UARS, MUCH worse sleep breathing disorder than you think! Upper Airway Resistance Syndrome in depth.

[@Freecpapadvice]

In depth look at upper airway resistance syndrome and how to treat. Long video, but it's as short as I can make it for the complexity of the subject matter. Thank you for watching!! As an Amazon Associate, I earn on Qualified Purchases: amzn.to/3drPax1 Channel Sponsor: cpapsupplies.com/lefty Use my CPAPSupplies.com (affiliate link): bit.ly/38yPlXk Don't forget discount code: TURKEYLANKY20 (for month of November) 20LANKY if all else fails! Links: 1. Have a PAP Analysis with me at: axgsleepdiagnostics.com 2. As an Amazon Associate, I earn on Qualified Purchases: amzn.to/3drPax1 3. Monthly basis: patreon.com/freecpapadvice 4. Donate one time at www.paypal.me/TheLankyLefty27

[@CheckTheWiki]

Uh Jahson. How about people who live outside of the United States like Canada? Do you have coupon codes or amazon links for them or do you let the guy from New Zealand get everyone outside of America?

[@ICSSNJ1]

This video is super accurate and correct. I have been diagnosed with UARS and am on bilevel in S mode, and it works like a charm!

[@jonvongeronimo]

@@ICSSNJ1What pressure setting are you using? I know everyone is different, but nothing is working for me so far. I bought a VAuto, but I want to try S mode. Do you change your settings occasionally? Are you looking for a certain pressure support setting? I’ve tried 4 different machines over the last 6 years and I’m desperate for a good nights sleep. Any advice or suggestions would be greatly appreciated!

[@ICSSNJ1]

@@jonvongeronimo12.6 pressure for iPap and 10 for epap. But in s mode you need to dial in the other fine settings for trigger and cycle to your liking. I use resmed.

[@htns]

Thank you for doing another video about UARS! For those of us that have it, it has been a real struggle to get information, treatment, etc. I feel seen when you make these

[@jakec5618]

Great explanation. Could you do another video and go more into the approach to treatment. Thanks

[@Freecpapadvice]

Absolutely.

[@ndfzen93]

I have a strong feeling this is my problem and why I struggled with cpap the last 5 years. It's interesting how I'm just figuring this all out after pulling plug on surgery for some relief. Note - I said some relief, not a cure. I had no idea there was entirely different dimension to OSA. My doctor/surgeon just kept using this term: CPAP-intolerant for insurance reasons I'm guessing. My insurance still refused to pay for entire surgery. This must be a new battle between health insurance and real doctors that want to actually improve lives. It's a shame insurance companies are playing doctor. It's murder in my opinion. America is really messed up when it comes to healthcare. I thought it was was going crazy because multiple family members love their cpap and feel so much better, but I continued to struggle. I had no peace at night unless I took sedative's, but I still felt terrible the next morning so it didn't really matter. I'm the ADHD poster boy. Just give him stimulants and he will keep going and stay stable. Yeah, that isn't going to work going into my mid 40's now. I hope they can really figure this UARS thing out and get people help early than later. I'm curious how much my surgery will help in the long run, but I can tell I don't feel as stressed out when I wake up. Sleep literally felt like work until I had surgery. Once I fully heal it will be interesting to get full night sleep for week to see if I'm less stressed out daily. Dr. Vik Veer explains this condition very well on You tube. Thanks for starting to cover this information Jason. I'll keep people posted on my recovery if anyone is interested.

[@kapfereq]

Any updates?

[@MrJBug]

I hope you're okay. I am also interested with your situation, as I have severe sleep apnea and was thinking surgery.

[@catallergiccat]

Hey Jason thanks for bringing up the topic of UARS! I am one of these people, higher pressure helps but also results in mouth leaking, taping makes air into my stomach, painful and more waking. BiLevel doesn’t work for me, VCom helps a little. I had a DISE recently to see the facts. Preparing for UPPP together with nasal and tongue based operations ..

[@HappyCupsInc]

Have you thought about jaw expansion?

[@catallergiccat]

@@HappyCupsInc I tried MAD, dual use it with CPAP, it didn’t work. My problem is more from my long soft palate, which backs up into my nose during mid-exhalation (EPO). That also explains why I am so prone to mouth leaking. I’m not sure how jaw expansion would help, according to Dr. Steven Park’s podcast in regards to UARS, it doesn’t to majority of people.

