Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[Equipment] Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
#1
Question 
Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
Hello. I am a woman in my early 30s in the UK. I have had symptoms of sleep disordered breathing for years, did an NHS PSG several years ago which was scored using AASM 1B without RERAs, showed AHI of 0 but 60 unexplained arousals per hour, and was sent away with no treatment. 

Fast forward to 2022 - I found out that UARS exists, saw a consultant privately for a second opinion, and did a repeat study scored using AASM 1A which showed AHI 5.8, RDI 10.3, so mild apnoea (though he described my sleep interruptions as 'UARS-like', presumably because I have as many RERAs as apnoeas). It also showed severe and constant nasal flow limitation. 

I was prescribed an oxymetazoline nasal spray to use for three days just to see if it made a clear difference to my nasal breathing, and...yeah. Turns out I've never really been able to breathe through my nose very well, and only now do I recognise the difference (though my sleep was no less fragmented while I was on the spray). I kind of wish I'd never tried it because now I am super aware of how congested/inflamed my nose is at baseline. I've been on steroid drops and an antihistamine spray for three weeks, but am not seeing much change in my nasal breathing yet. Breathe Right strips help a little, but no miracles. I'm awaiting an ENT appointment in a month's time.

Meanwhile, the OSA remains untreated and I am miserable and exhausted, and still wake up so often and so full of adrenaline that I am only managing to squeeze in about 5 hours of sleep a night. My consultant will only refer me directly to ResMed to get a machine, but my preference would be to try the AutoSet For Her 10 since the algorithm is supposedly better-attuned to more subtle breathing interruptions, and it turns out that ResMed in the UK is out of stock of the AutoSet For Her indefinitely. 

So I am now considering just importing a refurb machine. But that also means I can't try on masks, and just have to pick one. I have absolutely no idea where to start with this. There are so many. Where do you even begin?

My consultant has also warned me that I should try to unblock my nose before even trying a CPAP since it will likely make my nasal inflammation worse. I'm unclear as to whether this would also be the case if I were to use a full face mask (he seemed to think they were too uncomfortable to be worth considering, but you know what else is uncomfortable, only getting 5 hours of sleep a night). 

Is my consultant right, and I need to just tough out the OSA until the steroid drops start to work? If not, where do I start with masks? Nasal mask? Nasal pillows? Full face? What brand/type should I start with? How do you even begin to narrow it down? 

Any advice anyone here can offer would be hugely appreciated. I am pretty desperate for sleep at this point.
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
Hi Pod153,

The for her only treats OSA up to a pressure of 12cm water. Without doing a titration you do not know what pressure you need to treat the OSA.

AutoSet for Her mode
AutoSet for Her mode is based on key aspects of ResMed’s AutoSet algorithm and delivers
therapeutic responses tailored to the characteristics of female OSA patients.

The AutoSet for Her is similar to ResMed’s AutoSet algorithm with the following modifications:
 Reduced rate of pressure increments designed to help prevent arousals.
 Slower pressure decays.
 Treats apneas up to 12 cm H2O and continues to respond to flow limitation and snore up to
20 cm H2O.

Do you breath through your mouth now. A hybrid mask that covers the mouth and nose may work. If the congestion is caused by allergies, a machine may help because it has a filter.

Hopefully the ENT can help narrow the cause of the congestion.

Masks is very personal depends on face size and shape.
Post Reply Post Reply
#3
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
(11-01-2022, 04:03 PM)KeepSmiling Wrote: The for her only treats OSA up to a pressure of 12cm water.  Without doing a titration you do not know what pressure you need  to treat the OSA.

Ah, interesting, thank you. Would you mind expanding on this? Is it a reason not to pursue the AutoSet For Her machine? I have not been offered a titration, and the only readily available machine here that is not fixed pressure currently seems to be the standard AutoSet 10. 

I don't breathe through my mouth during the day (for the most part), but I wake up every morning with a very dry mouth so suspect i am mouth-breathing during the night. 
Post Reply Post Reply
#4
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
Hi, Pod153  Here's a link to a video that describes some of the drawbacks of the AirSense For Her algorithm:

https://www.youtube.com/watch?v=_RdD9WmSgA8

I recently had a cold and was able to sleep quite comfortably with CPAP and the p30i mask, despite having a stuffy nose.

Heated tubing and humidification are options with ResMed machines that can help the nose feel more comfortable.

I have the newer AirSense 11, but commenters here and on YouTube seem to be very happy with the AirSense 10.
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
Pod153,

I started a thread asking this question, because I could not believe what I read.

FOR HER mode ResMed AirSense - pressure above 12cm what happens?
http://www.apneaboard.com/forums/Thread-...at-happens

For many people the AirSense 10 Auto is a proven solid machine. The AirSense 11 Auto is a new, unproven machine.

