r/UARSnew

Title: New to BiPAP/VAuto settings — need help finding a safe starting point

Hey everyone, I’m new to bilevel and trying to figure out a reasonable starting point. I know nobody can give me my “perfect settings” because everyone’s airway, sleep data, and tolerance are different. I’m just trying to understand where to begin without randomly changing stuff left and right.

I was previously using CPAP around 9–10 cmH₂O with EPR 3. So from what I understand, that was roughly like:

- CPAP 9 with EPR 3 = inhale 9 / exhale 6
- CPAP 10 with EPR 3 = inhale 10 / exhale 7

I now have a machine with multiple modes available:

- APAP
- S
- ST
- T
- VAuto
- ASV
- ASVAuto
- iVAPS
- PAC

I tried iVAPS, but it felt like the machine was controlling my breathing and restricting my inhale. I tried S mode, but it felt like I had to force my breath in, almost like the machine wasn’t sensitive enough. VAuto felt much better.

The VAuto setup that felt the most natural while awake was:

- Min EPAP: 4
- PS: 6
- Max IPAP: 10

So basically exhale 4 / inhale 10.

I slept about 2 hours on it. My oxygen looked good, but my average heart rate was around 82, and I woke up hot/sweaty. I did have one 5% Truly that night, so I know that could have affected heart rate, sweating, and sleep quality.

I’m wondering:

1. For someone coming from CPAP 9–10 with EPR 3, is VAuto a reasonable mode to start with?
2. Is EPAP 4 / PS 5–6 / Max IPAP 9–10 a reasonable beginner range, or is that too much PS / too low EPAP?
3. Should I focus on increasing EPAP slowly if flow limitation still looks bad, or should I adjust PS first?
4. How do I know if PS is too high and causing arousals/clear airway events?
5. Is there any reason I should be trying S, ST, iVAPS, ASV, or PAC instead of VAuto for UARS/flow limitation type symptoms?

I’m not asking anyone to prescribe settings. I’m just trying to learn the logic so I can start safely, make small changes, and read the data properly in OSCAR.

Any guidance on where you’d start and what metrics you’d watch first would be appreciated.

Hello everyone, i had all the symptoms as everyone else and decided to do a watch pat, my ahi ended up being 1.8 but it did not score RDI. After demanding, i got an in person lab study, never saw the results but they told me i had an ahi of 19.4 and have moderate sleep apnea. I got put on cpap and have used it for 3 months, no improvement on my symptoms at all. I finally got them to send me the results, and it showed an AHI of 19.4 and an RDI of 19.4 which is very unlikely to happen. And an AHI of 1.8 to 19.4 seems to be way too much of a jump considering watch pats are supposed to be for the most part very accurate. I feel like the lab conflated the two and scored the AHI as the same as my RDI, when the true AHI was closer to that 1.8 from the watchpat. Some more info (entire night of 3hr test) : Obstruction Apneas = 0, hypopneas = 64, central = 12. This leads me to think I was misdiagnosed as sleep apnea rather than UARS, I am 21 years old and somewhat fit, cpap has been no benefit. And I have enlarged tonsils, and recently did a turbinate reduction which helped.

As the title asks..

And if not, did it at least help make CPAP/ BIPAP easier? And wouldn't it make nasal pillows a bit more user friendly?

And if not cured yet, Are you going MMA?

A combination of Atomoxetine + Oxybutynin is researched for treating obstructive sleep apnea. Studies indicate that it is highly effective for many people with AHI-reductions of around 50% to 70%.

Since the pathophysiology of obstructive sleep apnea and UARS overlap, this leads to the following question: Could this work for UARS?

What do you think?

Title

Thank you

Title

Thank tou

Hi everyone, I’m reaching out because I’m technically "fully treated" but I feel like I haven't slept decent in years. I’ve had intense brain fog and physical heaviness since my teenage years. I’ve been on CPAP for 2 months, and I sleep through the night consistently (7+ hours).

For the last 10 days, I’ve added a soft cervical collar to help with potential chin-tucking, but the fatigue remains unchanged. I also mouth tape. I am mostly a side/stomach sleeper.

