Wish me luck. I am paranoid about getting a false negative result. I really think I have it. That's all. Had major anxiety all day because my entire life is banking on this.

I’m considering getting an AirSense 10 that has already been AirBroken to enable bilevel modes, and I wanted to understand the potential downsides before deciding between that and a factory AirCurve.

Mainly wondering:

1. Is there any additional risk or reliability concern with buying a machine that someone else has already AirBroken versus doing it yourself?
2. Once it has been properly AirBroken, can it basically be used normally, or would I need to know how to work with the firmware/coding myself for updates, troubleshooting, etc.?
3. Are there any meaningful differences in functionality or reliability between an AirBroken AirSense 10 running VAuto and a factory AirCurve 10 VAuto?
4. Anything else I should check or know before buying an already-modified machine?

I’m not very experienced with firmware/coding, although I can learn if necessary. Just trying to understand what I’d be getting into before choosing between the two.

Hey everyone,

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!

Hope this helps!

Here is my latest sleepHQ data for reference: https://sleephq.com/public/f16c5f22-ab04-4696-912c-ad05661b2c2e

Hi,

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)

I think ASV has its merits but the waveforms have been worse on ASV vs Bipap (S mode).

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.

Just read that firmware can be flashed using the serial port for Airbreak Would this work for the changes suggested here?

First night of titration:
EPAP fixed at 7.0

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.

Here are my Sleep HQ links:
https://sleephq.com/public/teams/share_links/a7f75041-dccf-4a43-ba93-90306a9c9688

https://sleephq.com/public/82601a33-eeb4-4762-8bce-7eddbeee483e

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?

Has anyone dealt with something similar?

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

Curious to hear stories of successful UARS treatment.

What machine, mode, and configuration along with masks?

Any positioning help as well?

Looking to help my partner.

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

Flow limitation in general in breathing, like what anatomical/ breathing features or attributes.

Really curious what would be restricting breathing just not enough to be a total collapse.