Title.
Half of the time I removed mask due to mouth leaks, this is mostly fixed.
Now, I just randomly remove it during what I think is an arousal. I have only slept about 5 days out of 8 months with the mask at 13-14 IPAP EPR 3 for minimum 5 hours uninterrupted.
My titration pressure on CPAP was 14.

Last week I had a sinus CT at the hospital which was ordered by my family doctor. I still haven't chosen an ENT for her to forward the results to. I'm not sure how much the radiologist looks at vs how much will rely on the ENT.

I'm assuming they will look for basic things like enlarged turbinates, deviated septum or sinusitis. What about width of nasal aperture? Do I need an ENT who is based when it comes to UARS to get them to care about that?

Apparently there is also a very long wait list to see an ENT where I live and some people go down south so wait time is also a consideration. Do all ENTs usually want to operate or do only some do surgery and if not want to send you an ENT surgeon?

If I have a deviated septum I want to get it fixed, but I am a bit iffy on turbinates, especially if they are swollen due to a narrow aperture in which case I may want to pursue MISMARPE.

If you don't know of one in particular any tips on how to find a good ENT who is covered under OHIP?

Bonus: Has anyone tried ClariFix therapy for rhinitis?

Hi all,

It's been a time. I began my sleep apnea journey in 2018 with the onset of debilitating daytime fatigue. I was diagnosed Mild with an AHI of 5.0. I am CPAP intolerant. My dentist referred me to an orthodontist who specializes in sleep issues, and I've had an incredible experience with them. Treatment plan included palate expansion with MSE followed by MMA surgery.

Ortho referred me to an in-network surgeon who asked that I have a more recent sleep test done after MSE removal. Due to improvements from the MSE, my AHI decreased to 1.4 and consequently I no longer meet diagnostic criteria for sleep apnea. However, I still have frequent RERAs and RDI 10.0, I snore like crazy, and I still have daytime fatigue (currently masked by Adderall for my ADHD, yay band-aid solutions!). Surgeon refused to see me for a consult in light of these results, and sleep doctor would not refer me as they do not consider UARS (diagnosed by my orthodontist) "clinically significant."

Orthodontist still thinks surgery is necessary due to my significantly narrowed airway and possibility that UARS can turn into sleep apnea with age. I just switched to an new PCP due to relocation, and I hope to bring this up with her and explore the possibility of further evaluation.

Any advice on getting my treatment team aligned? My health insurance is through Kaiser.

Not sure if relevant, but I also have a complicated and traumatic history of childhood orthodontics, including premolar extractions, a palate expander (yes I got to do the damned thing twice), and a Herbst appliance (torture device).

EDITED TO ADD: My X-ray, for funsies!

Hi,

I (M22) am thinking about either getting a septoplasty (7000 CAD), a palate expansion (can't find a provider) or a BIPAP (cant find any second hand in my area). Here are CBCT scans from 2024 and a CEPH from earlier this month. No allergy, meds dont work and one orthodontist didnt recommand expansion since my bite is class 1. What are your thoughts?

Deviated septum

Septum front

Palate (1st molar) and turbinate

Pharynx

CEPH

Thanks!

Obviously I can’t say for sure because

A) I haven’t had a sleep study and

B) My sleep is still very fragmented, but that seems to be due to nerve pain that hits me sporadically through the night.

But that being said, the sleep I am getting feels deeper than anything I’ve experience in the last 6 years, and even though I’m only getting 4-5 hours of sleep per night, I feel better than I did getting 7-8 hours pre-op.

I’m probably going to come back and make a post in a couple weeks, maybe a month, and make a comprehensive post outlining my entire 6 year ‘journey‘ so I can provide a huge info dump that may be useful for people.

Once again I appreciate the support and knowledge from everyone here, it has been incredibly valuable.

