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Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
#1
Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
           

Did a sleep study a couple of months ago and the doctor told me I don't have sleep apnea. I have attached my results.

Do you agree with my doctor's assessment? I have had symptoms of low energy, fatigue, depression, anxiety and brainfog for the past 8 years and have tried everything under the sun, including MRI scans (particularly the pituitary), various blood tests, tests for POTS and CFS, multi-vitamins and other OTC supplements, counselling, CBT and SSRIs.

Recently, I tried testosterone replacement therapy to treat my low T and after 2 months I gave up because my brain fog worsened and my sleep was slurred.

What about UARS? If I don't have Sleep Apnea, could I have UARS? Please help.

           

Rest of the sleep study results attached here.
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#2
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
Your AHI is 4.6 so you do have apnea but not bad enough for insurance to pay for it. AHI of 5 is where they say you have sleep apnea. So you were close. Again the insurance won’t pay but you do have apnea.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
Would you say i have sleep apnea or uars? And based on everything you saw in my results, what is the best course of action?
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#4
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
There are 3 completely different types of apnea.
1. Central apnea - it is neurological and a regular Cpap machine will not work on it it takes an ASV MACHINE and they are more expensive.
2. Obstructed apnea that is your airway narrows or collapses and that is the type a Cpap is made for.
3. Positional apnea wher your air way is kinked by the position you are sleeping. This type of apnea can NOT be helped using a machine. You have to stop getting in that position. Also called chin tucking where your chin drops to your sternum and cuts off your airway.

Because your apnea was much worse on your back, positional apne did a real possibility for you. You could buy a cheap collar to keep your neck from kinking. I have a link in my signature to collars you should read.

You can get a collar at about any drug store and the main measurement is the distance from your chin to your sternum, that is the height of the collar you need.

That MAY be. 25 dollar fix for your problem.

You can also buy a Cpap with your own money but with supplies it would be 700+.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
Thank you so much for the detailed response. Does the collar only help with chin tucking or does it also prevent back sleeping? I think some of my apnea is in the supine position.
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#6
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
Back sleeping makes it much easier to chin tuck but you can do it in any position. It does not stop you from sleeping on your back
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#7
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
Unfortunately in this space there is inconsistency between scorers. On top of that, your testing time was very low, but the literature does show that most 2-hour tests are well-aligned with 8-hour tests for patients. I'm always suspicious when scorers mark 0 RERAs, which is the case for your study, but it's important we balance that with an open mind. In your case, it may prove helpful to get a second, well-scored, full-night test, if it's in the cards for you, with a lab that pays close attention to subtler disordered breathing. tldr; we cannot say that your symptoms are or are not from your SDB, and my advice is to retest with a reputable lab, provided you have the motivation and resources to do so. Alternatively, you could potentially send just your raw data to a reputable scorer, sidestepping the need to retest. With all of that said, there are some abnormalities in your sleep, like absence of SWS, low sleep efficiency, etc. There is also a phenomenon called 'the first-night effect', where patients either sleep better or worse than they typically do at home, which could be at play.
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#8
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
Have you ever had a CBCT scan done? I don't think you will be able to get any sort of diagnosis from a CBCT but it should determine how narrow your airway is. There is a strong correlation between narrower airways and sleep disordered breathing.
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#9
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
I've read about CBCT online, but I'm struggling to find any information about it in local radiology centers, etc. Is this a common type of scan seen everywhere, or something specialized that is difficult to find (and possibly considered experimental or something)? For context, I am in the United States and near a major city and thus likely any commonly available medical care is likely to be available here. I can ask my ENT next visit, but I don't want to be asking for something if it's not something likely to be available (after all, we only get X minutes per appointment and have to use them wisely).
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#10
RE: Desperate for help - Do I have UARS? Sleep specialist told me I don't have SA.
The study does mention 6.7 arousals per hour. It is likely a sum of AHI (4.6) plus arousals (would be 2.1). Not sufficient to qualify for insurance covering things, but enough that you should consider ways of mitigating them. Whether it is buying a machine, new or used, out of pocket or not is a personal decision. We can help tweaking the machine if you decide to go that route.
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