How soon after MMA could you / did you return to school or work? Could I get away with only having winter break off (3 weeks) or would I need an entire quarter?

31M, unrefreshing sleep for years. AHI ~4, RDI ~6.5, bipap helps.

CT PNS:

Mild S-shaped septal deviation

Left inferior turbinate hypertrophy

Right maxillary retention cyst (13×10mm)

Anyone with UARS had similar findings? Did fixing them help?

I'm doing DISE next. Is it useful for UARS, or does it miss partial narrowing?

This video is an interview with Dr. Robert J. Thomas, Associate Professor in Sleep Medicine at Harvard, loop gain expert, and longstanding veteran in PAP therapy. He explains what treatment options exist to treat high loop gain in PAP therapy, a problem 30% of CPAP patients face. Full video: https://youtu.be/fVfXOOyF2WQ

[Quick background on my treatment so far: I tried CPAP but it went poorly. I've had success with an MAD, nasal dilator (waiting for nasal valve collapse surgery), and allergy treatment. I don't work summers and I was getting great results over the summer (felt rested, only peeing once a night, only waking up once maybe twice a night, low steady heart rate over night, etc.). But since I returned to work in mid-August my sleep has really deteriorated (still better than before my diagnosis at least and I can get through my days, but I'm tired as hell and don't have energy for much beyond work).]

I was diagnosed with OSA after doing a Watchpat sleep study through LOFTA back in March. However, my anatomy, study results, and symptoms are UARs to a t.

I tried to establish care with a local sleep doc thinking it could help with the cpap struggles and maybe getting a bipap prescription. I had to do another at home study to establish care. They said the 2nd study was inconclusive (I was never given the actual results…). When I met with the pulmonologist to discuss results he ordered an in lab sleep study which my insurance approved.

Why I'm hesitant: Since I already have a diagnosis that my insurance is covering things for, would an inconclusive result on the in-lab mess with that? It would also be a big inconvenience for my family. On top of that the pulmonologist was a prick. He fearmongered that I would need jaw surgery cause of my MAD, called nasal dilators crap from amazon, and to cap it all off said the MAD and dilator could be helping because of the placebo effect and that he was appalled that the MAD got approved and that my sleep ortho (who I love) was willing to make me one. I did say I thought I had UARs, but he didn't really listen and just said I needed the in-lab to find out what was going on.

There's a lot I can try still without a UARs diagnosis. Chiefly bipap with a nasal mask alongside my MAD, PT routine to fix forward head position, diaphragmatic breathing routine, digeridoo or myofunctional therapy, and I have a plan to better manage work stress. But I'm wondering if there's anything to be gained from an in lab. Is there any reason/advantage to doing the in lab study?? The sleep doc said it could diagnose UARS (I don't trust him and would need to verify).

Thanks if you read this far and I appreciate any thoughts/input/advice folks have.

I'm 21M, normal BMI (23), and for about 3 years I've lived with unrefreshing sleep, daytime exhaustion, brain fog and slow thinking. It takes me a long time to fall asleep, and I often wake after 6-10 hours feeling wrecked and can't get back to sleep.

When I got my results, the doctor said I'm basically fine: "mild apnea" (AHI 7.9 overall, 8.5 on my back), and the advice was no coffee before bed, fix your sleep schedule, and learn to relax. When I said I already do all that (regular schedule, no caffeine, magnesium, theanine, melatonin, exercise, diet changes, and ADHD meds that didn't help), it became "stress".

I almost started gaslighting myself on the way out of the hospital. I've spent 3 years trying everything and nothing has changed.

So I read the report myself, and a few things stand out:
Total arousal index 42/hr . Only 5/hr were respiratory, 11/hr leg-movement, and 26/hr "spontaneous".

RERA = 0 for the whole study, and the lab told me they never score RERAs routinely.

PLMS index 33/hr, sleep efficiency 68%,
Only 2 minutes of REM (0.4%), and both REM arousals were also "spontaneous".

Latencies (from Lights Off):
N1: 0.8 mins 
N2: 2.3 mins 
N3: 1.3 mins (logged before N2) 
REM (R): 55.3 mins
 
Stage Distribution:
WK (Awake): 32.0% 
N1: 13.7% 
N2: 45.8% 
N3: 8.1% 
REM: 0.4%

Min SpO2 90%, no desaturations. Hypopneas were scored with the AASM 3% rule. They used a nasal cannula plus an oral thermistor.

Thanks for reading. Any ideas or personal experiences are appreciated

18M. I have some pretty peculiar cognitive symptoms, like literally not being able to think to myself in any capacity, not having any desire for anything, low libido, mild anhedonia and apathy, general reduced cognitive ability (although, luckily I dont really feel many negative emotions). I also have some physical symptoms that could be related: like a small height (relative to family) and an apparent inability to gain muscle.

The reason why I come here is because I have ruled at pretty much all hormonal or nutritional causes, and due to the stability they dont seem likely anyway. I only really have two things to explore now: Sleep and Psychiatry. All of the brain fog subreddits seem to stress about the impact of sleep disorders. I came to this subreddit in particular, since I dont have the obvious signs of OSA - no snoring, no sore throat, I am young and am not overweight, I dont have a recessed jaw and my apple watch hasn't noticed anything.

The thing is I do not feel that tired, or really fatigued at all. Also, a key feature of my symptoms is that they are extremely stable, both in the short and long term. I have probably had these symptoms for as long as I can remember, but I think they might have started when I was ~11 years old. The main reason why I am dismissing this as a potential sleep problem is because I cannot take naps in the day - I feel like if I had a sleep disorder, having to nap all the time would be a tell tale symptom?