Current Settings (ResMed AirSense 10):

• Mode: Fixed CPAP
• Pressure: 11.4 cmH2O (I've been slowly raising the pressure, .2 over every 4-5 days. Anytime I try above 11.8 I start to get air in my stomach.)
• Mask: N30i
• EPR: 3 (Full-time) (Can't turn this off, it makes me feel like I can't exhale when I do)

Sleep HQ: https://sleephq.com/public/teams/share_links/67adcbb7-dce0-427a-b0b2-b30783fa3c4f/dashboard

I know from looking at my flow that the peaks of my breath aren't curving perfectly at the top. Any suggestions or ideas I can do?

https://preview.redd.it/mgb02pmrpcyg1.png?width=1474&format=png&auto=webp&s=e8603266ceedb947fe7d8d8e9926f3b2313b8865

https://preview.redd.it/zx3tcymrpcyg1.png?width=2940&format=png&auto=webp&s=e6cb46411bc89f11d302840092cbfe37f2959b85

https://preview.redd.it/944sbqmrpcyg1.png?width=1474&format=png&auto=webp&s=0d908b0e4474d9b0f50f79a6e40b98131fe396dd

https://preview.redd.it/55snmrmrpcyg1.png?width=1474&format=png&auto=webp&s=7ebecbdd2d2c86b006586cd11017e01b88f67a57

I just tried electrotherapy in a chiropractic clinic similar to https://www.burlingamechiropractic.com/service/electrotherapy (not actually this clinic). They placed a couple of electrodes on both sides of the back base of the neck where it meets the shoulder, I don't think this is stimulating the vagus nerve. And a couple more electrodes at the mid back, on either sides of the spine. He also throws in a moist heat pad on my back, deep penetrative heat therapy which compounds this.

The parasympathetic shift is immediate, and the biggest part is that my arousal threshold seems to be increasing, sleep feels deeper despite my OSCAR data remaining the same. I'm using an ASV machine. I can feel the raw improvement in work productivity, calmness, sexual function, nasal breathing.

This makes me wonder if I'm a serious candidate for SGB, especially in this phase when I'm just waiting for my MMA surgery. I wonder if anyone has tried it, and if you've felt a nervous system reset.

I don't have proof that my autonomic dysfunction is entirely an effect of my untreated UARS for over a decade, although that is my gut feel. Only way to find out is to see how things are after MMA, PAP isn't able to treat my UARS entirely.

I don't know if this electrotherapy is stimulating my vagus nerve. I've tried the Nuropod VNS via the tragus, and barely felt any impact over a month, and I returned it.

just needing to make some very hard decisions! different opinions im getting from each surgeon!

As the title asks. Also, did you all try 'allergies' etc for nasal congestion?

Anyone had nocturnal nasal congestion and expansion helped 'treat' it?

Did this also help your sleep disordered breathing?

I’m currently 3mm fme expansion and my nasal breathing thru the day is fire but as soon as I lay down my left nostril blocks completely zero airflow. It is my non deviated septum side and I heard it happens because there’s more space so the turbinate overgrows.

I’m not getting turbinate reduction but does that mean I have to get septoplasty? Otherwise expansion is pretty useless because I’m just breathing thru my deviated side when I sleep. Ive tried nasal strips and sleeping on my right side but my turbinate is stubborn.

I had a sleep test about two months ago, which showed an AHI of about 8 and the RDI of 26. I’ve been looking into expansion and different options over the past few months. Last night, I did some deep emotional processing of some old stuff that I never really looked at and I really let myself process them. I had a tremendously good sleep afterwords. Now I don’t know how good it was compared to a regular person, but I had tons of dreams and I was in situations in the dreams that I was previously afraid of.

My question is how much of UARS is structural,( I have a recessed jaw, I have a narrow jaw and nasal passages), and how much of it is emotional?

Can someone help here. I get the problem of a tighter inhalation through the nose when my muscles relax. Is it throat muscles thats causing it? When nodding off i get a sort of relaxing of some muscle and the nose then gets tighter to breathe and i end up breathing through my mouth. Can anyone help. What kind of collapse is going on here? Thanks

Tell me, do you have nocturnal nasal congestion? Do you have nasal resistance? I have a strong belief our noses are the culprit to our SDB. Your mouth is open at night for a reason, your nasal passages are congested and restricted. Discuss.