[@tarapearce544]

I had a UPPP 23 years ago and can still remember the pain when my pain meds wore off. I can't stress enough - stay on top of the pain. Take the next dose before the previous one wears off. Overall, it's not the worst pain I've ever experienced and by week 3 it's much better. But set an alarm if necessary because being woken up from the pain and waiting for the meds to kick in is not fun. Not trying to scare you, just wish someone had warned me!

[@catallergiccat]

@@tarapearce544 Thanks for sharing but you did successfully scare me :p I know there are various of U3P, my surgeon told me mine will be minimal invasive and conservative, meaning not to cut out a lot of tissue but moving some muscle around. The pain would be 7 out of 10 .. How has the efficacy been? Hope you are breathing much better!

[@tarapearce544]

@@catallergiccat I am sorry if I scared you, not at all my intent, I just want you to avoid the misery of the meds wearing off. Take the next dose before the previous one wears off and you'll be fine! The pain meds (I had Tylenol 3s with codeine if I remember correctly) work well. Also, to be polite, I'll leave off exact details, but if you're given codeine, it can cause bathroom issues, as a head's up. :) As to efficacy? It's a long story, I thought the surgery worked until the post op follow up sleep study - when I was told that nope, basically no difference. My current sleep doc told me that some doctors say that, unless there is a huge difference. (I told him I had actually felt great until I was told it was basically a placebo effect.) I am now (23 years later) finally on CPAP which on paper looks like it's working but reality is I'm always exhausted. I have done an MSLT and "failed" that (3 min latency, 1 SOREMP) so I've been labelled as having "hypersomnia" but doc is trying several "Hail Marys" to rule out other causes before he goes full Idiopathic Hypersomnia. One is having an ENT take a look to see if I have a lot of scar tissue which doesn't allow my airway to expand properly, causing a lot of shallow breathing. That said, times have changed, the surgery has evolved and it sounds like you have a much better doctor than I did in those days. I truly hope it's a success and has minimal pain. I'm happy to chat more if you want, let me know and we can figure out how to take it out of Jason's comments. :)

[@cebruthius]

6:03 The definitions are different on a key point: A hypopnea requires 30% or more amplitude reduction, while the RERA definition does not. It only requires "identifiable flow limitation."

[@davidrengifo6770]

Hey Jason, thanks for the video. I’m actually in Albuquerque for titration studies at Dr. Krakows old lab for this exact issue. I will let you know how it goes.

[@Freecpapadvice]

Any news?

[@scowell]

We'd love an update! Hope all is well.

[@joeshmoe7899]

​@@Freecpapadvice video idea: interview a sleep tech at Dr. Krakow's sleep lab.

[@edwardsteiner8086]

Very Informative. I have learned so much from your CPAP University Classes 😊.

[@robertp.wainman4094]

I had my first home sleep study two years ago with follow up letter to ENT consultant saying I may have UARS - but it was never investigated further. A polysomnography last year showed mild sleep apnea with 'a sleep fragmented by multiple periods of wakefulness' - it was reported on by a respected respiratory consultant sleep specialist, who told me the term 'Upper Airways Resistance Syndrome' isn't used anymore in Europe. I'm CONFUSED.....all I know is that I wake up feeling unrefreshed, often with headache and am fatigued throughout the day. Tried MAD - but pulled crowns out, nasal splints - helped a little with blocked nose, have just started vocal exercises for snorers.....and am waiting for a DISE. I now get a few hours sleep first and then every time I'm about to nod off again I'm aware of being awoken by a noise in the throat - perhaps like the start of a snore - and this can happen many, many times a night. It's driving me to despair!

[@lucysky4541]

Are you on a CPAP yet? God, I hope so! I can breathe again. It’s the only thing for it!

