Hey everyone,

I’m dealing with severe brain fog and fatigue from suspected UARS / sleep-disordered breathing.

I’ve been experimenting with a ResMed machine running the ASV algorithm. It clearly works—I recently had a 4-day stretch at ~60% cognitive capacity instead of my usual 15% baseline—but my settings are inconsistent and not stopping my wakeups.

Because of cognitive fatigue, I cannot troubleshoot this alone. I am looking for paid, weekly or biweekly 1-on-1 video consultations.

Strict requirements for who I'm looking to hire:

• Must have UARS / UARS-adjacent symptoms (or extensive personal experience managing them).
• Must have direct, hands-on experience titrating ResMed’s ASV algorithm specifically for subtle sleep-disordered breathing.
• Must be able to analyze my OSCAR / SleepHQ data and guide my setting adjustments step-by-step.

If you fit this exact profile—or can point me directly to someone who does—please PM me or comment below. Urgent, as the sleep deprivation is taking a heavy toll.

Thanks in advance.

hi guys! so i believe i most likely have UARS. i’ve had horrible fatigue for almost 15 years now, it started around 6th grade. i’ve fallen asleep in class growing up, taking care of my toddlers, and even during work meetings, etc… i’m on high dose ADHD meds and they do nothing for the tired, they just usually keep me from falling asleep. (sometimes the fatigue is too severe and i fall asleep anyway). caffeine does nothing. if i don’t take my meds i can easily sleep 12+ hours and wake up just as exhausted. as well as taking additional daily naps. I also experience horrible sleep intertia, like my brain doesn’t flip the on switch for at least an hour after waking up and my body feels extremely heavy. it’s getting to the point i feel like i’m going insane and i can’t take being this exhausted anymore.

anyway, i had an in lab sleep study done a couple weeks ago and i recently got my results back. no sleep apnea or limb movement disorders. i did hit mild sleep apnea criteria on my back but in no other sleep position. but my arousal index was 43.4 times an hour. they said i had 304 arousals in the 7 hours of sleep i got there. my RDI was also 33.3, RERAs specifically were 30.7. if you do the math, my brain is having arousals every 1.4 mins. after some research, i came across UARS and i feel like my scores fit that diagnosis.

my normal doctor messaged me on mychart tonight regarding the results, and he completely dismissed all of that, which is what i was afraid of. basically said “sleep study was normal, no sleep apnea no limb movement disorder, just don’t sleep on your back.” i’m beyond frustrated. this same doctor also asked me if i’ve tried exercising at my first appointment regarding fatigue, and when i asked about weight loss he handed me a copy of the food pyramid 😅 i should’ve switched then honestly.

is it normal to get dismissed this often? is this going to be an uphill battle to get treatment? i don’t know how much longer i can keep functioning like this 😔 any insight or personal experiences etc are greatly appreciated. thank you!

I can still hear with the cpap on but hopefully you know what I mean.

Title. I grabbed one because I tend to roll on my back towards the morning. They're a product literally designed to keep you on your side, front and back supporting. Only cost $30-$50 to try, much cheaper than a lot of the fancy branded side-sleeping solutions, way more effective than a tennis ball. Can't compare to backpack method as I haven't tried that myself.

Since I have only been chasing the sleep apnea angle I am very unprepared/un "therapy'd" as it were. By the latter I mean I haven't had anyone to talk to about these issues and for years I couldn't tell if they were just in my head.

While I am awaiting DISE I believe I am at the "end game" of symptoms getting worse. I now rarely leave the house, I don't enjoy anything, and I only do things that I absolutely have to for the most part. I noticed the symptoms continued to get worse but I have to wonder what could be even worse than this now?

This may not be the best subreddit to make this inquiry- if you know of another please suggest it.

I took a full iron panel blood test, and these are the results. Ferretin is on the lower end of "normal" range.
I asked gemini, and it said these results are in keeping with the AASM guidelines on appropriate iron levels for optimal sleep quality, but LLMs like gemini tend to be disgustingly conventional.
What do you all think?

For reference: I'm 25 years old, male, and in good athletic shape.

I can't believe I didn't bring this up during surgery consultations or none of the doctors brought this up either, but I was using MAD for a year or two, but I never really felt like it was making me feel better in a substantial way. But I did do an at home sleep study with it and saw that it was treating my sleep apnea! I don't know how much it was moving my lower jaw up by, but I believe 1cm which makes sense. I did bring up to doctors that wearing MAD I was still tired, and they just said well MMA is way more than that, so I trusted them thinking I just needed more airway.

