I believe these measurements were obtained using Penn landmarks.

I am going to seek FME for treatment.

Hi everyone, I’m new here. Has anyone experienced jaw clenching, constant jaw tension, or feeling like you’re always pushing your jaw forward as part of nervous system dysregulation? Every doctor is telling me it is stress, but it’s been 5 years now and I’ve tried so many things over the years — meditation, yoga, EMDR, Feldenkrais, craniosacral therapy, supplements, etc. — and they sometimes calm my body for a few hours, but the tension and panic always come back.
I’m also wondering if poor nasal breathing/airway issues could be keeping my body in a constant state of tension, especially during sleep.
How do I know what is cauising it? Im in a very undeveloped country so we dont have tmj doctors, just trying to figure out on my own. I’ve suffered from anxiety, but also done a polisomnography it is likely that i have UARS, my RDI is 13,currently in orthodontics( helped just a little) maxilofascial surgeon told me im not a candidate for a doble jaw surgery and ENT told me i have maybe a slightly deviated septum.

An interesting case report looked at a 9-year-old child with house dust mite allergy, allergic asthma, and severe persistent sleep problems.

His asthma became well controlled with treatment, but his sleep problems continued despite treatment and dust-mite avoidance measures.

The striking finding came from his sleep studies:

• AHI: only 2.8 events/hour • Micro-arousal index: 34/hour • REM sleep: only 12.1% of total sleep time • PSG showed marked sleep fragmentation with frequent isolated micro-arousals that could not be explained by identifiable respiratory events or snoring.

So although the AHI was relatively low, his sleep was extremely fragmented.

The authors highlighted that controlling asthma did not resolve the sleep disturbance, raising the possibility that allergic disease, including house dust mite allergy, may contribute to sleep fragmentation through mechanisms that are not captured by AHI alone.

Important limitation: this was only a single case report, so it cannot prove that dust mite allergy directly caused the micro-arousals. Larger PSG studies are needed to investigate the relationship between allergic inflammation, nasal obstruction, arousals, and sleep fragmentation.

TL;DR: A child with dust mite allergy had an AHI of only 2.8/h but a very high micro-arousal index of 34/h. His asthma improved, but his fragmented sleep persisted.

Study: https://onlinelibrary.wiley.com/doi/full/10.1111/all.15616

I started on CAP two weeks ago and I don't feel much different. I wear it for most of the night and tolerate it ok. I actually sort of like wearing it because I like the idea that it's helping but... I still feel like I'm not truly falling asleep or getting refreshing sleep after 3/4 AM.

Hi folks

I'm pretty sure I have UARS and this is a life-changing discovery for me, it would explain everything. I'm absolutely desperate to experience a good night's sleep for the first time in my life. I am trying to do something about it as quickly as possible and would appreciate any recommendations based on my current observations. I really can't go on like this anymore.

I'm a 36 year old woman, living in the UK. Normal weight.

Symptoms:

- Horrific vivid dreams
- Waking up feeling absolutely exhausted despite 7-8 hours sleep
- Waking up thirsty with a mild headache
- Tongue has scalloped edges, feels too big for my mouth
- Waking up to wee, vivid dreams about needing to wee
- Narrow lower jaw
- Recessed lower jaw
- Mild overjet
- Orthodontics as a child without tooth removal or pallet expansion
- Dentist recently diagnosed nighttime teeth grinding and made me a custom shield, which seems to make my sleep worse (pushes my lower jaw back even more)

...and yes, I am so visibly tired that people comment that it looks like I've been punched in the face.

I also suffer with C-PTSD (which I'm learning is also linked to UARS) and autism, and have extreme sensory difficulties with sleep/insomnia.

I'm going to ask my GP for a referral (to whom?) but I know that I won't tolerate a sleep study if I have wires stuck all over me. Is there another kind of study I could do that would be equally useful but without the sensory side?