[@lucysky4541]

I can’t see my reply to your question so will write again here: ​​⁠yes, I had the DISE. I can’t remember how long it took. Maybe you should call them and get an update. I didn’t have to stay the night. He recommended some optional surgeries but said I wasn’t as bad as most. I could have a tonsillectomy but they’re actually not that big. He also said I could have my turbinates in my nose reduced, but of all the people I know who have had that done, including a lady in my office, it didn’t make any difference and in one case, someone on the FB UARS forum says it made her nose “sticky” and wishes she didn’t have it. There were a few other options like having some of my tongue shaved off which he really did not recommend as he said it’s a nasty procedure and can have adverse effects. He did recommend I go see a maxillary surgeon about my jaw, and that appointment has been cancelled and rescheduled FOUR times. I am now waiting for that. I also got a mouthpiece last week which I haven’t used yet. They also had my CPAP technician talk to me and they did a home study and I was just informed they want me to stay the night and do an overnight one too! So I guess they’re still looking into it!

[@robertp.wainman4094]

@@lucysky4541 I'm pleased it's working for you - but no, I'm not on cpap as yet.

[@robertp.wainman4094]

@@lucysky4541 Sorry, I've only just seen your reply - many thanks! Sounds good that further a further sleep study is being organised for you and I hope a successful treatment is found - as you'll well know the ongoing feeling of unrefreshed sleep is really waring. Did you have the DISE at the Royal National ENT hospital? I've now been waiting over 13 months - they tell me I'm on the list, but no appointment as yet. Goodness 'shaving' the tongue certainly does sound unpleasant, I too was told I had a slightly bulky tongue. I've just tried to sleep this afternoon but couldn't due to the sound I make in the throat which awakens me when about to nod off. Apologies burdening you with my problems - and best of luck!

[@ericelfner]

Any comment on studies cited in JCSM stating: "pharmacological studies addressing sleep-related upper airway muscle hypotonia suggested that the combination of atomoxetine and oxybutynin is effective in treating obstructive sleep apnea." I would really like to see these test results broken out by UARS vs OSA.

[@Indoorchicken1995]

Seems like that’s just reducing time in REM sleep and therefore avoiding potential events - at the cost of actually entering the stages itself responsible for restorative sleep ?

[@ericelfner]

@@Indoorchicken1995 interesting. I was in a clinical study for these drugs but dropped out before it started. I mostly wanted to talk with the sleep doc. After that I saw little reason to continue. Still hoping for 💤...

[@seanthornton3741]

Excellent video, Jason, per usual! 👏 I just had my home sleep study done in August with AXG and scored mild UARS. Discovering this channel and AXG has been an absolute gold mine so keep doing God's work!

[@MsFiFix1]

How are you treating it?

[@seanthornton3741]

@MsFiFix1 mostly following Dr. Park's advice. I mouth tape at night. Vitamin D with K2. Use labdoor to find a reputable brand. Anti-inflammatory diet to relieve congestion. I removed Processed Carbs and refined sugars from my diet to relieve congestion. I have a bipap machine and found a nasal mask that works. I sleep on an incline pillow, the rescline brand. Also, I'm experimenting with breathwork like the wim hoff method. And I will be getting ent surgery to make nasal breathing better. After that I will be exploring jaw surgery to expand pallaete. Either MSE, EASE, or MMA.

[@seanthornton3741]

@MsFiFix1 jaw Hacks is the best youtube channel on Jaw Sugery and pallet expansion, and Steven Park MD is the best channel for ENT MD. Clearly, you've already found the best CPAP channel.

[@MsFiFix1]

@@seanthornton3741 hi thank you so much!! Have you found relief using bipap . I am struggling allot with treatment - I get congestion at night also done anti inflammatory diet but is not helping to well. Is there a reason why your not happy just using bipap and are looking into surgery?! Also would your health insurance pay for this? Sorry for all the question I really appreciate the help!

[@SuperRmarvin]

I realize this is 10 months old, but it seems to hit the nail on the head for what I have going on since I started CPAP just 8 days ago. My experience with CPAP is more extensive. My wife was diagnosed in 2016 so I did a lot of research then and studied her OSCAR reports daily for some time. I have a lot to relearn. But in either case, we still find ourselves falling asleep in the afternoons and tired all day. Certainly not what I was expecting. We both have heart condition diagnoses, I have a pacemaker and she had been diagnosed with AFib. From looking at my OSCAR reports I see a flow pattern that looks much like the one you show and Dr. Krakow shows in his book “Life Saving Sleep”. How do I get my PCP or my mysterious sleep doctor whom I never met let alone spoken with to address my problem. Thanks for your videos. I like your conversation with Dr. Noah. I also listed to another video by another doctor who spoke about the KPAP algorithm. I have not yet invested in a VCOM devise as I want to put money in the best place to become more successful in my therapy. Thanks again.