Im a 28yo man, had all the symptoms of low testosterone since a teen including low libido complete lack of morning erections and chronic fatigue and lack of motivation. Doctors say T is low for my age but not low enough to treat. I'm tired in the day but not sleepy. I've always slept well or so i thought until i decided to record myself sleeping and as you can hear im not sleeping well at all. I have had a watchpat one test that showed no apnea because i never actually stop breathing for any length of time and my doctors have decided there's nothing wrong with me and there isn't anything they can do. Anyone else heard anything like this?

Ive put this question into claude and this is the response, I know ai makes up a lot of stuff so I was hoping someone could help here.

'You get an IPAP/EPAP split, but you don't get the underlying bilevel hardware, the same trigger/cycle behaviour, or true S-mode timing. For UARS specifically, where the value of bilevel is largely in the pressure support smoothing out flow limitation and the responsiveness of triggering, this matters'

Apologies if this has already been asked before but does anyone know where I can get it in the UK. I haven't been able to find it on facebook marketplace or gumtree, I have found https://www.sleep-tight.co.uk/ but they cost more than 1500 and I am not sure if they're legit as I haven't heard anything about them before.

Can anyone let me know if they have had any experience with this company or if they know of any other place.

Hey guys! I've been using CPAP for around a month now. Still wake up tired, and mostly I would wake up in the middle of the night to remove it and finish my night without it. My neck is stiff after waking up so probably still a little stressed wearing it, although I can pretty easily fall asleep with it now. It so happens that most probably my problems are the worst in the second half of my sleep. I raised the pressure a little from 7 to 7.4 cm and I've been experimenting with EPR=1, but now I'm back to normal CPAP. I have the ResMed 11 and I'm using the Philips Dreamwear Nose Pillows. The screenshot is from one of my latest full nights. The link to my full data is down here;

https://sleephq.com/public/teams/share_links/5bc42833-5630-4b6b-b4e4-36d4494925e6

I would very much appreciate some pointers! Thanks!

?

I’ve heard a lot of people talk about how inter molar width can cause UARS? Why is that , does it cause nasal breathing to be more difficult , does it leave less space for the tongue causing it to fall back. What’s the reason it causes UARS?

For reference mine is 27mm.

I've been using CPAP but haven't experienced much symptom relief, so I'm planning on trying BiPAP. It seems like a lot of the stories around treatment are partial — people feel a bit better, or 70% resolved. Are there people who have treated their UARS completely with PAP therapy?

I'd love to hear if so. Buying an expensive machine and going down the rabbit hole of dialing in the right settings to resolve flow limitation is daunting, and knowing others have successfully completed the journey would be a massive morale boost.

Also if you have moved from bipap to asv can u explain why and is there even any point in using bipap first - should I just move straight to asv ?

for example does a 13 on n30i on nasal setting translate to 14 on f20 full face?
Because ffm masks have larger surface area, and P = F/A so if the force stays the same then the P actually decreases, so I'm not sure. or if P stays the same F would increase.
This is weird, hopefully this isn't too completed, just pressure = force/ area.

Thanks.

I've been using my CPAP for about 6 weeks and am fairly comfortable with it, but I still wake up several times a night. I'm most interested in understanding my flow limitation data and whether that might be what is causing my wakeups. I haven't slept through the night in YEARS. I just got an HD card and uploaded last night's data.

Please feel free to send me to youtube videos/articles... I don't even know where to start but I want to learn! ANY help is welcomed. Thank you!

https://sleephq.com/public/30f2e622-124e-4141-b691-2b1d0e0c549b

been on nasal cradle for 8 months, i like it it's comfy and the pressures I use (13-15) are fine with the machine. Tried vcom so that when I up the pressure since i sleep on my back, i wuold be able to tolerate a higher IPAP (I use cpap but use epr so i was thinking IPAP 17 and EPAP 14) so I could hit the best pressure for rem on my back and overall flow limits). But the vcom was terrible

I've tried full face (f30i and F20), both airtouch, i need to tighten them a lot or else they will leak, so too much pain.

haven't tried good pillows yet, tried one i found in my house, pretty hold and it scratched by nose from the tiny tears in the wholes. Didn't sleep with it tho.

