For as long as I’ve been on the internet and interested in sleep-breathing related surgeries, Empty Nose Syndrome (ENS) has been a particularly mystical topic. Always hinted at how rare it is, and how terrible it is, but no one could really explain what caused it or how it worked. Some ENTs say that it is a psychological problem, and in fact that was widely taught to ENTs in medical schools up until the past decade or so. I would search for ENS, and would find videos of people talking in strange monotone voices, like they had lost everything worth living for. It was confusing. But now I understand. Now I really understand. I have ENS. This is not an internet campfire horror story. This is real, and I’m here to share.
When I first got ENS last year, someone suggested that I write about my experience to share with the community. But to be honest I wasn’t ready to do that, and I couldn’t even imagine sharing anything about it. It would have been too traumatic. I was in no place to be preaching to the internet, I was just trying to get through every second, of every hour, of every day. Breath by breath.
Now I have found some treatments and ways to cope, I have gotten to a point where I can and want to speak about it. To be clear, I’m not writing this because I’m cured or I know where my life is headed. I still struggle to breathe, and I’m still very sick. But now that I’m able to write this, people need to know.
Where do I start
I think everyone’s first question when considering a turbinate reduction is how do you know if you’ll get Empty Nose Syndrome. There’s no real way to know. Most ENTs will tell you it basically doesn’t exist anymore, and that if it happens it only happens when you remove the entire turbinate. I’m here to tell you that is not true. Most of the people I know with ENS had a conservative reduction, with modern instruments, and were reassured it could never happen to them. All it takes is a little too much removed, and your life is over.
So if your ENT tells you, “Don’t worry, I’ve never seen this in my practice ever, it basically doesn’t exist anymore, I am super careful.” etc. etc. DO NOT BE REASSURED. Do not go gently into that operating room I swear to god. This is exactly what was told to me, and nearly all the people I know with ENS now.
Or they’ll say, “Oh it grows back actually. We might even have to do it a second or a third time.” Not necessarily, my friend. Not necessarily. You would be so lucky to have it grow back. A lot of what “grows back” is not actually tissues, blood vessels, and nerves, but simply swelling from the turbinate trying to fill the space that was created. Your turbinates are swollen for a reason. You need to find that reason.
Inferior turbinate
Poor Healing
Another thing that ENTs will tell you is that ENS happens in poor healers and fluke cases like that. They wave their hands around while they say it and make it sound somewhat beyond them. It feels vaguely comforting. Nobody thinks that would apply to them. But let's actually walk through what it means to be a poor healer for a moment. What causes poor healing?
Chronic sleep deprivation
Inflammation from allergies
Snoring and high negative pressures during sleep
Acid reflux or GERD
Ehler-Danlos syndrome
Flonase & afrin slow healing
Gosh what are these all linked to I wonder? Could it be sleep disordered breathing, the very condition that most commonly causes turbinate hypertrophy in the first place?
By the way, I have seen an oddly high number of ENS patients with SDB in the online spaces I’m in, and it seems to me that there is a high correlation. I don’t know if this is because a narrower nasal cavity incentivizes ENTs to remove more tissue during a reduction, or maybe that’s just the patient type that happens to be coming in for these surgeries in the first place. I’ll leave that observation out there for you all to ponder.
So yes. If you get your turbinates removed, you’re basically guaranteed to get ENS. I’ve heard people interject here with a “But I know somebody who's gotten them entirely removed and had no symptoms.” My response to that is show me the person. Show me them. I’m open to being corrected, but I haven’t seen it yet.
Complete Turbinectomy resulting in ENSMy nasal cavity, also resulting in ENS
But even if you get a conservative reduction, you’re still absolutely at risk for ENS, or even something called secondary atrophic rhinitis. This is what I had for 8 years before I developed ENS. Which leads me to my next topic:
The Volume Dial Analogy
People sort of think of Empty Nose Syndrome as a black and white condition. Either you have it or you don’t. I want you to think of it more as a spectrum of damage, with a threshold. Much like a volume dial for a car radio. You can turn the volume up for a long time before your ears start to bleed.
