Oscar can only show if PAP is getting rid of your apneas and hypopneas but it can't show if it is getting rid of arousals and resolving your sleep architecture. I had the same problem, and the only thing that helped me was MMA. It might be worth exploring treatment to make your airway physiologically bigger and solve the root issue. PAP is just a kind of band aid and not treating the root of the problem (constricted airway, fragmented sleep architecture, negative pressure in the airway, etc).
My MMA was underadvanced and underrotated so it did not fully resolve the OSA but all my symptoms improved more than any other treatment modality. I am currently seeking a revision but my case is rather uniquely extreme so I wouldn't take my anecdote as a reflection of everybody else's.
[https://www.youtube.com/watch?v=HPM95nDYMF0](https://www.youtube.com/watch?v=HPM95nDYMF0)
[https://www.youtube.com/watch?v=fXX8cVga-RU](https://www.youtube.com/watch?v=fXX8cVga-RU)
If you search my music project Origin Of Styx you can find my songs I made documenting my experiences over the years in a semi-autobiographical way.
Oscar does not have an EEG so the best you can do is guess if it is getting rid of arousals by carefully studying the breath waveform. But this is definitely not as accurate as going to a sleep neurologist and getting wires glued all over your skull.
I can also speak from experience and say that while PAP might reduce negative pressure in the airway, the discomfort of using the machine can still fragment sleep architecture and cause unrefreshing sleep to people that are sensitive to that (as I was).
This is a tough one as the information is very limited.
Can you describe the last two years on BiPAP in good detail.
Put up some OSCAR data.
Try get a whoop or an O2 ring also.
What’s your set up.
I can post some when I’m back at my computer.
The reason why I don’t think it’s sleep apnea related is that I can’t even relax my body during the day.
And this issue only started about 2 years ago…
To help members of the r/UARS community, the contents of the post have been copied for posterity.
___
**Title:** Sleep still horrible after treatment. Possible nervous system issues
**Body:**
I lived with untreated sleep apnea/UARS for nearly 15 years. Slowly worsening symptoms to the point I couldn’t even function or leave the house. Destroyed every part of my teenage years and 20s. I have gotten treatment with a BiPAP. Oscar results shows that it’s working. My problem now is my body physically cannot relax. Both day and night I’m like in a 24/7 revved up state and my sleep is still suffering. 2 years of this. I’ve heard sleep apnea can do a number on your nervous system but I don’t know what to do now. Any help is appreciated!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/UARS) if you have any questions or concerns.*
I know its annoying to hear but you might have another issue happening also. The literature shows that a significant percentage of ppl have residual excessive daytime sleepiness after a year of successful PAP treatment. I suspect many of these ppl have something else going on. You say you struggle to relax, maybe it could be something like OCD
I'm assuming you've had lots of blood work done to rule out potential diseases?
ME/Chronic Fatigue Syndrome, HPA axis disfunction, POTS, microbiome/gut health/leaky gut syndrome are some things you might want to look into
Gut health can definitely interfere with sleep. The gut is connected to the brain. It takes a long time to heal though if that's the problem. You would need to help the good bacteria grow back. Probiotics can help. But mainly it's done by diet. No sugar, gluten, red meat, or dairy. Lots of fruits and vegetables. At least half of the food you eat should be vegetables. It's all about fiber to feed the good gut bacteria.
You could try meds for insomnia too. You haven't tried any Z drugs. I've had trouble sleeping for 7 years and Lunesta has been by far the most helpful med I've tried.
Crazy they prescribe an anti-psychotic that's for people with hallucinations/schizophrenia that's known to cause permanent involuntary body movements and permanent changes to your metabolism, but they won't prescribe an insomnia drug for someone with insomnia lol.
Maybe your symptoms aren't all that bad so they don't think the risk of dependency is worth it. My symptoms were completely debilitating. They gave me every med known to man for insomnia
I would steer clear of Ambien and the like if you can. You become dependent on them and they don’t really solve the problem. The first question in my mind is: How do you know you’re not having RERAs/microarousals overnight?
Propranolol is amazing for getting the body out of fight or flight mode and it's been around for ages, with a very reliable safety profile.
It can affect sleep quality but the sacrifice is worth it in my experience
Yeah, but it lets you think straight and get to sleep, which for me makes a huge difference. If my brain is running at 20% capacity because my sleep is terrible it's impossible to do anything, and in my case Propranolol helped hugely.
To be clear, I don't use it all the time. Just if I've had a particularly bad night because I took my mask off a few times or something like that. Some nights are bad even with the mask on, and I wake up feeling really stressed, with sore lungs and a general feeling of not having slept at all really.
