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Do I have UARS
#1
Do I have UARS
Hi All,
I have had sleeping problems for a few years now.
Thy main symptom is waking up with a strong urge to go to the toilet. I wake up about 4-5 times a night and rarely feel refreshed.
My memory is shot and i have a hard time concentrating, sadly. I need help. I need to fix this.



I have a healthy BMI, non smoker. A couple of drinks a night.
I've always had nasal problems and have had Nose surgery in the pain to clear out the nostrils and Jaw surgery to fix an open bite - around 10 years ago.
I do snore - scores on snorelab range from 15-50. I am unsure if i am a mouth breather however i do wake up a slight dry mouth regularly.
Susceptible to allergies. E.g Dust and pet.


Weirdly, sleeping tablets help. When i take one/half my snore score is in single digits! I feel like i get a much better sleep. Maybe arousals psychological?


I did a home sleep study and also a head CT scan of ariways recently, results here : https://imgur.com/gallery/93PRPsi
Low AHI, high RDI.


Is there anything obvious that jumps out from the both scans and Sleep study that would help me?
I did try a CPAP machine for a couple of weeks and did not tolerate, admittedly i could have given it louder however as i understand a bilevel would be better for me?
I would like to avoid a cpap machine, are there other options i could try? E.g MAD device? Provent?

I live in Australia and if i need a bilevel machine i need to buy it outright, which will cost about 4k.

I am planning to do a hospital sleep study and see phumumologist.
I am trying to resolve this and up for a few things to try. Any recommendations? Anything that has worked for other people?
Thank you in advance.
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#2
RE: Do I have UARS
Welcome to the forum.

No obstructive apneas, only hypopneas, High RDI, means high RERAs, means high flow limits. Yes this means that there is a high that you have UARS.

CPAP machine, it is fairly normal to be very uncomfortable with initial settings on a "CPAP" machine. Was it a ResMed? ResMed CPAPs with their implementation of EPR beet all others for UARS. You need Pressure Support for UARS so a BiLevel is better for UARS. The model we recommend is the ResMed AirCurve 10 VAuto.

IMHO ALL CPAP and BiLevel machines need to be optimized to do their intended job and do it comfortably.
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#3
RE: Do I have UARS
We prefer bilevel therapy for UARS, and anyone that displays flow limitation, RERA, Hypopnea and similar events on CPAP. the Resmed Airsense 10 Autoset CPAP has EPR which allows bilevel pressure up to 3-cm (difference between inhale and exhale), however a Resmed Aircurve 10 Vauto is the gold standard bilevel because we have as much pressure support as necessary as well as trigger and cycle sensitivity and inspiration timing controls that can fine-tune pressure and timing to help individuals with chronic inspiratory airway resistance. If you have any data from your CPAP experience we might be able to help you identify the problem.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#4
RE: Do I have UARS
Thanks for the advice.
Ok i am going to do trial for a month. My understanding is that will start my on a APAP machine, and i will request a Resmed so i can share the results.
After two weeks that will go to fixed machine.
Its unlikely they will trial me a bilevel machine. So its going to make a huge difference for me if i try out an APAP rather than a Bilevel? Is there anything i should ask on my first appointment to trial the machine?
Thanks.
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#5
RE: Do I have UARS
A Resmed Airsense 10 Autoset (auto CPAP) will let us learn what your therapy needs are and will allow us to work with the EPR (exhale pressure relief) settings to reduce any flow limitation. These settings should be transferable to any fixed pressure CPAP by Resmed. Be sure to download and install the free OSCAR software so you can provide useful data here.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#6
RE: Do I have UARS
(07-01-2020, 02:45 AM)Johnson4 Wrote: After two weeks that will go to fixed machine.

Do you mean that they will provide you with a machine that can only provide fixed pressures?  If so, that is not acceptable.
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#7
RE: Do I have UARS
Hi All,

Thank you for your comments.
Sorry its been sometime but due COVID i have had some problems getting the machine.

So they are issuing me a Resmed APAP for 2 weeks, CPAP for one week then Bi level for one week.

They said they will download the data but can i also do it via OSCAR?

My concern is that i will struggle with APAP because of the UARS diagnosis but i guess i wont know till i give it a shot. Hopefully if i share the data with you knowledgeable folks/ladies you could help me understand if Bilevel would be a better fit for me?

THanks.
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#8
RE: Do I have UARS
(07-29-2020, 02:06 AM)Johnson4 Wrote: They said they will download the data but can i also do it via OSCAR?

My concern is that i will struggle with APAP because of the UARS diagnosis but i guess i wont know till i give it a shot. Hopefully if i share the data with you knowledgeable folks/ladies you could help me understand if Bilevel would be a better fit for me?

Yes, you can download the data, so long as you make sure to have the SD card inserted.

Don't worry about auto; auto with EPR (which is like a mini-bilevel) or full bilevel is the preferred treatment for UARS. 

The data from the machine will tell us how you do with the ABAP with EPR.
Caveats: I'm just a patient, with no medical training.
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#9
RE: Do I have UARS
Just to echo Slowriter, yes, if there are SD cards in those machines, you can download the data into Oscar. It would be helpful to see them, especially to know what settings you're trying. It will be equally important to know how you feel each day.

I have no idea why they're trialing you on a CPAP machine, when they could simply set your pressures on an APAP machine to mimic a CPAP, but I'm glad they're going to try you with a bilevel as part of this try-out period.
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#10
RE: Do I have UARS
           
Hi All,

Settings are 6cm - 14cm
EPR of 2

Ok i tried it last night and could really only manage about 3-4 hours.
I still woke up 2-3 times and towards the tail end found it difficult to breathe out.

I woke up with a dry mouth so i wonder if i was still breathing through the mouth.
Am i waking up due to RERA's?

Are the leaks normal?

Are the settings ok? I notice it starts on 6cm and must adjust when i am asleep.

Images attached.

Any insights would be appreciated so i can make necessary adjustments for tonight.

Thanks.
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