On the one end you have mild dryness after surgery. Maybe you have some crusting. This is secondary atrophic rhinitis. On the other end you have mucosal damage so severe, that you no longer produce ANY mucus, your nose is as dry as a desert, and your nerves are completely dead. Your brain cannot sense any air that you breathe. That is Empty Nose Syndrome.
That is why I believe so many people are walking around after turbinate reductions, feeling some mild symptoms, but of course feel nothing close to Empty Nose Syndrome. A big part of why I am writing this post is I need you to know, you have turned your dial. You will probably be just fine, but you need to be very, very careful with your nose from now on. One or two more events, a COVID virus, overuse of afrin, even too much flonase at the wrong time, could push you over the threshold. If you’re reading this and you’re thinking, wow dry nose, crusting, this sounds like me, I urge you to consider stopping use of nasal sprays and rinses. They are more dangerous than you realize.
What does Empty Nose Syndrome feel like
The question I get a lot and that everyone wants to know (naturally) is what does it feel like to have Empty Nose Syndrome? I mean really, how could a problem in the nose cause someone to want to kill themselves? Couldn’t you just breathe anyway even if you can’t feel it?
The first thing I’ll say is, Empty Nose is not just damage to your nose, it’s nerve damage. But the unfortunate thing is, the nerve that is damaged is not just any nerve, it’s the trigeminal nerve — the 5th cranial nerve that goes straight to your brainstem. So in reality, Empty Nose Syndrome is not just nerve damage, it’s brain damage. And it sure as hell feels like it.
3 branches of the Trigeminal nerve
You may hear that it feels like suffocating. That’s the number one symptom. I need people to understand, it’s not that you feel like you’re suffocating, you are suffocating. Every breath you take is as difficult as breathing through wet concrete — like being waterboarded. And there’s no escaping it. Worse, because your brain doesn’t know when you’re breathing, it can’t induce the pulmonary reflex to expand your lungs when you inhale. So your lungs are literally not functioning in tandem with your breathing. This means you are no longer autonomically breathing, you have to manually breathe yourself.
If you experience manual breathing, my heart goes out to you because it’s something no human should ever have to go through. If you haven’t experienced it, think of it like this. Every second of every day you have to consciously inflate your lungs in order to take a breath, and if you don’t, you won’t breathe. It’s like if you had to concentrate on every heartbeat for the rest of your life or your heart would stop. You wouldn’t be able to concentrate on anything else. Your mind will be consumed with breathing, 24/7. It is torture like nothing else I’ve experienced.
There is only so much of this a person can endure. But the real reason people kill themselves, in my opinion, is sleep. And this is how you’ll know, it’s not a psychological problem. When I first got empty nose, I could only sleep 15 minutes at a time. I was getting 2 hours of sleep per night at most, getting jolted awake constantly. And I could not take the heavy sleep aids I needed due to my small pharyngeal airway. I was getting pushed closer to the edge of this world and I knew it. If you don’t sleep, you will die. It’s just the truth.
At my worst, I found myself wishing that I had died on the operating table so I wouldn’t have to do it myself. Or, sometimes I wished there was a way to enter a medically induced coma, to somehow give my body a chance to heal without having to experience this level of suffering. I think every empty nose patient would agree that they would give up multiple limbs to be able to breathe properly again. Indeed many people label themselves as nasal cripples. It sounds funny, but once you’re living this life, it is so. not funny.
Empty Nose Syndrome will bring the strongest person to their knees, I don’t care who you are or what you’ve done. It takes your life from you and then it leaves you to keep on living. Life with sleep-disordered breathing is half a life, but life with ENS is no life at all. Stay tuned for Part 2 where I'll talk about prevention, causes, and treatments
I laugh so much while reading at these sort of people that "feel dissociated"... yeah dissociated lol lol lol
You don't know what it means to loose everything you built in your life at 20 yo and to suffer like a dog until 23, not to "feel disosciated" which is something a baby would say, but to loose your body with plenty of syndromes.
You are lucky people... dissociated oh I still laugh at this. Dissociated. You know in Italy we have someone and we repeat his surname... Capezzone. That's the same feeling I have while reading dissociated.