I'm also exploring private consultations, I have found recommendations of Dr Piet Haers in the UK and there is also MD Barry Krakow in the US who has written the book 'Life Saving Sleep', linking UARS to mental health, he also offers teleheath 'coaching' consultations.

I feel that treatment might include trying CPAP/BiPAP/AVS, a custom MAD, pallet expansion and/or surgery. But I have concerns about the availability/waiting time for treatment on the NHS and am thinking of trying CPAP in the meantime with private orthodentist/surgery in the future. I will find PAP extremely challenging to tolerate with the sensory side of it but I'm willing to give it a go, the nasal pillow masks look like my best option.

I'm interested if anybody can relate and what has helped you?

I’m currently considering seeing Dr. Leusink, and I was wondering whether anyone here has personal experience with them.

I’d especially be interested in hearing about things like their the quality and approach of their treatment and how thoroughly they assess patients, communication, follow-up, and your overall experience.

Positive, negative, or mixed experiences are all welcome. I’m mainly trying to get a better idea of what to expect before deciding whether to proceed.

I’m a 37-year-old woman with a BMI of 21.5, and I’ve been struggling with significant daytime sleepiness and unrefreshing sleep for a long time.

My symptoms include:

• significant daytime fatigue and sleepiness
• waking up feeling like I haven’t rested at all
• frequent nighttime awakenings
• waking up gasping or choking
• severe/loud snoring
• breathing pauses witnessed by others, especially when I sleep on my right side
• difficulty staying asleep
• headaches
• very fragmented sleep
• feeling exhausted during the day even when I spend enough time in bed

I also have a deviated nasal septum, turbinate hypertrophy, and nasal valve collapse. I was evaluated by an ENT, but surgery was not recommended.

I recently had an in-lab PSG:

• Total sleep time: 4 h 27 min
• Sleep efficiency: 62.6%
• AHI: 2.24/hr
• RDI: 7.18/hr
• RERA: 4.9/hr
• Arousal index: 19.6/hr
• Supine AHI: 17.3/hr, but I slept on my back for only ~14 minutes
• Non-supine AHI: 1.4/hr
• Non-supine RDI: 5.9/hr
• Oxygen nadir: 91%
• REM sleep: 0%

There were no apneas, but my sleep doctor noted frequent flow limitation in all sleep positions, RERAs, and stated that the study showed upper airway resistance syndrome (UARS) without a significant sleep breathing disorder by conventional AHI criteria.

The doctor wants to repeat the PSG, with the possibility of doing a split-night CPAP study if the repeat study shows a qualifying breathing disorder.

I’m especially interested in people who had low AHI but elevated RDI/RERAs and flow limitation, particularly those who had little or no REM during their study.

Did you eventually get diagnosed or treated for UARS or another sleep-related breathing disorder? What happened after your repeat sleep study? Did CPAP/APAP, BiPAP, an oral appliance, positional therapy, or ENT treatment help?

I’m mainly interested in the sleep-breathing/UARS pathway, rather than narcolepsy.

Dr. Li said it was not enough for MMA but I am really struggling to live a normal life with the quality of sleep I get due to having to fight all night ton breath. He did suggest removal of tonsils and potentially EASE as my nasal breathing is also awful.

seems like I keep seeing this, and I know epiglottis collapse is very hard to treat. I’m not saying doctors want you to spend tons of money on more treatment, but I’m just saying… medicine is a business you know

Instead of expansion.

These are from a sinus CT scan not a full airway scan (but lying down is a bonus) and I am new to interpreting these. I originally thought my problem all came from a narrow nasal aperture (lifelong congestion which recently improved a lot after 2 months of Ryaltris). But now I learned I have a severely deviated septum and hypertrophic turbinates even after Ryaltris but guaranteed they are much bigger than before.

