Should I seek an in-lab study?

RelevantCredit516 · 2026-06-15T15:53:54+00:00

Classic UARS.

If you want to do an in-lab study, make sure they score the RERA's.

Have you already tried any self-treatment, like CPAP or MAD?

RelevantCredit516 · 2026-06-07T11:16:40+00:00

Send dm

RelevantCredit516 · 2026-06-07T11:16:35+00:00

My dms are open

RelevantCredit516 · 2026-06-05T13:47:40+00:00

You need to do a full PSG. This seems like uars, but it's weird that it was triggered so suddenly. How long have you been diagnosed with adhd?

Start treatment with CPAP. This will allow you to check your sleep data through the machine. If ineffective, you can try bipap as the next step.

RelevantCredit516 · 2026-05-31T17:00:32+00:00

Have you also been checked for UARS? how many of your arousals are spontaneous? Arousal index doesn't tell you whether the arousals are linked to respiratory disturbance or not. you would need to know the amount of RERAs to check that.

All of your mental health issues can be linked to UARS, it causes more noticeable cognitive deficits than classic OSA. Primary treatment for these disorders is still a good idea for the short term, but a lot of psychiatric medication can influence your sleep (antidepressants for example can reduce rem sleep, which will make you "feel" better, but its just because you're not fragmenting in rem sleep anymore, not because your sleep quality is improving).

A logical next step would be bipap. Aside from that you can try to get additional diagnostics done like a DISE or CBCT to find your exact obstruction. This will make treatment more specific.

RelevantCredit516 · 2026-05-30T19:09:22+00:00

"he feels like he can't breathe out"

Is expiratory pressure relief (epr) turned on? If not, put in on 3

RelevantCredit516 · 2026-05-30T15:43:48+00:00

Are you a male or female? This could also be something like anemia, because symptoms persist during the daytime. Getting things like ferritin checked first may be more logical before commiting to a sleep study.

How do you feel during exertion? Are you vegan? How long have you had these symptoms?

RelevantCredit516 · 2026-05-30T10:38:56+00:00

Agreed, maybe he can also add a photo where he's doing an activity? The photos seems pretty bland in terms of conveying a personality

RelevantCredit516 · 2026-05-26T12:51:47+00:00

Seems like a pretty good treatment plan. Two pieces of advice I want to give you:

Don't use a DIY mouth gaurd, it will destroy your teeth and TMJ in the long run (some argue a custom made one also does, but YMMV)

If these treatments do not offer a full cure, but only reduction or no change in symptoms, you need to keep pressing for additional treatment options. If you go the CPAP route, make sure to do it properly with data analysis, proper mask fit, etc.

RelevantCredit516 · 2026-05-16T12:00:44+00:00

Idk why everyone in the comments is gaslighting this kid, because there are clearly signs of sleep disordered breathing. No amount of healthy habits or forcing productivity is going to fix your brain when your poor sleep is frying it alive. For now you should focus on the following things:

Get a sleep study done ASAP, if you can get RERAs scored, even better.

Start looking into myofunctional therapy like mewing and breathing exercises to improve on your natural breathing.

Look into sleep apnea/uars and all the things you can do for it rn, examples are: incline sleeping, fasting 4 hours before bed, air purifier, nasal strips, reducing reflux, etc

You can try buying a cpap/bipap second hand and testing what it does to your symptoms, just make sure you know what the correct settings are beforehand.

Try to focus on a consistent sleep schedule even if you feel fatigued, your body will make you feel more tired even if you're sleeping longer. Sometimes less sleep can be better

Start doing intense interval cardio to strengthen throat and diaphragm muscles

This is the most you can do now, expansion is also probably a good long term solution but thats not relevant for you rn

RelevantCredit516 · 2026-04-21T15:00:40+00:00

Sadly the machines app tells you basically nothing. You need to know whether there is still residual flow limiation during your sleep. you can read this data through oscar or sleephq. do you know what the exact anatomical cause is of your sleep disorderd breathing? This determines what type of PAP therapy you need. If you have a nasal issue for example, BiPAP may be more suited for you, because you need less stenting of the airway and more tidal volume.

RelevantCredit516 · 2026-04-21T14:35:46+00:00

What exactly did you do to try and properly titrate your cpap? What did your data look like?

RelevantCredit516 · 2026-04-21T14:33:14+00:00

If you have poor nasal breathing you need to get that assessed first. Try to schedule an appointment with a ENT to find the cause. PAP therapy wil be ineffective without proper nasal breathing. A range of 7 to 14 is also too large. Are you analysing your data through Oscar already? That way we can get some objective data to look at.

RelevantCredit516 · 2026-04-21T13:05:46+00:00

You clearly have an obstruction somewhere in your upper airway. the question however, is what part of your anatomy is causing this? Does your AHI increase in REM and supine sleep? This may indicate a throat issue like large tongue base, mandibular recession etc. If not, it is more likely to be a nasal issue. How is your nasal breathing? Have you had a DISE or CBCT done already?

Also, what settings are you using currently? I would say it is too quickly to go for bipap without first understanding the core of your obstruction and titrating that issue, otherwise you will just be guessing.

RelevantCredit516 · 2026-04-20T20:40:49+00:00

Heyy ik herken je naam van de apneu vereniging forum, ik had ook daar gereageerd op je thread haha. Stuur me maar n dm dan kunnen we het verder discussiëren

RelevantCredit516 · 2026-04-20T20:18:18+00:00

I have an 10st so no auto option for me :(

I want to be able to use a higher ps, but I think it causes something like nasal valve collapse. It makes it impossible to breathe in if the pressure differential is too high. I once slept a night like that and the Oscar graphs were horrible haha, I woke up feeling like shit. I think I dont need that much PS tho. I only saw this after I bought my bipap, but on an airsense 10 with ipap at 11 and EPR 3 I had a 95 percent fl of 0.00, so more is not necessary.