[@tombullen5676]

Very good. Perfect help for me now. THANK YOU JASON!

[@Rainbowcrest]

THANK you so much for this!! I’m going to see Vic Veer soon and ask him about getting one!

[@robertp.wainman4094]

Have you had your appointment yet? I had a call with him and he arranged a sleep study on NHS, with follow up drug induced sleep endoscopy. Had the study over a year ago, but still haven't got appointment for DISE.

[@lucysky4541]

@@robertp.wainman4094​​⁠yes, I had it. I can’t remember how long it took. Maybe you should call them and get an update. I didn’t have to stay the night. He recommended some optional surgeries but said I wasn’t as bad as most. I could have a tonsillectomy but they’re actually not that big. He also said I could have my turbinates in my nose reduced, but of all the people I know who have had that done, including a lady in my office, it didn’t make any difference and in one case, someone on the FB UARS forum says it made her nose “sticky” and wishes she didn’t have it. There were a few other options like having some of my tongue shaved off which he really did not recommend as he said it’s a nasty procedure and can have adverse effects. He did recommend I go see a maxillary surgeon about my jaw, and that appointment has been cancelled and rescheduled FOUR times. I am now waiting for that. I also got a mouthpiece last week which I haven’t used yet.

[@lucysky4541]

@@robertp.wainman4094oh I’m also going for an overnight sleep study soon. So they want to look into it even more.

[@vivianriver6450]

If BiPAP is best for UARS, how do you know what pressures to use?

[@amandasaunders9947]

Such interesting info. Didn't know you could have sleep apnea and uars

[@KelseyBratcherAwesome]

Boof McTavish made me laugh super hard. I just started CPAP 2 months ago and I don’t know if I would have been successful if it wasn’t for your videos. Thanks man!

[@elly535]

Hello Jason, one of your many fans here, English living in Australia. Severe 0SA, 6 months on after a draw full of masks finally - amazingly / found one that gives me zero leaks. Have played around a lot with settings. Desperately wanted to be fixed CPAP but no go) Today on 12-15 with EPR 3 and I sleep okay with low AHIs (1-2) But something is not right, and I don't know if it is upper airway resistance. But I'm so tired for the first two or three hours when I wake up. I promised myself 6 months ago I will book a consult with you and I think that day is coming soon because it just has to be better than this. PS female, not overweight, never smoked and rarely now have alcohol , because it affects my sleeping PPS love your talks super informative- and so funny too❤

[@jackwaau]

You are in Australia, get a referral to a public hospital for a free sleep study. Or on private health will be free too.

[@elly535]

@@jackwaau have had 2 one when diagnosed and another after the prescription. That's why I need some more help from somebody who's more knowledgeable because the doctor was very nice, but I didn't think you have much of a clue at all.

[@Jammerqui]

Hey Jason not sure if you remember looking at me a while ago but man this is EXACTLY my experience. I was using an asv to treat UARS and would see exactly what you showed here, my breathing was best during random periods of high, consistent pressure support I've recently gotten onto spontaneous bipap and so far it seems to be working but lots and lots of pressure support is the key for me. I was actually going to book another session with you soon just to check in on it But definitely echo everything in this video. ASV was better than CPAP but still didn't get me where I needed to be, really high consistent pressure support (with a backup rate to prevent central events) seems to be the key

[@cebruthius]

Do you use ResMed ASV or Philips ASV? I find the DSX900 works great for me delivering the high PS when I need it (up to 10 cm of delta) and dialing it back when not, thereby avoiding inducing CAs. In fact, I disabled timed breaths (BPM) on my DSX900. Works great.

[@Jammerqui]

@@cebruthius I actually had both, switched from Resmed to Phillips. I found Phillips was better, but I now use it as a Bilevel and seem to get even better results

[@semiephemeral9]

​@@Jammerquihow did you set up your DSX ?

[@ASpectacular3777]

Thank you for explaining this.

