u/Pleasant_Window4070

I’m a teen with a normal BMI and was diagnosed with mild sleep apnea at 16, with a noticeable but not substantial flow-limitation component (similar to UARS), and I’m trying to understand what could be contributing to it at my age.

I have some nasal obstruction (with some possible nasal valve collapse), a mildly recessed jaw, deep bite/overbite, and a mildly narrow/high-arched palate, but nothing that seems extremely severe. I also had orthodontic treatment from around ages 14–16 for my deep bite/overbite that wasn’t very successful, and I’m now in Invisalign to fix some of the remaining issues. I’m not sure if the previous treatment may have contributed to some of my current bite/dental problems. No tooth extractions, some canine shaving, but not like all the way flat. There’s also some family history of sleep apnea.

What are some common reasons someone could develop OSA/UARS this young despite not being overweight? Has anyone here had a similar situation, and did you ever figure out the main cause?

I’m currently using CPAP APAP mode 11-15 with EPR 3 and still seem to have residual flow limitation. I’ve been advised to gradually increase my fixed pressure to see if the flow limitation improves.

The problem is that as I increase CPAP pressure, I start getting significant mouth leaks even with double mouth tape and a chin strap. Eventually the leak gets bad enough that I end up taking the mask off in my sleep. I currently use n30i airtouch.

For people who switched from CPAP to BiPAP for flow limitation, or anyone who has an idea on the matter: did bilevel make mouth leaking better, worse, or about the same? Since BiPAP can provide more pressure support without requiring the same expiratory pressure, could it potentially treat the flow limitation without making the mouth-leak problem as bad?

Also curious whether anyone had this problem with a nasal/pillow mask and ultimately had to switch to a full-face mask.

I’m 17 and have been using CPAP for a while, but I still don’t feel much better. My AHI is well controlled, but when I run my flow data through the Glasgow Index, I consistently get elevated skew/variable amplitude and other flow-limitation patterns.

I’m wondering whether residual flow limitation could realistically be enough to cause symptoms at my age, whether bilevel is something worth discussing/trying, or whether this makes you think I should be looking beyond sleep-disordered breathing entirely. My blood tests are fine.

I’m not trying to convince myself I need BiPAP. I’m really just trying to figure out why I still feel bad despite treating the obvious respiratory events, especially being this young and dealing with all of this.