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UARS (my story). Look for advice.
#1
UARS (my story). Look for advice.
Since three years or more I have started (since I wake up) feeling tired, too fatigued, and low concentrated, like if my brain was anywhere else than in my head. In fact, I was always afraid to sleep because I always felt (and still feel more tired than if I don't sleep at all). I finally got my sleep study and it showed an AHI of 7.2/h with RERA's predominance, mild to moderate number of micro awakenings and a decrease of REM sleep (I leave the pictures of the polysomnography here if anyone wants to take a look). The doc said at the end that it was nothing and it could be a narcolepsy, though my diagnosis was "mild Hypoxemia Syndrome with RERA's predominance"and it also says "Profile of UARS mild". I was treated with modafinil and Methylphenidate, but Modafinil didn't work at all and the Methylphenidate though did a "good job", it gave me a heart race up to 180BPM each time I took it (it was long release caps, 54MG). Finally I decided to get by myself a used APAP (a Philips REMStar/System ONE) with nasal pillows (it was included with the machine, but I think it's not too useful considering I'm allergic to dust mites and my turbinates are already enlarged with a mild deviated septum). I ended up using the cpap with the Wizard 230 nasal pillows and it seems not to low too much my AHI. I wonder if I should use a full face mask or do something else. I would love to hear some advice from people with the same experience.
Something that I forgot to mention is that each time I use the APAP, it shows some OBSTRUCTIVE apneas, which I didn't have at all on my polysomnography. And there are some "Clear Airway". The pressure is set on auto 4-15. Could be there any possibility that my AHI got worse through the months that have past since I had it? Or data from SleepyHead is not that trustable? Thank you for reading! And sorry my bad English since I'm a Spanish guy. Regards. imgur.com/a/WoM50AD
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#2
RE: UARS (my story). Look for advice.
Welcome, deity999. It's good that you are aiming to treat your apnea/UARS, and very good that you are already using Oscar. I'm sure an expert will come by to look at your chart and your sleep study, but in the meantime, could you make a few changes to the formatting of your chart?

* Close the right vertical panel.
* Close the calendar by clicking on the small triangle to the left of today's date.
* Include the leak graph in the screenshot. You can squeeze it in by grabbing the horizontal gray lines between the other graphs and moving them up to make room.

This way the experts will be able to see more of the relevant information.

One question: do you know when you fell asleep, and what position you were in toward the beginning of the night? (Side, back?) I'm wondering what was going on with the cluster of events that occurred soon after you began your session.
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#3
RE: UARS (my story). Look for advice.
Welcome to the forum


If you have UARS, and I'm inclined to think that you do, you need a device that provides pressure support (preferably) or EPR.

EPR is in ResMed CPAP/APAP devices. The ResMed AitSense 10 AutoSet (or the for Her variant) or better a BiLevel such as the ResMed AirCurve 10 VAuto which are capable of the higher levels of pressure support to best treat UARS/Flow Limits.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#4
RE: UARS (my story). Look for advice.
Hello. Thank you for replying! I slept on my side, and I already did the changes you suggested me. I hope it's better now. Regards

Hello, Bonjour. Appreciate your suggestion. Would it work better if I get an S9 or something cheaper? I think I made a mistake getting the machine I have now.

UPDATE: I fixed the pessure to 8 (CPAP mode). It seems to have improved, but I don't really know what to say. imgur.com/a/M8WEEkw
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#5
RE: UARS (my story). Look for advice.
Sleep Study https://imgur.com/a/WoM50AD

another Night https://imgur.com/a/M8WEEkw

The Central Apnea you are having, based on the sleep study from your first post (I missed the URL since it was not a link) is most likely Treatment-Emergent Central Apnea and should go away as your body adapts to therapy over the next 2-3 months.  This is caused by the better breathing efficiency caused by your APAP and increased flushing of CO2 from your system (blood).  A low concentration of CO2 actually suppresses your drive to breathe.  I want you to have some CA so your body can adjust and alter your apneic threshold.  

Pressure Support or EPR (and Flex in PR machines) will increase this flushing and as such increase your central apnea.  As I said before (increased) Pressure Support or EPR are used to treat UARS which are evidenced by the RERAs in your sleep study.  Your pressure change to 8 fixed has resolved much of the indicated issues, RERAs and Hypopneas, far better than I would have expected.

Let's try this, Fixed Pressure of 8, for a week and see what happens.  In the meantime look for a good deal on a ResMed AutoSet. the S9 AutoSet is fine and supported.  With a UARS indicated you will be better off with a ResMed.  Make sure it is a low hours device.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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