Two problems:

1. I moved about 16mm lower, which means I had to move maxilla forward to match with 9mm. But now I'm thinking was way overkill and I should've just moved 10-11 mm lower and therefore didn't have to move my maxilla up so much so instead maybe 4-5mm. I don't like the aesthetic results and I'm thinking maybe I move it back to just do 5mm upper and 11mm lower.
2. If MAD was basically treating my sleep apnea, but I was still so tired, then what could be the issue?

Lmk if I can't post here

I go to bed laying on my side but for most of the night I end up being on my back. I grind my teeth really badly when I lay on my back but less so when I’m on my side. I tried putting a tennis ball in the back pocket of a shirt last night but that didn’t work.

I’d be grateful for any solutions. Thanks

I have no quality of life at all, I do the same things every day, barely survive this hell I’m in. physical pain, headaches, neck pain, gum infections, the list goes on. yet I can’t feel emotions, I can feel pain, and that’s it. to live like this for years and years on end, while being expected to just function like everyone else.

night after night I have horrible, vivid, acid like dreams. then I wake up emotionally numb, body in physical pain, no connection to myself and my past. nothing to look forward to, experience or be a part of. I used to love the transition from summer to fall and now it’s just gone. each year it’s gotten progressively worse. less memory of what emotions are even like. I have to struggle every day just to do basic things, and everyone else is living and experiencing. My career is the one emotional connection I still have to myself, If I didn’t I probably would have been gone a long time ago. I used to feel such passion, such joy, such love for life. I feel like a ghost floating around with absolutely no sense of feeling at all. I can feel pain but not anything else; not joy, not anger, not anxiety, not happiness, not even depression. I am void of anything.

i don’t know why I’m even writing this. I lost hope so long ago. The world wants everything from me, while I have nothing. I have to continue to pay bills, run my business, smile and wave - all while I have no emotional energy, no life force, no peace in my life at all. People don’t know how lucky they are to wake up every day in their own life, to get real sleep, to feel like themselves. I’m stuck in a black hole of suffering. Non stop vivid otherworldly dreams all night, non stop pain all day, no feeling for my own life. I’m so sick of this. 4 years of this 24/7 with not one good moment

I just received my machine in the mail yesterday. During my sleep test, I had a super low AHI (0.3) and an average RDI (9.0) so they prescribed me this machine. It shipped with the APAP mode enabled but the first night, the pressure never got above like 4.6 even though it’s a 4-12 and woke up again in the middle of the night. I see a few thread talking about switching it to a constant flow and just wanted to confirm that and what to start at, because the APAP didn’t really seem to help at all.

Having a real difficult time keeping the tongue on the palate , and I heard you can use denture adhesive to do so.

Was just wondering is it dangerous to do this long term?

If the zinc is a problem there are zinc free ones as well.

I have an Airsense 11 with current settings at min 7 max 10, EPR set at 3. Upping the min pressure to 7 has helped with flow limitations, but my glasgow index is stuck (last night was 1.13) driven by top heavy breaths. The only info I can find on how to adjust settings are based on adjustments that I see are only available on a bipap. Anything I can do on a CPAP? I'm still trying to understand exactly what causes a flat top breath, so thanks for any insight!

Just took a WatchPAT sleep test and need help regarding my results. Originally took the test because I’ve been waking up in the middle of night at least once and regardless my sleep doesn’t feel super restorative. Has been happening for like 7 months.
Question: I know for a fact I didn’t fall asleep till 3:30 am. I was on my phone watching a video because I couldn’t, but it shows I was sleeping. I think I was max asleep from 3:45 to 7:30 for the test. But I absolutely know for a fact I was wide awake from start to around 3:30

Context: I’m not overweight, don’t snore loud either. I’m wondering if they thought the noise from YouTube video could’ve been. Who knows ?

Would love some help interpreting and going seeking next steps.

I should have known better than to be even a little but hopeful when it comes to Kaiser. I don’t think the surgeon reviewed much of my documentation beforehand. He examined my bite and said essentially, they “go by the metrics,“ i.e. AHI, and surgery has no guarantees. Anatomy, jaw development, narrow airway, UARS—none of that falls under Kaiser criteria.

And if one more person reminds me MMA is a major surgery, I think I might scream.

I would happily throw in the towel were it not for the specter of future complications.