[@davidpeterzell789]

Looks like the Dr Krakow you mentioned (UARS treatment expert) JUST published a book on sleep and mental health: Life Saving Sleep: New Horizons in Mental Health Treatment. Just ordered it. It looks like it's my kind of book! (see my long diatribe in the comments section of your recent Sleep Trackers video). It examines the link between disturbed sleep and mental health, as well as the effects of improving sleep on mental health disorders.

[@WoodyW2k]

Thank you so much.

[@teethree141]

I have this and a posterior tongue tie. Failed CPAP and BIPAP. Did multiple sleep studies. I had maxillary palatal expansion 2 months ago and can breathe so much better now. I am going to start myofunctional therapy tomorrow and get a tongue tie release. Hope this helps with sleep as I choke on my tongue when I sleep.

[@yahyaelmi8435]

So did the maxillary expansion help with the breathing

[@teethree141]

@lmi8435 it did. nasal breathing 50 percent better during the day.

[@SayCheeseAndDie01]

Update?^

[@teethree141]

@@SayCheeseAndDie01 sleep apnea got worse. nasal breathing got better. i get my expander out in september

[@christinal434]

@@teethree141 are you doing jaw surgery now? how arre you doing now

[@mikemeehan610]

What level of PAP Analysis is needed to diagnosis URAS? Will reviewing OSCAR or HQ give enough data?

[@elly535]

Good question!

[@cebruthius]

If you have pervasive flow limitation (note that not all FL shows up in the FL graph on ResMed devices) and you still have symptoms, try addressing the FL and see if symptoms improve.

[@LoveSidekick]

At the end, you said you saw URS patients who were on CPAP and got up to pressures of 16 and saw no change. For someone like that, who switches over to bilevel, can they do fine with IPAP pressure = 16, because the bilevel allows them to have a much lower EPAP? Or do they often need pressures higher than > 16?

[@ghost-in-the-ciel]

What kind of difference between inhale and exhale pressures are usually effective against UARS? Is it wildly different for everyone? I imagine it would need to be higher than 3 since basic EPR can get you that much.

[@scowell]

EPR ducks the exhale, PS pumps the inhale... much better machine, same exact hardware, just better firmware. A lab titration is the gold standard.

[@macknumber9]

I didnt get my results yet....but im worried that i had a test that does not look at RERAs....can i just take my sleep study results to a better sleep clinic or do i have to actually have a whole new test done and pay for that out of pocket once again?

[@tristanmartin9087]

I don't have insurance. How can I get a prescription for a bilevel machine online? All I can find is CPAP prescriptions.

[@mews1950]

The sleep center who sold you a Apap will most likely sell you a bipap

[@tristanmartin9087]

@@mews1950 nope. It's all online, so without a bipap script they won't sell me a bipap machine

[@newporttom]

So the AirCurve S10 10 VAuto Bilevel would seem to be a machine to address this? Any others?

[@scowell]

You can use it in S mode, or as I do... just set 21/17 PS 4, same thing as 21/17 S mode.

[@shuikai272]

I feel like Medicare changed the rules to allow RDI? But I don't really recall.

[@alkinwheel]

S mode seems to be more complicated with rise time. Can you explain simply TiMin TiMax, Trigger, CyCle, Rise Time and backup rate related BiLevel terms and how we could manage to setup ourselves, thanks for the imformative videos. You are the best.👍

[@Freecpapadvice]

I already did: kzbin.info/www/bejne/qqScnYGAZ8xkf6c

[@semiephemeral9]

This was a great video Jason but there is a lot of confusing info out there, a lot of it driven by certain "forums" (and certain people on those forums). They all like to cite Dr. Krakow. On the other side of the coin you have William Noah, who doesn't seem to be much of a proponent of Bi-Level at all (and I believe he has the compliance data to back that up). Here's some examples of stuff that's confusing to people. V-Com. IPAP is actually slightly lower than EPAP. And yet it can treat Apneas/Hyponea's/RERA/Snoring. CPAP without V-Com can treat same. And then you have the "EPR are the things crew" who like to say things like "EPR treats flow limitations" and then they point to BiPap "titration protocols" that say: 1. EPAP for Obstructives 2. IPAP for hyponea's/RERA/Snoring That's their main justification for "EPR all the things". Those protocols. "Have you seen the protocols?!!! Pressure support is NEEDED, EPR is actually therapeutic!" IPAP > EPAP for everyone. (I watched your Bi-Level for everyone video and it was great by the way) Hopefully I'm not just ranting here. It gets confusing quick (primarily from the forums crew). Like, how can some people do just fine with V-Com, "regular CPAP", and some need Bi-Level? Seems like three different mechanisms of action there. Best! N

[@Freecpapadvice]

Someone I was doing a PAP Analysis with was really interested in this as well. It was a couple, so I was looking at one primarily, and did a quick analysis on the other. They summed it up with "I see now that everyone is different" and "there is a blend of art and science to this." Very true. There are a lot of factors involved, so there isn't always one best method. Ironic since one of the groups referenced feels my methodology is too rigid.

