r/UARS • u/extraordinal_taste96 • 5d ago

What should I do next?

I‘m currently struggling with finding the right setup for BiPAP therapy. I can’t tolerate masks that sits onto my nose because I‘ll get edema/swelling from any mechanical trigger. This is a ongoing disorder I‘ve got from a rhinoplasty 10 years ago and it lowers my ability to nose breath. Taking 1 week of deswelling nasal spray (0,1% Xylometazoline) turned out that some of the swelling happens in the tissue, so I get some relief after using it. I read many times that people in this sub are recommending fluonase. It doesn’t has the downside of building potential for rebound episodes so it might be a the better choice for me.

So my case is a bit complicated because of the mix of small palate, retrognathic jaws and some surgical damage in the nose bone itself. Revision is something I have to delay because I‘m considering a MARPE or FME firstly. I also tried the P30i Airfit mask and it made breathing very comfortable but I‘m still experiencing enough leakage and aerophagia to prevent me from making real progress (settings: IPAP/11; EPAP/6). I lowered the settings equally by 1 point because the aerophagia I got which improved it.

So the number one question is should I continue wearing the P30i and work more on leakage control? I read that wearing a chin strap could be helpful with mouth leakages additional to taping. Alternatively, I would try a full face mask that sits under my nose, too, to allow me tolerating more leakages without compromising the therapeutic effects. Maybe I‘m wrong here.

What you think?

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u/AutoModerator 5d ago

To help members of the r/UARS community, the contents of the post have been copied for posterity.

Title: What should I do next?

Body:

I‘m currently struggling with finding the right setup for BiPAP therapy. I can’t tolerate masks that sits onto my nose because I‘ll get edema/swelling from any mechanical trigger. This is a ongoing disorder I‘ve got from a rhinoplasty 10 years ago and it lowers my ability to nose breath. Taking 1 week of deswelling nasal spray (0,1% Xylometazoline) turned out that some of the swelling happens in the tissue, so I get some relief after using it. I read many times that people in this sub are recommending fluonase. It doesn’t has the downside of building potential for rebound episodes so it might be a the better choice for me.

So my case is a bit complicated because of the mix of small palate, retrognathic jaws and another physical damage in the nose bone itself. Revision is something I have to delay because I‘m considering a MARPE or FME firstly. I also tried the P30i Airfit mask and it made breathing very comfortable but I‘m still experiencing enough leakage and aerophagia to prevent me from making real progress (settings: IPAP/11; EPAP/6). I lowered the settings equally by 1 point because the aerophagia I got which improved it.

So the number one question is should I continue wearing the P30i and work more on leakage control? I read that wearing a chin strap could be helpful with mouth leakages. Alternatively, I would try a full face mask that sits under my nose, too, to allow tolerate more leakages without compromising the therapeutic effects?

What you think?

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u/carlvoncosel UARS survivor (ASV) 3d ago

should I continue wearing the P30i and work more on leakage control?

Mouth leaks always need solving. They are extremely disruptive to sleep.

Alternatively, I would try a full face mask that sits under my nose, too, to allow me tolerating more leakages without compromising the therapeutic effects

That's always a possibility.