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Moderate UARS about to start treatment
#11
(01-10-2016, 01:14 PM)DariaVader Wrote: UARS question for you experts.... is UARS correlated at all with Asthma? What about UARS in a person with a naturally high TV - is it mutually exclusive? or would that make it harder to detect?

Although not an expert and therefore not invited, I'll dare to venture a reply anyway.

I think Asthma is a lung condition and therefore not related to Upper Airway Resistance Syndrome.

I think naturally high Tidal Volume (the average volume of air breathed in or out per breath) would have to do with lung capacity and breathing style and would be mostly unrelated to UARS, except I think the higher the air velocity is in the airway, the stronger the vacuum effect is in the airway, worsening the symptoms of UARS. So I suppose if we can learn to inhale less forcefully (and longer, to compensate for the lower rate of airflow) perhaps that might lessen the symptoms of UARS. Just a guess. Don't know whether it would be possible to change our breathing style during sleep.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#12
Also not an expert. Interesting question Daria. Asthma is an inflammation or swelling in bronchial airways in the lung, rather than the upper airway. UARS to my understanding is an obstructive sleep disorder rather than a chronic disease. It is a pattern of arousals or RERA that result from increasing effort to overcome obstruction that does not block the airway to the extent of an OA. That being the case, increased IPAP pressure can assist with inhalation, while lower EPAP allows for comfort and more complete exhalation.

I think there is even some controversy whether UARS is a real condition or not...insurance generally does not pay for treatment of UARS in the absence of clinically significant obstructive apnea, and I'm not even sure the FDA lists UARS as a condition for CPAP or BPAP efficacy. Anyone know? So when we discuss UARS, we may not even be discussing a condition recognized by the mainstream medical community. A very good article here if you want to see more: http://www.medscape.com/viewarticle/494651

I have TV that is very high (mid-600s to low 700s mean TV). I experience relatively high RERA on auto CPAP of 1.5 to 3.0, but on auto BPAP this drops to less than 0.5. Is that UARS in the presence of a high tidal volume? Probably not, but I wouldn't rule out the possibility that a person can be successfully treated for OSA but be left with residual UARS that might benefit from either increased pressure or BPAP.

I'm kinda far out on this limb, so it would be interesting to hear your thoughts.
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#13
I don't know very much about UARS other than it is characterized by RERA. My sleep doc did not mention it - likely because many Insurance companies don't recognize it and he is all about giving a diagnosis that will allow his patients to be treated affordably - however my sleep study was full of RERA, so it is possible that I should take note of what works for UARS and why... when reading about it nasal congestion is listed as a cause, which is definitely correlated with allergies and asthma. Asthma causes difficulty with expiration (and lower tv) and could account for why bipap is more effective in UARS if these factors all play together.

Really just mulling data around at the moment Big Grin I have a fairly high TV for a short woman --- median ~450 most nights, but I also have mild chronic asthma which I mostly am allowed to leave untreated because of the very good lung capacity I exhibit. I usually temporarily use inhalers anytime I get an upper resp infection (although not yet needed with the current one. yay for humidity)
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#14
Thank you very much for your advice, I really appreciate it! I feel like I'm going into this blind... I've been reading up as much as I can, but it's all still very confusing.

I'm hoping to do a rental first in order to see if I'll be able to tolerate the machine and if it will be helpul, also to be able to get a proper fitting of the mask. However, if the trial is as expensive as the machine itself, I might have to reconsider and purchase one online. The DME I'm going to doesn't seem to sell BiPAPs. Here is the list of their available machines:

Fisher & Paykel Novo
Fisher & Paykel Premo
Fisher & Paykel Auto
Philips Respironics REMstar SE
Philips Respironics REMstar Pro
Philips Respironics REMstar Auto
ResMed AirSense CPAP
ResMed AirSense Elite
ResMed AirSense Auto
Transcend Portable CPAP (Standard, Pressure Relief, or APAP)

It's very interesting to hear the discussion about asthma, as I also have mild to moderate asthma.
What is minute vent and tidal volume?

Also, has anybody tried the DreamWear mask? Due to the positions I sleep in, I'm thinking it might be the most comfortable, of course, I don't know if that kind of mask is appropriate for me yet, but it's the one that appeals to me the most searching online...

I'm questionning whether I should request from my doctor a proper in-lab polysomnographic study before investing in a machine? So far all I've done is a home study. The test will be free, but there could be a waiting list.
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#15
The home-study I had done was a cardiorespiratory polygraphy.
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#16
(01-11-2016, 12:20 AM)Geniale Wrote: I'm hoping to do a rental first in order to see if I'll be able to tolerate the machine and if it will be helpful, also to be able to get a proper fitting of the mask. However, if the trial is as expensive as the machine itself, I might have to reconsider and purchase one online. The DME I'm going to doesn't seem to sell BiPAPs. Here is the list of their available machines:

Fisher & Paykel Novo
Fisher & Paykel Premo
Fisher & Paykel Auto
Philips Respironics REMstar SE
Philips Respironics REMstar Pro
Philips Respironics REMstar Auto
ResMed AirSense CPAP
ResMed AirSense Elite
ResMed AirSense Auto
Transcend Portable CPAP (Standard, Pressure Relief, or APAP)

Again, since it seems likely that you have UARS, I suggest it would be a waste of money to accept less than a bilevel, preferably a bilevel Auto.

If you inform the company that you will only consider a trial with a bilevel Auto, you may find that they are suddenly able to do that for you, but my advice in any case would be to get a written quote for the full price of the trial and everything involved, including all masks, supplies, possibly a restocking fee if you do not purchase a machine from them, perhaps a separate physician's analysis fee, whatever.

I think you may find it less expensive to buy the best machine for your condition on line from Supplier #2.

And although I think Supplier #2 does not offer mask return insurance (which is, if you pay somewhat more up front and find you don't like a mask for whatever reason, you would be able to return it for refund), but I think there are several on-line suppliers which do offer mask return insurance for a reasonable price. This makes it much less costly if you guess wrong on a mask.

The Philips Respironcs BiPAP Auto DS760 with heated hose option is completely versatile, able to provide therapy like a fixed-pressure CPAP, and APAP, a bilevel or a bilevel Auto. It has full data and is supported by the free SleepyHead sleep data viewing software.

Good luck with whatever your decision is.

Take care,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#17
(01-11-2016, 01:28 AM)vsheline Wrote: The Philips Respironcs BiPAP Auto DS560 with heated hose option is completely versatile, able to provide therapy like a fixed-pressure CPAP, and APAP, a bilevel or a bilevel Auto. It has full data and is supported by the free SleepyHead sleep data viewing software.

You mean DS760 ?
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#18
(01-11-2016, 01:45 AM)Lazer1234 Wrote:
(01-11-2016, 01:28 AM)vsheline Wrote: The Philips Respironcs BiPAP Auto DS560 with heated hose option is completely versatile, able to provide therapy like a fixed-pressure CPAP, and APAP, a bilevel or a bilevel Auto. It has full data and is supported by the free SleepyHead sleep data viewing software.

You mean DS760 ?

Yes, thanks. Corrected now.
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#19
Geniale, I agree with vsheline's post and given the price of these machines in Canada, you could spend a lot of money to get less. Supplier 2 (see list link at top of this page) provides very good prices and can ship internationally. It's pretty safe to say you won't be covered by insurance or the provincial health plan for UARS treatment, so might as well go the private route.
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#20
I agree! What I've decided to do is get a quote from the DME, get fitted for a mask, etc. but not take the machine right away. Then, unless it's really not worth it, I'll order online from Supplier #2.
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