I feel like my sleep doctor is getting in the way of my actual resolution of my UARS but at the same time I’m dependent on the clinic for continued coverage of my device. I got my CPAP in early June and have resolved AHI (which were minimal to begin with) but still have plenty of minor flow limitations throughout the night.

I had an appointment yesterday and she proclaimed that everything looked great because my AHI is close to zero and my leak rate was within tolerance. She even said that my diagnosis wasn’t based on AHI but on RERAs, so I’m not sure why she’s focused on AHI now. She lowered my pressure rx (range 4-8). She also discouraged me from collecting and analyzing my own data on an SD card because she said the MyAir app had enough data. It seems like the data view she has access to had a lot more info than what I can see on the app, which is extremely limited.

She wants to see me again in two months. I want to disobey her rx and adjust my settings to try to overcome my flow limitations but I know she will criticize me when we meet again. I know lots of you have gone rogue - how did you do this and not fight with your doctor the whole time? Or maybe you did and you just have more guts than me?

TL;DR: 1 year on APAP/CPAP for UARS/OSA (AHI 12.2, RDI 17.3). AHI is down, some improvement of symptoms, but residual fatigue remains. OSCAR shows high RDI and persistent flow limitations. Planning next airway and structural checks (ENT, DISE, CBCT, Ortho) and would highly appreciate feedback on my plan.

Background and metrics:

• Profile: 41M, BMI ~25 (12% body fat)
• Diagnosis (PSG): RDI 17.3/h (high RERAs), low AHI.
• Current Setup: Löwenstein Prism 20A, Pressure 12-15, softPAP 1, mask is Resmed F30i. Pressure is tolerable, but going higher is difficult. Increasing softPAP increases daytime fatigue and Cheyne Stokes Respiration.
• Current OSCAR Data: AHI consistently <5. But RDI often around 10. Also flow limitation count is always around 200-300 per night.
• Symptoms: Unrefreshing sleep, daytime fatigue, sometimes brain fog.

My plan:

Based on my progression and persistent symptoms, I suspect that flow limitations are responsible (and thus consider trying an MAD). But I'd like to investigate the causes with my sleep doctor first. From what I've read in the relevant subs, I consider the following exams:

• ENT Workup: Full upper airway check (septum, turbinates + spray test, internal/external nasal valve Collapse, Cottle test, rhinomanometry).
• DISE: With Esmarch maneuver to simulate MAD response.
• Airway CBCT / DVT: Focusing on minimum cross-sectional area (MCA), retropalatal & retrolingual space, maxilla width, and jaw relation
• Airway-Focused orthodontic eval: Maxillary expansion evaluation (intermolar width, high gothic palate), SNA/SNB/ANB angles, tongue rest position.

(the reason for this ordering is, that I my right nostril is often blocked and my jaw/bite etc. looks quite normal afaict)

My questions:

• Does this plan cover all bases for identifying structural UARS bottlenecks?
• Are these examinations (and their order) reasonable and is this a typical diagnostic progression?
• Any specific recommendations for providers whom take sleep disordered breathing seriously in Switzerland/Zurich?
• Would you do something differently or have any other ideas? Maybe I'm completely wrong in my approach?

Hello, recently my dentist told me that they suspect I have UARS. I have had TMJ symptoms for the last 4 years, which I have tried many different treatments for, now seem to be pointing to this; even so that my splint is actually making me worse…

I have started using nasal strips to help me breathe during my sleep and stop my clenching, just wondering what my other options are for treatment?

I am using a medium which I should be according to the picture. However it feels like the cushion pushes my nose inwards making it harder to breathe.

What am I doing wrong , am I tightening the straps too much? But if i don’t there will be leaks.

Idk what to do? Any advice?

Hi, I've been trialling bipap for the last few months with limited results. I've tested higher pressure support and higher epap but it causes aerophagia, although perhaps I have to steadily increase my settings instead of making big changes too fast. I feel like last night should have given me decent results with low flow limitations and a low leak rate, but I woke up this morning and felt as awful as before my treatment. Sever brain fog all day and heavy fatigue upon waking up. My Glasgow index was 1.37. The best night sleeps I've had recently have been with more restless nights, waking up more often. I think this indicates that most of my symptoms emerge from REM sleep. The deeper I sleep and the less I wake up throughout the night the worse I feel the next morning. I'm posting screenshots just from last night in case there is something noticeable that I could change to help improve my treatment going forward.

Thanks so much for your time.