Can Upper Airway Resistance Syndrome Explain My Poor Sleep?
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- čas přidán 30. 11. 2021
- Upper Airway Resistance Syndrome is commonly missed or even dismissed by many doctors as a source of your chronic fatigue or poor sleep. Dr. Park explains what UARS is and answers your live questions.
My interview with Dr. Christian Guilleminault on UARS
doctorstevenpark.com/guillemi...
My interview with Dr. Barry Krakow on ASV for UARS
doctorstevenpark.com/krakowin...
Discover 5 Simple Steps to Wake Up Refreshed and Ready to Go!
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Hello there from the UARS sub reddit. Thank you for your advocacy!
These days we're on r/UARSnew
Really good. Thank you so much for this info
Rhinomanometry gives you objective measurements of nasal function. This is clinically VERY relevant
Wow this is so helpful. My Ferratin is so low, it is at 4. So the low levels are possibly contributing to the breathing disorder during sleep.
Thank you! I missed the part in the video about Ferratin. My iron levels were tested low about a year ago. I had not made the connection.
Hi Dr. Park,
Your information about upper airway resistance syndrome was very informative.
From the comments below, viewers might be interested in learning about sleep. If you are looking for a doctor's perspective on this subject, then Doctor Avinesh Bhar would be interested in doing a podcast with you on this subject. He is a fellowship-trained and board-certified doctor in sleep and pulmonary medicine. He is based in Macon, Georgia, and has a sleep treatment practice.
Thank you.
One other request Dr. Can you publish a video on dual therapy, with both MAS and CPAP for treating UARS. Some people it seems CPAP does not address UARS, even at high pressures
22:54 That is such a inspiring case! Is the higher suspension and palatalplasty you mentioned a U3P procedure or one subclass of U3P? Is it a major surgery or done in the office? Please offer a little more detail, as I’m afraid of the painful U3P. Cheers!
Can you publish a video on Nightlase laser treatment? In particular, how it can be beneficial for some one already using CPAP with flow limitations (as seen in CPAP data) -UARS. They want to continue using CPAP but increase the airway open volume to reduce UARS.
Such an informative video - thank you. I've just been diagnosed with UARS in the UK and it makes such sense of the symptoms I've had for several years.
Yours and an English surgeon's videos give great hope! Is it possible for you to place the links you mentioned in the comments section?
Which symptoms did you have? I think i might also have UARS
@@coredeadman5980 Sorry, only just seen your question? Symptoms: Unrefreshed sleep, fatigue, morning headache and awareness of momentary awakenings in night.
Sleep study didn't show sleep apnoea - but did show RERA's (Respiratory Effort Related Arousals). ENT consultant showed no interest, so asked for appointment at Royal National in London, headed by Vik Veer - who makes wonderfully informative videos on CZcams. Hope this helps - good luck.
@@robertp.wainman4094 did he treat you?
@@coredeadman5980 Still waiting for appointment.
@@robertp.wainman4094 ah ok, i am also waiting for an appointment at a clinic.
I'm in western Canada. My private sleep clinic has never heard of Flow Limits (one of the basic parameters measured by CPAP machines) and my local ENTs have never heard of DISE. My nervous system is a mess from UARS. I really wish I had access to Dr. Park's kind of expertise.
There's a doctor in LA at the breathe institute named Dr. Coppelson who treats UARS. He treats patients from all over including out of the country. Might want to look into that. He is doing my MIND procedure in a month to treat my UARS.
For handling my nervous system, I avoid coffee for the most part, I take CBD oil 1-2x daily, and I do buteyko breathing exercises at least 2-3 times a day to help calm me down. I try to relax as much as possible. I also go into the steam room a few times a week. HANG IN THERE!! HOPE THIS HELPS.
@@teethree141 Thanks so much for the advice, I really appreciate it! I hope things improve for you too.
@@teethree141 Hi, may I know what was the procedure you received to improve your UARS? I may undergo U3P but scared.
Dr. Park, does Hypothyroidism cause UARS/apnea or does UARS/apnea cause hypothyrodism. I've heard that hypothyroid does disturb sleep
How will having a total rhinectomy affect my breathing?
Hi Dr. Park, I just completed a home sleep study. Clinically, I have been diagnosed with a narrow palate, elongated soft palate, retrognathic mandible, abfraction on the majority of my teeth, Class II occlusion, anterior open bite (only 4 of 32 teeth contact when I occlude), osteoarthritis of my TMJ and myofacial pain in the masseter muscles. I personally know I snore (loudly). I wake up exhausted and have daytime sleepiness. I have morning headaches 5-6 days a week. I wake with dry mouth and a sore throat. My sleep study results came back after a one-night home sleep study. What are your thoughts about whether or not I should request an in-lab sleep study? I am also looking into mandibular advancement since my jaw has signs of DJD, worn condyles and flattened articular eminence. I'm worried that insurance may not cover my jaw surgery if I do not have diagnosed OSA. Here are my results of the sleep study: There was 10 hours of recording time including 8 hours 59 minutes spent in bed. During that time, there were 24 respiratory events recorded including 10 apneas, majority of which were obstructive in etiology. The respiratory event index was 2.7 per hour. The supine REI was 4.6 per hour. The minimum saturation was 89%. The oxygen desaturation index was 1.8 per hour. Saturation was less than 90% for 0.1% of the night. Snore index was 17.7%. Average heart rate was at 69 beats per minute.
IMPRESSION:
1. The study quality appeared to be adequate for interpretation.
2. The patient does not have significant OSA based on an REI of 2.7 per hour with a total of 10 apneas, a minimum saturation of 89% and an ODI of 1.8 per hour. There was no significant clustering of respiratory events in supine sleep.