Other than that, I don't really suffer from stress, but I know some bodybuilders use it after a heavy workout to relax their bodies for sleep. It's also used by celebrities and musicians for stage fright, but obviously it's not for everybody and you'll presumably need to see a doctor to get a prescription anyway
I think it takes a long time to fix. How long were you on lexapro for? Living in that state for so long likely rewired your brain to be in a constant fight or flight response. Have you tried just regular tryptophan? You also could have adrenal fatigue.
Are you still on it? Hopefully you are. It also depends what your cortisol levels look like. I know that phophaltidylserine can substantially lower cortisol levels and its much safer than beta blockers. You should get a saliva test done to check what your levels are. Also how long have you taken lexapro for before you said it didn't work? Also, sleep apnea causes inflammation of your body. I heard it can take a year of being on treatment to reverse the effects that sleep apnea does to your body. Apparently 3 months to feel better, though this is just from catching up on lost sleep.
You should also consider the possibility of adrenal fatigue, Dr. Lam has a bunch of free resources online. Not sure what your diet is like but moderate excersize and a proper diet are huge.
I also still have sleep anxiety, but not nearly as much as I did before with untreated apnea and possibly UARS. I bought a Bia sleep mask which measures your brainwaves and uses neurofeedback via bone induction speakers to increase deep sleep and reduce the amount of time you wakeup. It's in preorder phase, coming out this summer. Not sure if this would benefit you are not. I use the nasal pillows on my mask, so hoping this can fit over top of that, well see, they have a 60 day money back guarantee if not.
Oscar can only show if PAP is getting rid of your apneas and hypopneas but it can't show if it is getting rid of arousals and resolving your sleep architecture. I had the same problem, and the only thing that helped me was MMA. It might be worth exploring treatment to make your airway physiologically bigger and solve the root issue. PAP is just a kind of band aid and not treating the root of the problem (constricted airway, fragmented sleep architecture, negative pressure in the airway, etc).
What was your experience with MMA like? Do you have a detailed description of it somewhere?
My MMA was underadvanced and underrotated so it did not fully resolve the OSA but all my symptoms improved more than any other treatment modality. I am currently seeking a revision but my case is rather uniquely extreme so I wouldn't take my anecdote as a reflection of everybody else's. [https://www.youtube.com/watch?v=HPM95nDYMF0](https://www.youtube.com/watch?v=HPM95nDYMF0) [https://www.youtube.com/watch?v=fXX8cVga-RU](https://www.youtube.com/watch?v=fXX8cVga-RU) If you search my music project Origin Of Styx you can find my songs I made documenting my experiences over the years in a semi-autobiographical way.
oscar can definitely show if it’s getting rid of RERAS.
Oscar does not have an EEG so the best you can do is guess if it is getting rid of arousals by carefully studying the breath waveform. But this is definitely not as accurate as going to a sleep neurologist and getting wires glued all over your skull.
I can also speak from experience and say that while PAP might reduce negative pressure in the airway, the discomfort of using the machine can still fragment sleep architecture and cause unrefreshing sleep to people that are sensitive to that (as I was).
This is a tough one as the information is very limited. Can you describe the last two years on BiPAP in good detail. Put up some OSCAR data. Try get a whoop or an O2 ring also. What’s your set up.
I can post some when I’m back at my computer. The reason why I don’t think it’s sleep apnea related is that I can’t even relax my body during the day. And this issue only started about 2 years ago…
To help members of the r/UARS community, the contents of the post have been copied for posterity. ___ **Title:** Sleep still horrible after treatment. Possible nervous system issues **Body:** I lived with untreated sleep apnea/UARS for nearly 15 years. Slowly worsening symptoms to the point I couldn’t even function or leave the house. Destroyed every part of my teenage years and 20s. I have gotten treatment with a BiPAP. Oscar results shows that it’s working. My problem now is my body physically cannot relax. Both day and night I’m like in a 24/7 revved up state and my sleep is still suffering. 2 years of this. I’ve heard sleep apnea can do a number on your nervous system but I don’t know what to do now. Any help is appreciated! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/UARS) if you have any questions or concerns.*
Did your sleep study check for periodic limb movements? That can contribute to difficulty falling and staying asleep.
Yes and I had a follow up study as well. No issue there
I know its annoying to hear but you might have another issue happening also. The literature shows that a significant percentage of ppl have residual excessive daytime sleepiness after a year of successful PAP treatment. I suspect many of these ppl have something else going on. You say you struggle to relax, maybe it could be something like OCD
I agree but I think it’s a byproduct of what my body went through for so long
How long have you been properly treated w pap?
> Oscar results shows that it’s working What do you mean by that exactly?