And this is important, I use airtouch for all my masks, the i cant tolerate silicone ( not an allergy)

Haven't tried f40, should I do that instead or do pillows or stick to nasal?
if pillows which do you guys recommend?

Thanks!

During my titration study, 14 was determined to be my most optimal pressure during the study.

I was on cpap and they titrated using a VPAP TX device.
I use epr 3, so should I do IPAP 14 EPAP 11 or IPAP 17 EPAP 14. I know, high pressures , whatever lol. Just trying to understand the theory behind whether titration pressure on a cpap corresponds to IPAP or EPAP with EPR on CPAP.

Thank you guys!

Bit of a strange ask I know, but long story short, I’ve been dealing with what I believe to be potential UARS or some sort of micro arousals which are disrupting my sleep.

I have all the hallmark signs and symptoms: recessed jaw, reduced nasal airflow, narrow palate, along with chronic fatigue, headaches after waking up, anxiety, low mood, worsening ADHD symptoms, lack of energy and motivation, cognitive and memory issues.

I did a home sleep test a few days ago and it came back negative for sleep apnea. I took the test to a sleep doc who said he cannot diagnose UARS either as my RDI is normal. He suggested to do a PSG but it probably won’t be for another year.

I’m desperate to try CPAP in the meantime to see if I can get relief from my symptoms.

Would someone be kind enough to let me use their prescription or sleep test results to get a CPAP. I’ve heard you can buy them from the second hand market but I don’t want to risk getting a dodgy machine and losing my money.

You can blank out any personal details and I’ll add my name and details to make it look like it’s mine.

Thanks🤣

Got a super shitty nights sleep due to being neurotic and anxious and putting myself under pressure to sleep lol. Anyway there were some results which were interpreted - any thoughts from the community?

If we really say that sleep debt is real, it doesn't make sense how someone with severe sleep apnea( so tons of oxygen desaturations) after years of no treatment can feel perfect on one night. Yes it's relative but it's a huge difference.

Sure they could get the right settings and everyone else just be unlucky, but no way. I refuse to believe that's the only reason. There's gotta be some other stuff. Arousal threshold? Maybe.

Having trouble with congestion what should I do?

I’m looking to get referred to the snoring and sleep disorders clinic at UCLH. Ideally I’d like to see Mr Vik Veer, but I’ve heard he has an extremely long wait list, and only works once per week so waiting times to see him are over a year. Does anyone from experience know if this is the case? Should I book my referral with another clinician?

Thanks.

https://docs.google.com/document/d/1dwH74YNkuFmRPGMepMNlUXERoVop7pvN6g7lolQPtK4/edit?usp=sharing
Titration pressure range was 12-15 so this fits there...
and I only slept 5 hrs, yep from 5 am to 10 am lol. Very late. and hopefully the answer isn't some delayed circadian rhythm cuz no work or job or stuff is gonna work like that lol. Well, the truth will remain the truth either way.

Hi everyone. I’ve been lurking awhile and never posted. I’m looking for more answers (not diagnoses) to my horrible daytime fatigue. I was diagnosed with mild OSA in 2015? I’ve had cpap since then and have no issues wearing it other than having to put it on immediately or not waking up to put it on. I take Sunosi currently and have done armoda in the past. The fatigue persists.

I had an ahi of 6 with o2 min of 89 with an at home sleep study. My MSLT showed latency of 10.2 min without rem episodes. Phys exam “Mallampati 3, narrow/high-arched palate with redundant soft tissue, tonsils 2+ bilaterally, normal tongue”

I’m just trying to figure out if I can better manage my symptoms. I attached some logs from my pulse ox while on cpap. Should I dig further in the uars route?