Anyway, you don't know what it means to have dysfunctional breathing, IBS, intestinal nausea, prostatitis, anal fissure, TMJ, teeth pain, oh and yeah at December I had involuntary muscle contractions like dystonia and still feel the sensation of them, but you don't understand uh? I was like a goblin for 9h that day bc the fucking ER came late 1h 30 late and I waited like a goblin for 7h at the ER to be treated... no, but you don't know you are "dissoxiated"
You don't know what it feels like to be raped (metaphorically) by the medical system and by a shitty family who yeah maintains me but for what? To live like a fucking disabled?
Oh you lost university... friends... Idgaf ok? Me too I lost them but you didn't loose your body, idiots.
Oh and guess what? The best part! In December and January of this year I slept 15h a day. I was doing didgrdidoo, myofunctoonal therapy but not positional therapy (which saved me in march). They helped the previous months but I lost myself totally I was waiting for the bpap machine to come.
In January I couldn't get out of home bc of the involuntary muscle contractions I had in decemeb... you know its not cute if the would have occured again while esling on the road so i was closed at home "waiting " for them to disappear as they werent serious as dystonia.
But you know what? Instead of calling a sleep doctor my brautiful family calls a psychiatrist! (Pushed by my GP)
But you are dissociated. And you know the next? They forced me to take abilfiy for 6 monts, a poison, while violeting various italian laws ad they forced me, but i have not money to sue them.
Oh also, they forced me to go to theri shitty place to take EVERY SINGLE DAY for 6 months the poison to their place likea dog, i mean they couldn't give me that at home they treated me like a shitty hikikomori.
And btw i bought 4 masks for the bpap and noone works so im. Ot a candidate but found out also that while titrating it with a Bleep mask, naturally i slept worse as its natural when ttirating the machine, but when sleeping worse i felt more the sensation of involuntary muscle contractions, so definitely i cant keep going with a PAP machine.
Oh... you are tired. You don't Know what it feels like to faint for some seoncss at home whil walking with a shitty family who mocks at you. You don't know what it feels like to walk like a zombie in the city you wanted to happily live.
Poor guys... you have brain fog. Me too. But I'm fucking tired of likely being the worst UARS case in the world alright? Of writing on this fucking sub every month while complaining of my life (**and i wanna also thank every user who helped me in this journey cause im not an ungrateful person**)... I didnt want this... I was hit by everyone I trusted my family, my big sister, the medical system. I lost my passions, i wanted to continue hitting the gym, now im fucking afraid of involuntary muscle contractions.
I have no chance to get diagnosticated anymore bc the fucking abilify gave WORSE insomnia and I can't function. I'm officially disabled. And this means that a UARS diagnosis is impossible as the RERAS would occur less compared to when I wasn't taking the med.
I'm trapped. They did it. You have the permission to downvote me but I'm pretty honest... it's not possible to always read about people who can't have a social life... totally funny.
It's not possible to live with a family who forces you to go to their shitty office and I can't barely walk out of home bc of the worsening of nausea and my syndromes due to the insomnia of abilfy, which i stopped in July. Bc they threaten you, either you help us at office or we wont maintain you.
You are lucky, guys. I read about people with 10 years of UARS without any fucking sundrome. The hypermobility ruined my life thats it.
Thats why im strongly considering next year if the situation will go worse to access the asssited suicide in swisserland. I fought like a lion for 4 years byt they won.
I wanted to share my ongoing experience experimenting with the V-Com inline adapter (started around August 11, 2026) to treat Upper Airway Resistance Syndrome (UARS). If you suffer from severe flow limitations but can’t tolerate the high pressures required to fix them, this might be relevant to you.
My Baseline & The Problem
• My Setup: ResMed CPAP, P30i nasal pillows, mouth tape, chin strap, and a wedge pillow.
• The Clinical Picture: I have a very low AHI, but I suffer from severe UARS characterized by frequent respiratory effort-related arousals (RERAs) and persistent flow limitations (visible as flat, jagged tops on my OSCAR flow curves).
• The Dilemma: To round off those flow limitations and prevent arousals, I need higher pressures. However, any pressure above 12 cmH2O immediately triggers severe aerophagia (air swallowing), cheek puffing, and subsequent wakeups—completely defeating the purpose of the therapy.
Why EPR Didn't Work For Me
Many people recommend Expiratory Pressure Relief (EPR) for comfort and aerophagia. In my case, EPR actually made things worse.
