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[Diagnosis] Newbie - Potential UARS - Advice appreciated !
#1
Newbie - Potential UARS - Advice appreciated !
Hi All

I am new to this forum - I have suffered from fatigue/sleepiness/headaches/brain fog/GI symptoms/anxiety/depression/morning headaches and sore throat, for years, and after intensive investigations down the usual routes (endo/gastro etc) have turned up nothing, I am suspecting that SDB may be behind some of my symptoms. I am also waking up in the night with night sweats. 

I have recently done a WatchPAT home test. I am in the UK  and I am without private healthcare, which means that in absence of analysis from a qualified sleep lab any time soon, I am trying to manage this myself to improve the symptoms. 

WatchPAT results were as follows:

Total Sleep Time - 5hrs9min
% REM - 19.2%

Respiratory Indices
RDI
Total Events: 61.  REM: 16.4      NREM:10.8      All Night: 11.9

AHI: 0.2/HR

RDI: 11.9/hr (indicates airflow limitation according to report)

Minimum SpO2 94%

I am a 25 years old male, of thin/slender build.

On the back of this I have hired an APAP machine (Resmed S9), however I have not yet used it...  I think I may be in denial somewhat, and I am reluctant to use it ! 

I was hoping to get some advice on the following...
1) Based on the above, is it possible that this is UARS? Would this be consistent with my results?
2) Would the APAP i have be any use for addressing the symptoms?  If so can you recommend settings and how to best titrate this?
3) I have seen that BiPAP may be useful for treating this condition, is there likely to be any use of the APAP I have or am I best going for a BiPAP ASAP?

Thanks in advance. 
Shaun
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#2
RE: Newbie - Potential UARS - Advice appreciated !
UARS cannot be reliably diagnosed by a home study. It can be treated, however, in the same manner as obstructive sleep apnea. Your high RDI and low AHI indicate that you are experiencing a large number of RERAs((Respiratory Effort-Related Arousals) A RERA is characterized by increasing respiratory effort for 10 seconds or more leading to an arousal from sleep, but one that does not fulfill the criteria for a hypopnea or apnea.  They are treated by pressure support Which is an expiratory pressure lower than inspiratory pressure. Your machine has a setting called flex which will provide pressure support up to 3cm of water pressure and may effectively treat your problem. There is no way to know without more data. I suggest you try the machine with a minimum pressure of 6, a max pressure of 15, and flex turned on at a setting of 3. Download the free OSCAR software and post a daily chart as described in the links below.  Go here https://www.apneaboard.com/resmed-s9-cpap-setup for the instructions to access the clinician settings for your machine. I believe your machine will detect RERAS. Have you selected a mask. Getting the right mask and adjusting it properly can be a challenge. Please read the mask primer (link below).
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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#3
RE: Newbie - Potential UARS - Advice appreciated !
Hi Melman

Thanks for your reply. 

Thanks, I will try the machine tonight with these recommendations. Is FLEX the same as EPR? 

I have a Nasal Pillow mask, F&P Brevida - it seems to fit well and be comfortable. 

I have nearly used the CPAP a couple of times but found it really unnatural and unable to sleep, and therefore have given up and taken it off ! 

I am considering using an OTC sleep aid (diphenhydramine) to help me drift off with this tonight and to get used to it.... do you have any thoughts on if this would be detrimental to the therapy initially?

Thanks again for your help
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#4
RE: Newbie - Potential UARS - Advice appreciated !
[img]blob:http://www.apneaboard.com/3e14e768-42df-4afe-890a-9236ba086582[/img]

I have also spotted this, which would suggest that the S9 auto set doesn’t track RERAs - would this mean that the machine is of no use to treat my condition? Thanks
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#5
RE: Newbie - Potential UARS - Advice appreciated !
I have also spotted an image which would suggest that the S9 auto set doesn’t track RERAs - would this mean that the machine is of no use to treat my condition? I am unable to post images or links as a new member. Thanks
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#6
RE: Newbie - Potential UARS - Advice appreciated !
If you are referring to the daily report shown on the machine, you are probably correct. My airsense 10 doesn’t show RERAS either. OSCAR software uses the data recorded on the SD card to determine and report much more than is shown on the screen or is available in Remed’s MyAir ap., including RERAS. The S9 should be capable of treating your condition unless more pressure support is required. We won’t know without data. Using a sleep aid should not affect your treatment. I suffer from insomnia as well as obstructive apnea and use medication for sleep every night. My APAP treatment is quite effective.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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#7
RE: Newbie - Potential UARS - Advice appreciated !
(06-06-2019, 01:17 PM)SRW142 Wrote: I have also spotted an image which would suggest that the S9 auto set doesn’t track RERAs - would this mean that the machine is of no use to treat my condition? I am unable to post images or links as a new member. Thanks

RERA reporting is a new feature beginning in the AS10 series machines. With that said, the AS10 doesn't possess any additional features to treat them, it just reports that you may have had them.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Beginner's Guide to Sleepyhead and OSCAR
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Newbie - Potential UARS - Advice appreciated !
Sorry I misinformed you. I didn't know RERA reporting was new to the AS10 series.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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