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UARS and Mandibular Advancement
#1
Thinking-aboutAfter almost 15 years of PAP therapy & with no noticeable improvement in my quality of life & because my SH data (I monitor every day) shows AHI's of between 3.5 & 6.5, & indicates almost 100% hypopnoeas, I'm beginning to believe I suffer from UARS (upper airway restriction syndrome). I'm guessing there are in fact many causes of UARS, one being the falling backward of the lower jaw when sleeping which causes the back of the tongue to restrict the airway. With this in mind I purchased "Snoreblock", a mandibular advancement device, Made in Australia. What I found when I opened the box was a piece of translucent plastic sort of material in the shape of a human jaw. This material is softened by boiling, then placed in the mouth over the teeth of the lower jaw, which before biting down is pushed forward somewhat. After pressing the sides in against the teeth on the inside with the tongue & outside with the fingers, the device is removed and cooled in ice water. One inserts the "Snoreblock" before donning chinstrap and mask.
There's no doubt it advanced my lower jaw (mandible), but my SH data next day showed no improvement. For AU$16, I can see this device being a great help to some sufferers, but, it seems, not to me. I wonder what do other members think? It has to be said that the tension on lower strap of FFM's tend to draw the lower jaw backwards & the fact that straps on NPM's don't do this is to their great advantage.
[Image: signature.png]Keep on breathin'
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#2
woozie38, what is your Spleep Specialist saying about no noticeable improvement after 15 years of CPAP, there have been huge advancements in that time and if he / she doesn't have any answers, I would be looking at another Sleep Specialist. Have you had any follow up sleep studies since your initial diagnosis? I have one every two years and an Sleep Specialist appointment yearly where mine reviews my data.

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#3
(10-26-2014, 06:59 PM)Tez62 Wrote: woozie38, what is your Spleep Specialist saying about no noticeable improvement after 15 years of CPAP, there have been huge advancements in that time and if he / she doesn't have any answers, I would be looking at another Sleep Specialist. Have you had any follow up sleep studies since your initial diagnosis? I have one every two years and an Sleep Specialist appointment yearly where mine reviews my data.
Hi Tez,
Thanks for your thoughts. As you have done, I have had a sleep study (PSG) every two years, but since my AHI rarely goes over the mandatory 5 ,the diagnosis is always "mild SA", few or no OSA. - CPAP @ 8 ~18 + O2 supp # 2lt/min. That's where I am right now. My next Sleep specialist appointment is 12/11 so hanging out until then. He is yet another sleep doc & new to me. I'm hoping this one has a wide approach & a broad mind, & not concerned with machine sales etc.
[Image: signature.png]Keep on breathin'
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#4
I have read that a condition known as "Sub Glottic Stenosis could also be a possible cause of registering all hypopnoeas with no OSA. I am getting desperate for answers. My ENT examined my upper airway as far as the glottis with a tiny camera inserted via my nose, found nothing significant. I am still registering all hypopnoeas on my SH charts & my AHI is still around 5, is this a possibility?

What do other think? I very much would like to hear from anyone who has any thoughts on this.
("stenosiss" = narrowing)
[Image: signature.png]Keep on breathin'
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#5
OK... What is your pressure actually doing? You're showing a range of 8 -18, which to me is too large a range. I think it needs tightening down. So for instance, if your 95% pressure was let's say 12, then I'd like to see what would happen with a range of 9 -15, possibly after awhile, 10 - 14. I think sliding the bottom up a little might kick the hypop's in the outback. ...and hopefully give you a nice, calm flow limit to boot.

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#6
(10-28-2014, 05:58 PM)retired_guy Wrote: OK... What is your pressure actually doing? You're showing a range of 8 -18, which to me is too large a range. I think it needs tightening down. So for instance, if your 95% pressure was let's say 12, then I'd like to see what would happen with a range of 9 -15, possibly after awhile, 10 - 14. I think sliding the bottom up a little might kick the hypop's in the outback. ...and hopefully give you a nice, calm flow limit to boot.

Hi RG,
Here is my SH chart from last night. - & here too , it is typical of every night. Little variance, mostly all hypops plus a little FL. Although a better night than most, on previous nights the pressure rose to 18. The point is, going by my AHI, docs would say there's nothing wrong with me - but i know there still is. It looks like, going by the data, my settings could be ok. What do you think?
[Image: signature.png]Keep on breathin'
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