[@semiephemeral9]

@@Freecpapadvice indeed it IS ironic, because they seem quite dogmatic about certain things. PS being one of them. I re-read the SleepRes Whitepaper last night, and I'm half convinced based upon the physiology described that V-Com might (MIGHT, no medical advice given here) be useful for UARS. Twould be interesting to ask Dr. Noah or Dr. Farney about that. Happy Holiday dude :)

[@beltycat5490]

Jason - a couple questions from your last video. - You mentioned in the video that lots of your patients are pilots that obviously need to be alert and have SA successful treated . Who else are your patients? Doctors? Law enforcement? Truck drivers? other people that need to be wide awake for their profession? Do employers order sleep studies from you for employees? Do people often resist a diagnosis of SA because it will affect their job ? And most importantly Where is Stewie ? I haven’t seen him for the last 2 videos 🐈‍⬛

[@Freecpapadvice]

I only counted pilots as ones who used FAA paperwork for their intake forms. I know there are a few physicians in there. College students too. I usually don't know what they do unless they tell me otherwise. Employers have not, but unions have pointed people in my direction. I'm sure resistance is from possible job repercussions in the pilot population. Some people are glad something was found.....there is a huge mix. I believe you can see Stewies giant behind sleeping on the bed in this video. I'll upload a YT short of Stewie to my other channel for your viewing pleasure.

[@beltycat5490]

@@Freecpapadvice thank you 🐈‍⬛👍

[@blazejp0601]

I resent the notion that you're not going to get proper advice at primary care. I'm a GP and I watch LankyLeft, I'm savvy...

[@Freecpapadvice]

Noted... Savvy GPs to visit: blazejp0601 Non-Savvy GPs to avoid: all others. I will not be updating this list. 😂

[@blazejp0601]

@@Freecpapadvice Much appreciated, Lanky! Your advice goes against what most people on sites like apneaboard claim. The difference is you've got hundreds of patient consultations, all they have is their own experience. I highly value what you have to say.

[@hmmmm9821]

Unfortunately you won't get knowledge care from most gps or sleep Drs it's a cash cow Drs add into their services without serious knowledge on sleep science. Most of the medical field barely believe there is such a a thing as sleep medicine.

[@robertreihsen9096]

Can an ASV be set to emulate a bilevel?

[@k6txh]

I set my ASV to ASV Auto, which varies EPAP as well as IPAP, and set EPAP 5 to 15 and PS 4 to 15. That seems to work better than leaving EPAP to a single pressure in the ASV mode.

[@cebruthius]

This can be done on the DSX900 but not on ResMed devices.

[@susanfrederick866]

Know any good sleep docs in Columbus,Ohio? Not happy with current doc

[@snospmoht3252]

👏 Now if only it wasn't so difficult to get a doctor's script for something other than an apap or cpap. 😞

[@MsFiFix1]

What if you have both sleep apnea and uars

[@andrewbarnes605]

Another informative and crisp video, Jason! A quick clarification question: when using a ResMed AirCurve 10 VAuto in "S Mode", do you recommend turning "EasyBreathe" off? Thanks, AndyB

[@joeshmoe7899]

When in doubt, try it out.

[@joeshmoe7899]

CPAP Induced Sleep Disturbance Syndrome. Waiting on that one.

[@cebruthius]

Krakow calls that "EPI"

[@Marcos-SB]

Hello Jason greetings from Mexico.when you refer to bilevel you mean S or ST ? Because the price difference is huge Thanks

[@BettyGone]

I just had an overnight sleep study where UARS was found. My 3rd study over many years. Never mentioned before. I was told by another tech that adrenaline could be the reason I can’t get back to sleep. I’m miserable when it comes to sleep. I’ve lost 150 lbs, so the apnea has resolved itself. But still waking up WIDE AWAKE. My follow up appointment is coming soon. To me, the breathing issue abruptly wakes me up, causing adrenaline to surge. Does that make sense?