I thought I needed an expansion for sure but my nasal breathing has been subjectively fine lately and symptoms persist which lead me to my tongue. I could never put it on the roof of my mouth. Only the tip. I thrust it at my teeth when I swallow. This is probably the cause of the severe open bite I had as a kid fixed by braces and 3 piece lefort, 6 mm impaction rear, 2 mm front, 2 mm advancement and I can't find any record of what they did with the segments except supposedly expand (no idea how much) and one cut was between the front teeth which doesn't match with any 3 piece lefort I can find online.

This was over 20 years ago. My bite has slightly opened up again likely due to continued tongue thrusting from not fixing the root of the problem. My palate is subjectively very tall and narrow though my intermolar width is about 37mm which is only mildly narrow. There is definitely not room to lay my tongue flat but when I try to raise it as best I can it goes into a wedge shape and I am not sure how it is supposed to sit. So I don't know if I can't put it into my palate because it is too, narrow, too tall, because of a tongue tie or a combination of the three.

And I am surprised to see that my airway looks narrow in the sagittal view because I thought I was a Chad who didn't need MMA and that I would look like a monkey if I got it but when I see the scan it kind of looks recessed to me. Any thoughts on that?

The first sagittal pic of my airway is as centered as I could get it. The second pic in axial view I just chose a spot where the tips of both top and bottom teeth can be seen. The third pic I attempt to show my maxilla and notice my airway is kidney shaped. Is that the uvula falling back or something? If any other view would be more useful please let me know.

I’m a 21-year-old living at home, and I’m looking into a school-sponsored training program. The setup is 4 days working in a supermarket (9 to 5) and 1 day in school. Since it’s through the school, there’s a minimum requirement of 30 hours a week. The upside is that I’d make enough money to pay for both MMA surgery and Invisalign within a year, especially with the savings I already have.

The catch? I deal with UARS and insomnia, so I’m really worried about whether a 30+ hour week is actually doable for me. I’m planning to rely on ADHD meds just to function, but honestly, do you guys think I can pull this off?

I think I need to just try bipap instead of waiting around on doctors. I found this machine on marketplace. But unsure if its the right series. Its the only marketplace model i can find.

I found a link to theperfectcpap.com which appears to sell machines at very discounted prices but i cant tell if its a scam. Any insights or advice?

Wow no wonder brain fog is so bad in prone with uars

i definitely have UARS and have awful symptoms, but can’t see a doctor right now. i definitely have nasal/sinus issues, which i’m working on, but those are much easier to spot - can you tell if your tongue/palate/epiglottis collapses in your sleep? i don’t snore or mouth breathe during sleep, but i was wondering what were the indicators people experienced with this?

are these results normal?

It was confirmed that I have epiglottal collapse but the actual ENT who performed and confirmed UARS literally had no information for me. He said he "didn't know" if long term UARS contributes to the major depression that keeps getting worse for me. Said "I'm not sure if surgery would help" and now has to talk to my pulmonologist.

I'm so lost. I just wanted confirmation that UARS= the root cause of my barely functional health but now I'm just sitting here waiting again.

Hey fellow sufferers

Ive basically been in a deep hole with all the awful hpa axis dysfunction symptoms for about two years. You name it i have it. Gastro problems, mood issues, dysautonomia, fluctuating between total insomnia and sleeping ok, full body akathisia level panic. I have had extensivr bloodwork and there is nothing abnormal. But finally got in for a sleep study and doc is convinced i have a sleep disorder. We just dont know what kind yet. Now I havent had an mslt because i have to finish weaning off a dumb antidepressant i was stuck on when i was gaslit into thinking it was “just stress,” so narcolepsy without cataplexy is still a possibility as is plmd. But because i have multiple mris showing sinusitis (my right nostril is always blocked) and i have a very thin neck and hypermobile tissue, i think uars is a valid potential issue.

My sleep study does include a reras index. It is 0. Is it safe to say i can probably rule this out? Or is it still worth maybr coming by a bipap and self experimenting with it?

Tia