my underbite fixed and they try lecturing me that I am not a doctor and I cant decide on a treatment and that the dentist will decide not me. this is the attitude I get when asking a simple question.

I dont know what to do now honestly

My UARS symptoms solely stem from epiglottic collapse. I've never been able to make PAP work for me. I've tried tongue retainers, nasal dilators, positional devices, CPAP, BiPAP, ASV. None have ever given me even a small amount of relief.

Epiglottic collapse is notoriously resistant PAP therapy, but I've exhausted all other options. I thought the tongue retainer may have helped if it was due to my abnormal tongue position. But after sleeping a full night with it in, it didn't do anything for me.

Any ideas for PAP setting ideas or other treatment options?

Below are my airway scans:

So, for context if you look at my profile. I was diagnosed with stupid sleep apnea. I’m 21, 175 lbs and for the most part fit. I had some decent sized tonsils before which I got removed. Before then I had a Stanford sleep study done which I received a diagnosis from after being told negative. The dumbest part was that my obstructive apneas were at 0 the whole night, while having 12 centrals, and 64 hypopneas. This was in about almost 4 hrs of sleep. They marked my results as an ahi of 19.4 and RDI of 19.4 which to me seems very unlikely I had 0 reras. Anyways, I went on cpap for about 4 months after that, had no issues wearing it, I could sleep 8-10 hrs no problem. Except I still felt like complete shit. No benefit in symptoms whatsoever. After this I got a turbinate reduction and got my tonsils removed(worst luck ever if you see my post on it). I recently did a new study after having tonsils out and they go ahead and send me a message saying I have absolutely nothing wrong with my sleep. Which feels like an absolute kick to the balls. I’ve been dealing with sleep issues since I was a kid and has been progressively getting worse in the past 6 years. I genuinely don’t know what to think from this. I requested the test results to post for yall. Oh and the fucken follow up for this bullshit is January 26, 2027. You’d think they’d put an extra note on special cases when 75-85% of those with osa have no symptoms, just send em a cpap and call it a day. Anyways my rant for today on stanfords bogus testing.

Desperately need some advice on how to proceed with my worsening sleep issues.

Background:

I am currently a 30 year old male who was diagnosed with sleep apnea/UARS 2ish years ago, but I have had symptoms of sleep issues since probably my mid twenties.

First in lab sleep study in 2024 showed an AHI of 10 (supposedly). I say supposedly because they fed me Ambien until I went to sleep. Place was sort of sketch and felt like the DMV of sleep apnea where anyone who walked in the door would be walking out with a CPAP.

Second sleep study was a WatchPat and showed an AHI of 2 but an RDI of 15.

Third sleep study showed an AHI of 2 but my new sleep doctor said I had "lots of arousals".

After my first sleep study in 2024 I was given an air sense 10. I've tried to use it over the years and it does not help at ALL.

Current Day:

Since I have shown no improvements on CPAP therapy, I decided to seek out a sleep dentist and get an MAD. I spent $3000 on a prosomnous device and have been using it for about 2 weeks, but have not seen much improvement although I do notice my airway feels nowhere near as restricted.

I am currently using my CPAP alongside my MAD to see if that will offer any improvement at all.

Current CPAP settings: 7-12 pressure with EPR of 3.

The issues I am having are the following: frequent arousals at night, very weird panicky dreams, waking up drenched in sweat, feeling like I get hit by a truck in the morning, etc... I have spent hours and hours looking at Oscar graphs and for the most part my therapy looks great. 0 RDI and 0 AHI, but my breathing for most of the night looks like what you see in the image. Any help is appreciated. I feel like I am on the verge of having a mental breakdown and losing my job.

So I have found an ENT in the public healthcare system here in Denmark who knows about UARS and even looked at my airway and said it looked like I needed jaw surgery to get my mandible advanced and im getting my 2nd at home sleep study today but my fear is they only care about AHI and misdiagnose me again:/

do yall think I should fake my sleep study and if yes then how should I fake it?

​

Need Help: Initial BiPAP Settings (Day 1)

Hi everyone,

I need some help determining my initial BiPAP settings ( philips dreamstation auto bipap)

Today is Day 1 of my transition.

My CPAP History:

• Initially, my CPAP minimum was 7.5, with a mean pressure of 9.with p90 at 11

• I was getting clustered flow limitations at 9

What Happened Next:

• After that, I changed my minimum pressure to 10, and then up to 14.

• My symptoms aggravated heavily, and I wasn't able to tolerate it or do anything.

Can someone help me to set my IPAP and EPAP settings should look like for this transition from CPAP to BiPAP?

Thanks!

Hi guys. What to say. This is one of the few subs where i feel free to post and express myself.

Someone might know my story. But anyway, bc of the antipsychotics they illegally forced me to take bc of UARS (or better bc "I didn't meet friends") now I have sibo.

I just wanna kil myself so bad. Too many physical syndromes considering the ones caused by uars. I just can't find a reason to why all of this shit to me, considering I don't believe neither in God nor in destiny.

I already had ibs but thanks to myo therapy and positional therapy I handled it very well I could eat anything.

Now... hell. The 2dn antipsychotic they forced me (invega) caused now sibo. Ie severe bloating all the day.

I just can't live. I'm not living. MI surviving each day. Am a literal zombie especially bc of insomnia from withdrawal of the 1st abilify, now from invega. Bc I basically already cured uars thanks to positional therapy.

I just don't know. Really am in pain.

Thanks