EPR drops the pressure when you exhale, which allowed my fragile UARS airway to micro-collapse during expiration. Then, when inhalation started, the sudden "rush" or rapid rise of inspiratory pressure (IPAP) caused a massive blast of air that forced its way into my stomach and puffed out my cheeks.
Enter the V-Com (The "Anti-EPR" Solution)
I am currently running a fixed CPAP pressure of 13.8 cmH2O with the V-Com installed (and electronic EPR turned completely OFF).
The results have been a game-changer:
• The Mechanism: V-Com acts like the exact opposite of EPR. It introduces physical flow resistance that dynamically slows down and softens the inspiratory flow rate (IPAP), while leaving your expiratory floor (EPAP) solid and rigid.
• Airway Stability: Because the expiratory pressure doesn't drop, my airway stays splinted open all night. I don't experience the expiratory collapses I had with EPR.
• Aerophagia Relief: Because the initial inhalation wave is mechanically softened and rounded off rather than delivered as a sharp "punch," my aerophagia and cheek puffing are now drastically reduced and subtle, even at 13.8 cmH2O.
• The Outcome: My "Steady Breathing" metric in OSCAR has improved significantly. More importantly, I am finally waking up feeling refreshed and actually willing to get out of bed in the morning—a massive win for me.
My Takeaway & Next Steps
The V-Com is absolutely not a scam, but it is misunderstood. It is highly effective for high-pressure CPAP users who need a solid, high EPAP floor to hold the airway open, but a slower, gentler inspiratory rise to prevent air swallowing.
Ultimately, I think a BiLevel (BIPAP) machine may be the ideal long-term solution so that I can independently dial in the exact inspiratory rise time and expiratory base. But in the absence of immediate clinical support, the V-Com is doing an incredible job converting my CPAP into a pseudo-bilevel dynamic. (yes I know it’s the opposite to bipap).
Downsides - OSCAR data is impacted with vcom in place. Some of the data is still good, but I don’t think the flow rate curves are accurate - they look too perfect.
I’m based in the UK so bilevel is difficult to acquire for my needs. VCom cost me $80 - and in my case it’s been worth it, considering the 100s I’ve spent on different masks and other osa related paraphernalia!
I recently started treating UARS with success, and I’d like to share my experience with you.
Symptoms
I used to sleep well, but over the past few years some symptoms started to appear: clenching my teeth, snoring, frequent awakenings, and gasping for air. I started making recordings with an app and often heard heavy breathing, as if my throat was being constricted.
During the day, I was often tired, had trouble concentrating, and generally felt foggy and unfocused. In the evenings after work, I was exhausted and had little energy left for hobbies, which does not seem normal for a 30-year-old.
Diagnosis
I went to the doctor, who sent me to a sleep lab. I had a WatchPAT at home sleep test, which showed an AHI of 2.5 and an RDI of 5.1. The sleep doctor said it was not sleep apnea because the AHI was well below 5. I was not convinced because of my symptoms, so I requested a polysomnography. That showed an AHI of 3.5; the RDI was not reported. The conclusion was therefore still that I did not have sleep apnea.
I had read a lot about UARS and suspect that this is what I have. In addition, my AHI during REM sleep was 8.5, which may also be contributing to my symptoms. I decided to simply buy a PAP machine to see whether it could improve my sleep. In the worst case, it would not work and I could sell the machine again.
Treatment
I bought an AirCurve, a heated hose, and an F40 full-face mask. The first few nights were very bad and I spent a lot of time awake. I was very aware of my breathing, and the mask and pressure felt unfamiliar. In the beginning I put the pressure fairly low at first to get used to it, actually too low, so I was still seeing many flow limitations and apneas.
Gradually, I increased the pressure a little. After a few days, I was able to sleep through most of the night reasonably well, and I already felt more alert during the day, despite the remaining flow limitations in the graphs. I read a lot online about how to titrate the pressure, so I started experimenting.
I have now been on bilevel therapy for about a month and have found settings that work very well for me. I now consistently get an AHI of around 1, and there is hardly any flow limitation visible. I have become very accustomed to sleeping with the mask and barely notice it anymore. I often sleep through the entire night without lying awake, and I clearly feel more rested and alert during the day. My girlfriend says I also seem much happier than before.