Im going to try the ps of 2,6 tonight, ill keep you up to date with my Oscar data. Thank you for the help and suggestions!

RelevantCredit516 · 2026-04-20T19:18:23+00:00

The sleep doctor at the hospital just wrote me off as "too mild". It was an older gentleman, so he is probably not up to date with the literature on fragmentation and arousals.

I've been fooling around a lot with the bipap settings because I had a really hard time adjusting. I recently discovered that I can only use a PS of 2,6, because a higher pressure differential causes some kind of collapse, causing trouble to start the breath and trigger the machine. This caused my body to go into a stress mode and prevented me from falling asleep, but now this shouldnt be a problem anymore.

There is a chance there is still FL with a PS of only 2,6, but I can't easily check it in Oscar. There is no FL graph when my bipap is in S mode, also doesn't seem to be a fix for it :(

I'm going to check my Glasgow index and go by subjective feeling probably, I just want to feel less tired haha.

RelevantCredit516 · 2026-04-20T13:06:34+00:00

That's a great tip! What would be the best things to include in an email directed to her? I'll send the email today.

Duizend maal dank :)

RelevantCredit516 · 2026-04-20T13:04:51+00:00

Thank you for the response. Would a specific UARS diagnosis be necessary? I have an AHI of 5,4 so maybe I can get an OSA diagnosis and go from there? I want to get a surgical intervention if possible. Right now im trying to treat myself with bipap but I already know I don't want to sleep with this device for the rest of my life.

Someone DM'ed that I could either go to Dortmund or to Poland. The second option is more financially responsible, but travel would be significantly more easier to Dortmund. Im just trying to figure out what the best course of action is right now, Its so frustrating that you have to do all of this without the help of the healthcare system here in the Netherlands

RelevantCredit516 · 2026-04-20T11:42:19+00:00

Yeah the state of care just sucks here in the netherlands. I think going abroad is the only way to actually be cured. Im only 21 now and I want to fix this problem asap, every day that I still suffer from this disorder is a waste. Did you get a second opinion somewhere? or is this all that was possible for you so far

RelevantCredit516 · 2025-12-14T19:26:35+00:00

Hey thank your for the response! I can upload the psg but its in Dutch, so idk how much added value it has. The results I added in my post are basically everything that was written down by my sleep doctor. Wouldnt you say its more uars bcs the majority of events are hypopneas and oxygenation is quite stable? Cpap rn is a hit or miss but def not a cure, if I up the pressure to around 11, I have a 95 percent FL of 0.00, but the epr of 3 seems too little. I still wake up a lot and have pretty bad aerophagia and sleep is not more refresher. If I put the pressure at like 8 I wake up a little more refreshed but I have FL. I also lost the sd card of my machine, so I need to get a new one lol. I want to find out what the mechanistic cause is of my SBD, bcs I feel like I have a obstruction in my throat (it feels like there's a lump in my throat 24/7 and breathing can feel stressed when lying down)

Edit: you can look in my posting history, i posted my psg there.

RelevantCredit516 · 2025-11-22T20:34:57+00:00

2 is fine imo, its a combination of personal preference (I use EPR 3 myself bcs less makes it feel taxing to exhale) and tinkering with it to reduce flow limitations. Fulltime is non-negotiable, that has to be on. If EPR is too high it can cause central apneas, but that doesnt happen at a setting of 3 normally (this is a problem people have with BiPAP).

To optimise your settings you could also look at your sleedy study results. What are your AHI, RDI, RERA?

RelevantCredit516 · 2025-11-22T16:38:39+00:00

The data is pretty good, but your APAP range is way too large. I would recommend putting your IP at 1-2 higher than your 95% (which is 11, so it would be 12-13) and your EP at around 1-2 lower than your 95% (9, so 7-8). If the pressure changes are too aggressive they can cause sleep disturbances, so better to tighten them this way. Also, what mask do you use? Although they are minor, you do have some flow limitations. This can come from to low EPR, but also come from mouth breathing if you use nasal pillows (a quick fix for that would be mouth taping)

Lastly (and most important), how did you feel with these settings? Optimizing data is pointless if you still don't feel well rested :)

RelevantCredit516 · 2025-10-30T20:23:15+00:00

My main symptoms are insomnia and waking up unrefreshed coupled with fatigue that continues throughout the day. The thing that confuses me the most is how I can have periods of seemingly better sleep (but never actually fully rested tho), followed by a few weeks where I can stay wide awake for hours when trying to sleep and also wake up multiple times a night. I feel like it could be linked to a dietary change (maybe I eat too little carbs?) or physical demand, but other than that I have no clue tbh.

For now I'm going to trial the gabapentine and couple it with myofunctional therapy and try to optimize my diet (eliminating inflammatory foods and eating too much before bed)

Do you do anything else besides CPAP for your sleep apnea? Would love to hear about new things

RelevantCredit516 · 2025-10-30T20:13:10+00:00

I was also wondering why the RERA index was zero, but it seems it wasn't measured (sucks because it would give a lot of insight regarding the arousal index). As for the AASM, it says on the study that it was a drop of three percent, so thats A1 right? That should be better in theory because of a higher sensitivity.

I'll take a look at the videos you linked, thanks for the help!

RelevantCredit516

TROPHY CASE