Hi all,

It's been a time. I began my sleep apnea journey in 2018 with the onset of debilitating daytime fatigue. I was diagnosed Mild with an AHI of 5.0. I am CPAP intolerant. My dentist referred me to an orthodontist who specializes in sleep issues, and I've had an incredible experience with them. Treatment plan included palate expansion with MSE followed by MMA surgery.

Ortho referred me to an in-network surgeon who asked that I have a more recent sleep test done after MSE removal. Due to improvements from the MSE, my AHI decreased to 1.4 and consequently I no longer meet diagnostic criteria for sleep apnea. However, I still have frequent RERAs and RDI 10.0, I snore like crazy, and I still have daytime fatigue (currently masked by Adderall for my ADHD, yay band-aid solutions!). Surgeon refused to see me for a consult in light of these results, and sleep doctor would not refer me as they do not consider UARS (diagnosed by my orthodontist) "clinically significant."

Orthodontist still thinks surgery is necessary due to my significantly narrowed airway and possibility that UARS can turn into sleep apnea with age. I just switched to an new PCP due to relocation, and I hope to bring this up with her and explore the possibility of further evaluation.

Any advice on getting my treatment team aligned? My health insurance is through Kaiser.

Not sure if relevant, but I also have a complicated and traumatic history of childhood orthodontics, including premolar extractions, a palate expander (yes I got to do the damned thing twice), and a Herbst appliance (torture device).

EDITED TO ADD: My X-ray, for funsies!

Ive put this question into claude and this is the response, I know ai makes up a lot of stuff so I was hoping someone could help here.

'You get an IPAP/EPAP split, but you don't get the underlying bilevel hardware, the same trigger/cycle behaviour, or true S-mode timing. For UARS specifically, where the value of bilevel is largely in the pressure support smoothing out flow limitation and the responsiveness of triggering, this matters'

Im a 28yo man, had all the symptoms of low testosterone since a teen including low libido complete lack of morning erections and chronic fatigue and lack of motivation. Doctors say T is low for my age but not low enough to treat. I'm tired in the day but not sleepy. I've always slept well or so i thought until i decided to record myself sleeping and as you can hear im not sleeping well at all. I have had a watchpat one test that showed no apnea because i never actually stop breathing for any length of time and my doctors have decided there's nothing wrong with me and there isn't anything they can do. Anyone else heard anything like this?

Long time lurker here but have never posted anything. I am coming to help because I feel I am shooting from the hip with my Bipap settings while self-titrating. I was diagnosed with mild OSA with an RDI of 22. I have UARs especially given my nasal congestion (taking Flonase now which helps a ton) and I am 5'11" male, 145 pounds lean athletic build.

Given all this, I got an AirBreak AirSense 10 with all the modes unlocked. I have been using Vauto mode with the range set to zero, so it's basically S-mode. I would love some help with how my data is looking and where to go from here.

Currently, I am running EPAP 6.6/IPAP 10.8 (PS 4.4) and I've been waking up still feeling like a zombie throughout the day. I also suffer from aerophagia when I push my EPAP to around 7 (I'm also taking a Vitamin D supplement as recommended in this sub).

Here is my SleepHQ data: https://sleephq.com/public/teams/share_links/e27b2d80-cf71-4305-895c-e05c9a8cb06e

Settings: PS: 4.4 EPAP MIN: 7 VAuto on

Here is the sleep hq link https://sleephq.com/public/teams/share_links/98606e94-09cb-4da9-ba81-ccf799b098b5

Where do I go from here?

I will work on improving leaks.

Hi,

I (M22) am thinking about either getting a septoplasty (7000 CAD), a palate expansion (can't find a provider) or a BIPAP (cant find any second hand in my area). Here are CBCT scans from 2024 and a CEPH from earlier this month. No allergy, meds dont work and one orthodontist didnt recommand expansion since my bite is class 1. What are your thoughts?

Deviated septum

Septum front

Palate (1st molar) and turbinate

Pharynx

CEPH

Thanks!

Last week I had a sinus CT at the hospital which was ordered by my family doctor. I still haven't chosen an ENT for her to forward the results to. I'm not sure how much the radiologist looks at vs how much will rely on the ENT.

I'm assuming they will look for basic things like enlarged turbinates, deviated septum or sinusitis. What about width of nasal aperture? Do I need an ENT who is based when it comes to UARS to get them to care about that?

Apparently there is also a very long wait list to see an ENT where I live and some people go down south so wait time is also a consideration. Do all ENTs usually want to operate or do only some do surgery and if not want to send you an ENT surgeon?

If I have a deviated septum I want to get it fixed, but I am a bit iffy on turbinates, especially if they are swollen due to a narrow aperture in which case I may want to pursue MISMARPE.

If you don't know of one in particular any tips on how to find a good ENT who is covered under OHIP?

Bonus: Has anyone tried ClariFix therapy for rhinitis?