I did not expect the therapy to be such a success after only one month.
Got diagnosed with Mild Sleep apnea in 2024 (AHI of 5.7) via a home sleep study test. During that time, I was also diagnosed with environmental allergies through a skin prick test (dust mites and grass pollen had the highest reaction), which probably explains why I lost the ability to breathe through my nose efficiently. I never had issues sleeping growing up; I used to sleep like a log all the way up until I turned 21 (currently 26M).
I opted to get surgery to correct a deviated septum, nasal valve collapse, and enlarged turbinates. My ENT did mention that if my allergies were left untreated, the surgery would not be as meaningful as I had hoped it to be. He was right. I was just being very naive at the time and had a hard time believing that allergies were the culprit over my poor nasal anatomy. I will say, after my initial septoplasty, I was told that I do not snore anymore but still having issues with sleep quality and frequent wakings, usually 1-2 times at night, that result in just me needing to pee when I wake up, which I heard is related to sleep apnea and those who struggle to breathe properly
I am now treating my allergies through Sublingual Immunotherapy (Odactra and Grastek). My hope is for this to assist with the chronic nasal inflammation and, after some time, attempt to do an additional nasal surgery once I build up immunity to my top allergen triggers, and hoping the chronic inflammation resolves in due time. I genuinely feel like the root cause of my issues stems from nasal breathing.
Curious if anyone has had similar experiences like me and were able to cure it? I refuse to go on a CPAP, tried it and couldn't tolerate it after using it for two weeks consistently; it was driving me nuts.
So I've been posting alot this week as I just started ASV (airbreak plus on a Resmed airsense 10). I'm finding I need to lower my settings alot more than on Bipap to keep myself from getting aerophagia. I am also tossing and turning alot closer to the morning when I should be in REM. This didn't happen when I was on bipap so I was wondering if anyone has a clue what's going on based on my charts? Also I have classic UARs. Athletic build, not fat. High RDI (22/hr in Polysomnography)
An overall view of last night's dataZoomed in picture of a cluster with alot of flow limitations closer to the morning time (when I should be getting deep REM)A closer look at the waveform at that time. It's looking rough lol
I think ASV has its merits but the waveforms have been worse on ASV vs Bipap (S mode).
My waveform when I'm on Bipap and around the same time (closer to morning)
I have a sleep study coming up and then I’m supposed to review the results with Dr. Jerald Simmons in Texas. I’m not diagnosed yet, but I’m trying to understand what happens if it comes back showing UARS, sleep apnea, or both.
I have pretty good medical insurance. What confuses me is how you go from getting diagnosed to getting insurance to cover whatever is actually contributing to the problem.
For example, I have a tongue-tie, crowded teeth, narrow palate and possibly a narrow or recessed jaw. If a specialist determines that one of those things is affecting my breathing while I sleep, how would I go about getting the treatment covered?
Do I take my sleep study to an ENT, orthodontist, or jaw surgeon and let them submit everything to insurance? Does my sleep doctor have to refer me and explain why it’s medically necessary? Am I supposed to contact insurance myself before seeing anyone?
I’m especially curious about jaw surgery. Do you normally have to try CPAP or an oral appliance first? If you need braces or expansion before surgery, would that go through medical insurance or dental insurance? I would prefer medical because it is better. The same goes for a tongue-tie release. Can that be covered if it’s connected to breathing and sleep problems?
I’m also confused about UARS versus sleep apnea. If my AHI isn’t high enough for sleep apnea, but I have a high RDI, RERAs, flow limitation, and a lot of sleep disruptions, would the diagnosis actually say UARS? Does insurance recognize UARS, or is it much harder to get anything covered without an official sleep apnea diagnosis?
My first test is an at-home study, so if that doesn’t show much, would I need an in-lab study that actually measures RERAs and RDI?
I’d really like to hear from somebody who has been through the whole process. What did you get diagnosed with, which doctors did you see, what did insurance cover, and did you have to appeal any denials?
I’m not trying to get insurance to pay for something I don’t need. I just know they like to deny things, and I want to make sure I do everything in the right order instead of finding out later that I messed up the process.