The good thing about the AirSense 11 Auto is that it has the For Her algorithm in it and both 10 and 11 can be used as a CPAP
Post Reply Post Reply
#6
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
My case was quite similar to you, though in my case the nasal obstruction was caused by allergic rhinitis (even getting to sinusitis from time to time) and turbinate hypertrophy. My sleep doctor had diagnosed me with OSA, but refused to prescribe CPAP until I got the nasal problems resolved. He only prescribed CPAP after I had undergone the turbinectomy and fully recovered. I currently use a nasal mask (ResMed N30i) and have no problems with mouth breathing or other leaks.
Post Reply Post Reply
#7
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
(11-01-2022, 10:28 PM)KeepSmiling Wrote: Pod153,

I started a thread asking this question, because I could not believe what I read.  

FOR HER mode ResMed AirSense - pressure above 12cm what happens?

(I'm not allowed to even quote posts with links because I'm too new to the forum so have taken this one out)

For many people the AirSense 10 Auto is a proven solid machine.  The AirSense 11 Auto is a new, unproven machine.

The good thing about the AirSense 11 Auto is that it has the For Her algorithm in it and both 10 and 11 can be used as a CPAP
Thanks for this, very helpful. The AirSense 11 is not an option for me at all unless I buy from overseas since it hasn't been released in the UK yet (I've been in touch directly with ResMed to ask about this today and they have no idea when or even if it will come out here). 

I was interested in the For Her model because it would at least give me the option to try it as an alternative to the standard algorithm, and my understanding is that it can do both. My expectations for professional support and follow-up are quite low at this point, and I am a bit of a data-head so happy to roll my sleeves up and try things out myself, so I figured the more flexibility (up to a point), the better. 

However the fact that there is no UK stock of either the 10 For Her or the 11 is (to put it lightly) a bit of an impediment.


(11-02-2022, 12:07 AM)sergioag Wrote: My case was quite similar to you, though in my case the nasal obstruction was caused by allergic rhinitis (even getting to sinusitis from time to time) and turbinate hypertrophy. My sleep doctor had diagnosed me with OSA, but refused to prescribe CPAP until I got the nasal problems resolved. He only prescribed CPAP after I had undergone the turbinectomy and fully recovered. I currently use a nasal mask (ResMed N30i) and have no problems with mouth breathing or other leaks.

I strongly suspect that this may also be in my future. Several years ago an ENT noted that I had moderate turbinate hypertrophy but didn't seem particularly concerned about it at the time. I would not be surprised if it's worsened, and at the moment steroids don't seem to be touching it. I guess I'll be able to confirm that once an ENT has seen me in person. It's great to know that it did resolve it for you.
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
Pod153,

If it is UARS then what about a bi-level like the ResMed AirCurve 10 VAuto. While you are waiting for the ENT read up on UARS and treatments.

[However the fact that there is no UK stock of either the 10 For Her or the 11 is (to put it lightly) a bit of an impediment.] In September I started looking for the AirSense, it was hard finding machines, when some became available I saw large jumps in price
Post Reply Post Reply
#9
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
I suspect I am unlikely to be prescribed a bilevel machine by ResMed, so to go that route I would also have to scrap the idea of accepting a formal referral and switch to just managing treatment myself. Essentially it seems like my options are: 

  1. Stay in the system and accept a generic AirSense 10, or 
  2. Self-manage completely, and order a machine from overseas without prescription, choosing between the AS10 For Her, AS11, or a bilevel machine like the VAuto. 
I'm really not sure which is preferable, in part because I really don't know whether to expect much or any formal follow-up anyway.
Post Reply Post Reply
#10
RE: Mild OSA/UARS, awful nasal congestion, don't know where to start with masks
I used to have an AS10 (now have an AirCurve). I have never had a AS10 For Her, but the AS10 has a “Soft” setting that has some of the characteristics of the For Her, I think. In any event, I tried the Soft setting and liked it. Evidently the For Her algorithm is proprietary, so how it and Soft differ is unclear.

As far as the mask. I really like the hybrid FF masks myself. They have the flexibility of being able breathe at pressure from either the nose or mouth, and have an unobstructed field of view. I don’t see why you would not be able to use one. They are a bit tricker to fit, but have an excellent seal once you find it. Personally, I find breathing with one more natural and comfortable than a nasal/pillow mask.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Need Help. Might have UARS or REM only Sleep apnea Nikhil222 1 69 9 hours ago
Last Post: jcoleman
  HELP needed titrating ASVauto (UARS) Dutchie 6 111 Today, 09:39 AM
Last Post: Sleeprider
  full face masks cberistain 10 360 11-26-2022, 09:04 PM
Last Post: cberistain
  I have UARS. Need help with analyzing OSCAR graph and titration baskinghobo 6 351 11-23-2022, 09:07 PM
Last Post: Sleeprider
Smile [CPAP] UARS/Mild OSA New To CPAP. Please Help! alwaystiredpleasehelp 23 1,687 11-17-2022, 08:12 PM
Last Post: lplayer24
  Noobie UARS, pls help me fix my breathing :/ newuser1002 10 560 11-10-2022, 10:56 AM
Last Post: jcoleman
Arrow AHI < 1.0 now, but still tired? Is it UARS, RERA, arousals or FL in your FR peaks? 2SleepBetta 57 9,404 11-09-2022, 02:28 AM
Last Post: 2SleepBetta


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.