[@scowell]

O2 desats can cause this... wear an O2 monitor like the O2Ring that records your blood oxygen all night. This and Oscar will give you the full picture... you can import both your machine and O2 into Oscar and see what's going on.

[@mattk8621]

Hi Jason, what do you recommend for UARS patients that also have mixed sleep apnea or treatment emergent central apnea? Bilevel ST to achieve their best static pressure?

[@elliottortiz2]

Hey Jason, what is the average bilevel pressure range do people typically need to control UARS when cpap doesn’t work?

[@mattkojetin8198]

Great content. I had polio and it complicated my breathing but most sleep Doctors don't understand that. At one time I had a bilevel s and sleep was great but now I'm on an auto and it's not so great. I set it to cpap and then it is sort of better but still not great.

[@lorenzoishere]

Which sleep study is best to diagnose UARS? There are devices that measure the AAI (autonomous arausal index) through the PTI (peripheral tone index)

[@Freecpapadvice]

The best way is with Pes....but that's fairly unrealistic. Type 1 (in lab) or Type 2 like I do. I have no faith in the WatchPAT. No EEG recorded, no method of measuring airflow, no method of measuring respiratory drive.

[@cebruthius]

If there ever was a clinical study comparing Pes and WatchPAT concurrently, sign me up. I did Pes one time, I love me some Pes.

[@ThePhilcam]

Any sleep docs or tech in New Zealand watch this? Looking for local assistance to refine cpap… ideally someone that’s not just going to tighten a mask and actually looks at the data in this sort of depth.

[@amandasaunders9947]

Why do people with uars tend to need higher pressures?

[@scowell]

Airway harder to open.

[@lorenzoishere]

Do you recomend taking the ansiolitic pills before the sleep test? or withdraw them? does it changes the results?

[@user-px2sn8pr5t]

?treatment?

[@larzdiz]

This is the Mr beast of sleep apnea

[@CheckTheWiki]

Liked and subscribed to Boof Mctavish.

[@davidpeterzell789]

Leave us out of this, OK? Sincerely, Icebergs Find a different acronym, OK? Signed, Unmanned Air Reconnaissance System, Undocumented Alien Reimbursement System And Upper Atmosphere Research Satellite What did the Apnea-Hypopnea Index say to the resistant upper airway? If you show me UARS, I’ll show you nine.

[@davidpeterzell789]

And you know what? Leave pharyngeal out of this. Sincerely, The Ferengi.

[@Freecpapadvice]

Your humor is that only a PhD PhD could achieve. It truly is next level. 🤣

[@davidpeterzell789]

@@Freecpapadvice If you keep cranking up the pressure, it doesn't solve anything because of UARS and... it causes aerophagia. THEREFORE --- Resistance is fartile.

[@s1879278]

Is BiPAP recommended for people whose UARS is caused by sinus problems like septal deviation and turbinate hypertrophy?

[@Freecpapadvice]

Short term I'd move to a full face mask. Long term I'd have an ENT evaluate for septoplasty and turbinate reduction.

[@Vinylrebel72]

My son sleeps well at night and barely snores, his dentist today said that he may have UARS, and told him it was deadly… my son is autistic… this dentist was non chalant about it. All these years he’s been going they have not once mentioned this to us.

[@rickgledura3194]

Thought I could get some useful information. But couldn't take all the joking which I felt was totally unnecessary

[@Freecpapadvice]

“All the joking” is like 60 seconds of an advertisement. Scrub through like everyone else. 🤣 Let’s try to toughen up a little Ricky.

[@semiephemeral9]

@@Freecpapadvice Lego Man rules, no way I'm scrubbing through it dude.

[@putthegundownkinkade]

Hey! I know you aren't usually a fan of EPR but could it help with UARS?

[@cebruthius]

Yes, it can. See: Braindump on UARS and BiPAP (from archive)

[@scowell]

It's really a poor substitute... EPR ducks the exhales, where PS pumps the inhales. Also way more adjustable. Love my AC10!