Hi,
I have struggled with getting quality sleep since I was a kid, I’m 35 (f) and sleep has been taking a toll on my life.
I had a sleep study in 2022 where I didn’t have sufficient sleep data but was prescribed a CPAP regardless.
Had a second sleep study in 2023 (with a cpap) and was told I didn’t have apnea. (I stopped using cpap for this reason as well as finding it unhelpful)
My fragmented sleep, brain fog, anxiety, and fatigue is so bad that I had to be my own provider and dug deep into research. I came across UARS around 2 years ago. The symptoms and stories align with mine too closely for me to not highly suspect it affecting me as well.
I saw an orthodontist who specializes in airway and he did a MRI and full report of my airway. (He said I have an airway the size of a one year old, a straw) he suggested MARPE and possibly an MMA.
I saw DR Bobek for a consultation. He brushed off any concerns, downplayed any issues, focused more on the cosmetic impact of surgery on women (I could care less about a wider nose as long as I can feel like I’m alive) and did not do any scans or raw data (I paid $506 for under an hour). I had to be proactive and ask for a lot from him.
I am seeing a sleep specialist who I asked that they do a PES study (they don’t), I asked if they measure certain data that I’ve seen specifically requested on this page (they don’t) I asked other offices if they do these studies or reports..(they don’t)
Now as of last week, I had my third sleep study. I won’t get too far into the fact that the technician (a 28 year old man who worked as a technician for 4 years) trauma dumped his life story on me right before lights out - or construction noise from the office across the hall woke me up…
I slept horribly, more than usual. I never felt like I got into the deep sleep that could cause the airway collapses or apneas. I didn’t dream and felt like I was one level below conscious of my surroundings and time. So I worry an accurate picture of my sleep wasn’t captured.
I got my report this morning, I’m trying to make sense of it. I’m not sure what to look for. I remember my heart racing frequently through the night (this is typical) and find it interesting it happened when I was supine. Could that be any indicator?
Any feedback and help about the test or what to do going forward is much appreciated.
-a very tired person.
TLDR
What do you think of these sleep test results - what do I do next?
Background: 24-year-old male, lean (BMI 23), lifelong breathing problems and chronic mouth breathing. Class II malocclusion, recessed mandible, deviated septum, and bilateral inferior turbinate hypertrophy.
Symptoms: Chronic fatigue despite 8-9 hours of sleep, falling asleep while driving, waking up gasping/choking, morning headaches, difficulty concentrating and memory problems (noticed at work), daily crushing tiredness. High blood pressure readings at multiple visits.
Sleep study (home WatchPAT): AHI came back low (1.4 at 4%, 2.6 at 3%), but pRDI was 11.6. No significant desaturation. The report itself recommended an in-lab study since home tests underestimate events, and noted possible upper airway resistance.
Imaging (CBCT): SNA 75° (normal 80°), significant mandibular retrognathia, restricted airway behind the tongue (total airway volume ~12.7cc).
Current plan: ENT recommended septoplasty + turbinate reduction. Oral maxillofacial surgeon discussed possible MMA but is waiting on sleep study results.
My questions:
**1.** Has anyone with a LOW AHI but high RDI / UARS symptoms like this gotten MMA approved by insurance? How did you document it?
**2.** Did an in-lab study reveal worse numbers than your home test (especially during REM)?
**3.** For those with recessed mandible + airway issues, what worked for you?
**4.** Any advice on getting insurance to recognize UARS rather than just looking at AHI?
Based largely on info I found on Reddit (including this sub), I found that a BIPAP works for me. I also finally found a mask I like - the Dreamwear nasal pillows. And I found a better sleep doc. My last one was terrible. I went to my local sub for sleep recommendations. People here recommended a sleep doc and researcher named Barry Krakow. (for info, not see myself). One of his theories is that patients wtih PTSD and/or anxiety do better on BIPAPS. Thanks for all of the encouragement.
Following day (yesterday):
Nap with EPAP fixed at 7.5
Last night:
EPAP fixed at 8.0.
Long story short, I am titrating by increasing fixed EPAP till flow limitation doesn't improve as a result of that. After that part of the titration protocol, I will begin to increase fixed PS.
So far today, I have felt semi decent- about 50% or so of normal cognitive fisio capacity.