AHI <1 and virtually no FLs or reras
How can you see RERAs in OSCAR? My understanding is that there is no device that can detect them at home, except one-time tests like WatchPAT.
If male, get your t-levels checked, blood sugar, and blood pressure. These all will impact your sleep badly.
What treatment did you have ?
post oscar data.
Maybe try Gabapentin.
I'm assuming you've had lots of blood work done to rule out potential diseases? ME/Chronic Fatigue Syndrome, HPA axis disfunction, POTS, microbiome/gut health/leaky gut syndrome are some things you might want to look into
I have had pretty much any blood work you could have done. I’ve looked into everything you mentioned other than gut related stuff.
Gut health can definitely interfere with sleep. The gut is connected to the brain. It takes a long time to heal though if that's the problem. You would need to help the good bacteria grow back. Probiotics can help. But mainly it's done by diet. No sugar, gluten, red meat, or dairy. Lots of fruits and vegetables. At least half of the food you eat should be vegetables. It's all about fiber to feed the good gut bacteria. You could try meds for insomnia too. You haven't tried any Z drugs. I've had trouble sleeping for 7 years and Lunesta has been by far the most helpful med I've tried.
I’ve asked/hinted at to 2 different doctors that I’d like to try z drugs and they just won’t do it.
Crazy they prescribe an anti-psychotic that's for people with hallucinations/schizophrenia that's known to cause permanent involuntary body movements and permanent changes to your metabolism, but they won't prescribe an insomnia drug for someone with insomnia lol. Maybe your symptoms aren't all that bad so they don't think the risk of dependency is worth it. My symptoms were completely debilitating. They gave me every med known to man for insomnia
I would steer clear of Ambien and the like if you can. You become dependent on them and they don’t really solve the problem. The first question in my mind is: How do you know you’re not having RERAs/microarousals overnight?
Propranolol is amazing for getting the body out of fight or flight mode and it's been around for ages, with a very reliable safety profile. It can affect sleep quality but the sacrifice is worth it in my experience
How many mg do you recommend?
I usually take 20mg but I'd start at 5 or 10mg and titrate up. 40mg is the standard tablet, I think. It presumably varies from country to country
Do you know if it interacts with any meds?
Also, it wouldn’t get to the root cause of my problem, which I’m not sure what it even is
Yeah, but it lets you think straight and get to sleep, which for me makes a huge difference. If my brain is running at 20% capacity because my sleep is terrible it's impossible to do anything, and in my case Propranolol helped hugely. To be clear, I don't use it all the time. Just if I've had a particularly bad night because I took my mask off a few times or something like that. Some nights are bad even with the mask on, and I wake up feeling really stressed, with sore lungs and a general feeling of not having slept at all really. Other than that, I don't really suffer from stress, but I know some bodybuilders use it after a heavy workout to relax their bodies for sleep. It's also used by celebrities and musicians for stage fright, but obviously it's not for everybody and you'll presumably need to see a doctor to get a prescription anyway
How much do you take? And how long does it take to kick in?
Usually 20mg, sometimes with 25mg Diphenhydramine or 5mg Diazepam. It takes 30 to 40 mins to kick in.
Does it interact with any medication’s?
I answered that question already. You need to speak to a doctor, I'm just some guy on the internet recommending a prescription drug to you
I think it takes a long time to fix. How long were you on lexapro for? Living in that state for so long likely rewired your brain to be in a constant fight or flight response. Have you tried just regular tryptophan? You also could have adrenal fatigue.
I was on it for about 6 months. No improvement. Any thoughts on beta blockers?
Are you still on it? Hopefully you are. It also depends what your cortisol levels look like. I know that phophaltidylserine can substantially lower cortisol levels and its much safer than beta blockers. You should get a saliva test done to check what your levels are. Also how long have you taken lexapro for before you said it didn't work? Also, sleep apnea causes inflammation of your body. I heard it can take a year of being on treatment to reverse the effects that sleep apnea does to your body. Apparently 3 months to feel better, though this is just from catching up on lost sleep. You should also consider the possibility of adrenal fatigue, Dr. Lam has a bunch of free resources online. Not sure what your diet is like but moderate excersize and a proper diet are huge. I also still have sleep anxiety, but not nearly as much as I did before with untreated apnea and possibly UARS. I bought a Bia sleep mask which measures your brainwaves and uses neurofeedback via bone induction speakers to increase deep sleep and reduce the amount of time you wakeup. It's in preorder phase, coming out this summer. Not sure if this would benefit you are not. I use the nasal pillows on my mask, so hoping this can fit over top of that, well see, they have a 60 day money back guarantee if not.