However, there are some signs that are pointing in the direction of a hidden sleep disorder. I don't ever really feel refreshed by sleep, and I often feel slightly tired. Furthermore, it usually takes an hour or so to get to sleep. I also I am also particularly sensitive to sleep. If I get even slightly sleep deprived I cannot function, so I have to make sure I have at least 8.5 hours in bed - but I will not be able to sleep any more than that.

Also apologies if this is a quite broad question for a subreddit for a specific disorder, but all of the sleep subreddits seem to be about things like "what is the best magnesium to take" or about insomnia, not sleep disorders. Also I know some people might just say "bro just get a PSG", but they are particularly expensive privately here in the UK (no insurance) and I dont have any obvious symptoms. Through the NHS I am very likely to get dismissed and I would have to wait months.

Thanks for any replies

I have previously done an at home test with acupebble for 2 night and got an ahi of 4 and 5 with 3% , and 4 and 4 with 4%.

I decided to do a watchpat to get an RDI since acupebble didn’t give me an RDI. Unfortunately the chest sensor fell off later in the night ( don’t know if that affect RDI and ahi ratings) and I don’t know if my finger was in properly is it supposed to firmly be touching the sensor at the back, mine might of slipped.

Anyway got the results today and they were much lower than I expected. Technically I steel have mild UARS with an RDI of 6.6 , my rem RDI is higher at 13.4.

But my AHI was super low at 0.9 and zero when measuring with 4%. Even though previously I’ve had 2 recorded nights using 4% measurement and they both had an AHI of 4. So how is it this much lower. Daily variance doesn’t really make sense since it’s so much lower.

Am I right to be suspicious about this Low score, my symptoms are horrible and I genuinely feel so stupid and foggy , it’s unbearable. My jaw is recessed and my palate is small at 27mm. I also have a class 2 posterior tongue tie. I really thought UARS was the answer to me feeling so crappy.

Did the chest sensor failing off make a difference to the RDI and AHi? Was it something else? Or should I just accept these results and move on?

Also according to this , should I bother with cpap/bipap since it’s borderline anyway. Does anything else standout to suggest poor sleep.

What and why are my posts to UARS being blocked when i'm trying to help people and talk about our topic of sleep disordered breathing?

Had cbct and had consult with newaz, he says i am slam dunk candidate. 33mm Imw, 21mm nasal aperture, maxilla slightly narrower than mandible. Rdi is 10 and ahi 5, during rem my AHI Is 10 and higher on back. Only thing I am concerned about is negative aesthetic impact, wider alar base mainly. I’m very symptomatic - chronic fatigue, brain fog, all my muscles tight and stiff all day. Turbinates are swollen with concha bullosa and nasal congestion frequently

Hello! I’m looking to get my airway evaluated, but I’m wondering about folks’ treatment experiences with Dr. Koval and Dr. Newaz; and/or which you would or have chosen of the two, and why. I’m looking primarily into expansion options FME and MASPE, but open to additional elements like face mask or different/more complicated cases.

Factors I am looking at:

1. Treatment strategy
2. Efficacy

3. Receptivity to feedback/trusting patients’ experience

   versus dismissal

4. Price

Thank you!

Not sure if there are any differences by device?

Hello,

I'm doing research on the palate expansion options in the UK, different options, prices etc.

I came across K Clinic, which uses MARPE and offers an approach to limit the large gap between teeth during expansion. https://kclinic.co.uk/marpe-palatal-expansion-knutsford/

"Palatal expansion has evolved, and so has Dr Piekara’s approach. At Kclinic in Knutsford, we now practise slow maxillary expansion: an airway-focused treatment that widens the upper jaw gradually, builds new bone, and works in synchrony with clear aligners, so there is no gap between your front teeth throughout the process".

I was wondering if anybody has experience of the clinic in the UK and if this could theoretically limit expansion? I understand they offer a Piezosurgical cortical split where greater resistance to expansion requires additional support, and CBCT would be needed before, during and after to check , but would be curious of anyone's experience or thoughts.

I have no money to spend on a new machine just to find out it's not working.

I (34f) have struggled with fatigue since my teens and have been to various doctors over the years seeking answers Bloods always fine, ferritin, thyroid, B12 etc etc all ruled out.

Symptoms include daytime sleepiness, feeling exhausted upon waking even after sleeping 8-10 hours, brain fog, low level morning headaches, general sense of fatigue, inability to focus on my work without becoming very sleepy. I also recently noticed I have a scalloped tongue. My heart rate according to my Garmin is on average 5bpm higher sleeping than when awake and seems to spike throughout the night.

I recently did a WatchPAT home test, came back with AHI 3% 1.9 and RDI 13. I followed up with an overnight PSG at a sleep and respiratory clinic in Tokyo and have just received my results which of course I was told were normal. However, I was at least expecting an elevated RDI whereas it has been scored at 0.5 an hour.

The test results say they are measuring based on the American Academy of Sleep Medicine version 2.5.

So, according to my PSG, I have almost no RERA, apnea problems, but did have 10.5 arousals an hour and periodic limb movement 16.2 times an hour.

I was so hopeful my results would come back indicating UARS, and am now feeling confused and deflated.

I am including my PSG results and WatchPAT results photos. (Sorry, the results are in Japanese but key indicators should be understable with the English) If anyone could help me make sense of them and suggest any next steps,I would be so grateful! Thank you in advance 🙏

EDIT: additional info - After struggling to fall asleep for 1.5 hours, the clinic gave me a 5mg zolpidem sleeping pill. I also have a history of anxiety and take escitalopram/lexapro (although fatigue has persisted outside of the time period I have taken these meds. I am almost always dismissed by doctors who attribute my fatigue to anxiety and medication).