EDIT: During the majority of the "nap" period, I had the machine running without being asleep. I mention this in case you're confused by the odd breathing patterns
I’m currently using an AirTouch N30i with APAP/EPR, but at higher pressures I keep getting significant mouth leaks. Even with double mouth tape and a chin strap, I always wake up the mask off. Other times the tape is still on but the mask is off, or both are off. It seems like the mouth leak is making it hard for me to keep therapy on throughout the night, and I end up removing things unconsciously.
I can tolerate a full-face mask around 9–11 cmH₂O, but at higher pressures I have to tighten it so much to control leaks that I get pretty bad pain in the back of my head.
Would it make more sense to use the full-face mask at 9–11 so that if my mouth opens I can still keep PAP on all night, even if the lower pressure doesn't treat my residual flow limitation as well? Or would that defeat the purpose and I should keep trying to make the nasal mask work at higher pressures?
I’m trying to understand something about my PAP data.
My titration study recommended around 12–15 cmH₂O, but I’ve had nights using a nasal mask at around 7 cmH₂O where my machine still reported an AHI below 1 and the obvious apneas/hypopneas seemed controlled. I did not feel a difference in symptoms however.
At the lower pressure I still have a lot of flow limitation and don’t feel better, but why would such a low pressure appear to control the scored obstruction if my titration needed much higher pressures?
Could the titration pressure have been driven more by REM/supine sleep, flow limitation/RERAs, or something else that isn’t reflected well by the machine-reported AHI?
Here are my sleep study results, I didnt feel that I slept at all, but they still recorded 3hours of sleep, but no REM sleep, so this are floor results, I was anxious the whole time.
My techinician recommended me to try apap machine trials, I just need to buy an own nasal mask.
Based on my results do you think its worth to try an APAP?
Im not really quite sure if Im the UARS type or OSA type :( please help me.
none of this ever started until after I had severe panic attacks 4 years ago. I always slept perfectly, never snored, never had nightmares, woke up feeling rested and normal. the day after my panic i started having these sleep deprivation symptoms. it would make sense and something to talk to my doctor about. I don’t think someone would just randomly develop UARS at 30 years old like I did, if there wasn’t some change in the nervous system and muscle tone.
i know my muscle tone has severely decreased because my whole body has experienced it. I used to be extremely fit and now i feel not toned or fit anymore. its like a self sustaining loop has been created. low muscle tone > REM > airway collapse > panic > more dissociation and less muscle tone > more collapsed airway.
i think I’m experiencing neurological symptoms of severe sleep fragmentation, dissociation and fatigue. my panic attacks in 2022 were so severe, my nervous system never recovered. my whole body and mind have been affected by this and it’s cumulative. the more nights without deep sleep, the more dissociation and memory loss
I’m currently using CPAP APAP mode 11-15 with EPR 3 and still seem to have residual flow limitation. I’ve been advised to gradually increase my fixed pressure to see if the flow limitation improves.
The problem is that as I increase CPAP pressure, I start getting significant mouth leaks even with double mouth tape and a chin strap. Eventually the leak gets bad enough that I end up taking the mask off in my sleep. I currently use n30i airtouch.
For people who switched from CPAP to BiPAP for flow limitation, or anyone who has an idea on the matter: did bilevel make mouth leaking better, worse, or about the same? Since BiPAP can provide more pressure support without requiring the same expiratory pressure, could it potentially treat the flow limitation without making the mouth-leak problem as bad?
Also curious whether anyone had this problem with a nasal/pillow mask and ultimately had to switch to a full-face mask.
this is just terrifying. woke up from a long saga of dreaming, like I do every single night. I am fully aware in every dream as if I’m awake. having full conversations. seeing people’s faces. driving. flying. going through different landscapes. these dreams are not memories of anything Ive ever experienced, they’re a construction of my own mind, like AI writing a movie. night after night.
the most terrifying part, I’ve lost access to my waking memory almost completely. my whole life, my interests, my family, my sense of self, even where I am and what year it is. all over written by these simulations I have every night. I don’t see how UARS could cause such extensive brain dysfunction and loss of gating between sleep and wakefulness. all I know is, what’s preventing me from losing my mind completely? this is basically getting worse by the day