Thank you!!!
Ms. Harris, I understand your predicament. It's clear you may have UARS but have a "normal" sleep study. It sounds like you may need extensive orthodontics, palatal expansion, and/or perhaps even jaw surgery. The home studies aren't very good at picking up subtle respiratory events. One home test that I like is the WatchPAT device. It detects your sympathetic arousals, rather than breathing pauses. You need an AHI or RDI > 5 for coverage of OSA treatment if you have major symptoms or complications. Some will require the threshold to be > 15. Also, sometimes if you slept on your back for too short a time, then your overall RDI will be lower. Good luck, and please keep up updated on your progress.
@@stevenpark5218 Thank you again for the information after I sent my first message. I wanted to update you to inform you I had a CBCT scan done of the TMJ and head/neck region. Interestingly, I found our my oropharyngeal airway is very narrow. The jaw specialist had my scan sent to a maxillofacial radiologist for review and determined that the minimum cross-section of my oropharyngeal airway is 68 mm squared during the day, whereas, in a normal person, it should be between 300-400 mm squared. Of course at night, it is most likely being constricted even more. Unfortunately, I cannot be seen by a sleep specialist for 3 months, but am hopeful that I can have another sleep study done (in lab). I'm wondering if insurance might cover jaw surgery, given the narrowed airway. I'll keep you updated on what I find out! Thanks so much for bringing light to this complex topic!
I cannot sleep with a snorkel on my face. I’m screwed.
Thank you, Dr. Park for your help with navigating this complex realm. I have small nose, collapsed nasal valves, allergies, UARS (CPAP does not work) w/ significant TMJ due ti childhood extractions, retractive orthodontics as a child. My TMJ dental specialist does not recommend a MAD as my jaw is already forward due to years of grinding I have enlarged mandibular tori and use a dentist prescribed bite splint at night to prevent grinding. It only helps off and on with sleep arousals. I'm not keen on major surgeries or invasive expansions, or even Envisalign, as I have neck and head pain once I start changing my bite. I'd be open to considering other options, minor nasal or other surgeries. Would you have any other possible ideas? I still need to have a sleep induced endoscopy.
Rainbow & Sunsets, sorry to hear about all your health struggles. Unfortunately, there's only so much you can do given a very constricted airway due to a small mouth. All the conservative options will only give you mild results at best. Some people with UARS do well with CPAP, but most don't. Major jaw expansion, orthodontics and even jaw jaw surgery may seem too aggressive for you, but at a certain point, you may have to start thinking about it. Best wishes.
@@doctorstevenpark Thank you kindly for the reply! 🙏🏾
Gosh I’m sorry for all that suffering! I got pushed into Invisalign by my dentist and there are many problems it can cause, I think you’re wise to avoid it. Praying for your healing 🙏
@@Jo-lp1px Thanks. I am managing very nicely without doing anything painful or drastic. If you'd like I could share what has been working for me. Breathe well!
did u find anything that helped?
Thank you for the great video. I was wondering if you knew of ENT/Sleep doctors or pneumologist that are aware and know how to "treat" UARS in Canada - Quebec - Greater Montreal region? It seems to be very difficult to find someone relatively aware of that condition. It's very frustrating to not be understood.
Sorry, but I don't know anyone in your area. Your best bet is to start with an airway-centric dentist. Good luck!
I am a dentist in Ottawa and may be able to help!
Hello, can UARS also cause frequent urination at night? Thank you doctor
@@stevenpark5218 why are you using that site? Isn't that a phishing/malware site?
can you post a clean link?
Thanks for letting me know. Yes, UARS can cause nighttime urination. See Dr. Deb Wardly's paper here.: tinyurl.com/2p86xvj8
@@doctorstevenpark Thank you doc, meanwhile I did the sleep study and the doctor said I do not have sleep apnea, yet I do have the symptoms of someone that has it and I'm also thin. I noticed much better sleep after using nasal irrigator ,nasal strips (my nose is thin and constantly congested), and switching sleep position (tennis balls technique). I will see an ENT next.
update for anyone that cares: I'm getting deviated septum surgery and turbinoplasty. Hopefully this will be enough
@@jamesdarwin6608 same here, I’m struggling with brain fog, always feel tired and lack of concentration. I have a deviated septum. Hopefully the surgery will make it so much better, good luck to you too
Hi Doc thanks for the video. I have UAR and sleep apneas, CPAP is not working for me. In general, how should a CPAP machine should be programed to treat UAR?
George, although there have been some patients with UARS that respond to CPAP, the overall rates are not good. Besides other troubleshooting steps with CPAP, another option is ASV or auto-bilevel. People who have found success like the Philips model better. There is a new Chinese option that's less expensive. It's not something your sleep doctor is familiar with, so you'll have to do it on your own. Are you able to breathe well through your nose?
@@stevenpark5218 Thanks for the answer. Yes i can breath through my nose, but im also a mouth leaker so i tape my mouth and kind works. I´ve tried APAP, AutoPAP not a big difference with diferent preasures and ramps, nothing seems to work. I make my follows with the OSCAR software, my AHI are all bellow 1, but it seems that i have lots of arousals that arent detected by OSCAR. Some nights i also use a mouth guard with a fullface mask but no diference Havent tried bilevel yeat
@@lorenzoishere What was your RDI? Did you do PSG sleep study? No in-lab titration to see if the PAP is working right?
@@shuikai272 Hi sorry for the delay. Dont remember my RDI but it was high. Yes i did a lab titration but as i said before, the numbers using a CPAP are good, RDI still high, but AHI is 1 or below so they tell me everything is OK
@@shuikai272I think I have UARS and my resmed airsense 10 doesn’t seem to be working :/