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?

Has anyone with excessive daytime fatigue (without insomnia) been diagnosed with sleep apnea, narcolepsy, or idiopathic hypersolemnence and then later discovered that MHT (progesterone and/or estrogen) fixed their issue?

I have a PSG with next-day MSLT scheduled at the sleep center. But my PCP prescribed me oral progesterone. I was going to wait until AFTER my sleep study to start the progesterone, but I discovered in just a few days of a trial that progesterone ACTIVATES me. Like, so much that I had to take it in the morning...which made me NOT HAVE TO NAP.

I almost cried when I realized it was the progesterone keeping me awake all day. Because this excessive daytime fatigue has been DEBILITATING.

I'm stopping the progesterone until after the sleep study because I'm afraid it will mess with the tests.

I got my CPAP in May, waited a week for an appointment showing me how to use it, and then immediately went away on an international trip for three weeks. I told my doctor that I was not going to take it with me on my trip since it was so new and I didn't want to be fussing with a new device on my trip, and they assured me it would be fine for my compliance. I also had many nights where I ripped it off mid-sleep, or had so many leaks that it was waking me up too much, etc. Other little things - power outage, leak issues, unexpectedly having to go out of town, etc. have meant that there have been several nights where my usage was less than 4 hours. But I persevered and now I have the settings dialed in to where my AHI is less than 1 and my flow limit is very low. I got an SD card, learned how to upload and interpret my data in sleep HQ, even check my Glasgow index (usually around 1.15 so okay but not perfect). In other words, I'm on a roll and its working decently well. Today I got a call saying that my 90 day compliance window is over and I've failed. I needed to be at 70% compliance and I'm only at 57%. They blame it mostly on my lack of compliance in the beginning when I was waiting for my first setup appointment/away on my trip, which my doctor gave me permission to do.

I mean, WTF? Why are they punishing me for three grueling months of trying to make this work? What is wrong with our system that stupid misunderstandings/administrative rules and making it so that they are taking away a device that is actually working for me? I just can't understand. They told me that they had to take it away and that my doctor can re-prescribe so I can reset my compliance period. Jesus. Is there nothing on this journey that is easy??

I’m currently using Invisalign and have mild mandibular retrusion/overjet. My orthodontist told me that the longer treatment option they originally offered would have included mandibular advancement with Invisalign, but I’m not currently using the Precision Wings for that.

I also have mild OSA/sleep-disordered breathing and still have a lot of flow limitation on PAP. Has anyone tried Invisalign mandibular advancement, and did it help your breathing, sleep, or PAP needs? Does anyone think this would help? I know Invisalign mainly helps with bite and teeth, but it does say mandibular advancement in the name.

I know it’s not guaranteed to treat OSA/UARS, but I’m wondering if it could help since my lower jaw is somewhat recessed.

I did the Cottle Maneuver it did something, I did use afrin though for two nights as an experiment, one night with cpap, and one without, no difference in how I felt or therapy.

So could it be the cause of my problems or no?

My ENT never diagnosed me with it last year, only nasal obstruction. Kinda weird.

Currently on the waiting list for PAP, due soon, but I want to get my ducks in order for next steps and am looking into MMA etc. What are the key scans and whom should I go to, OFMS?

I see people post:

- X-rays

- CBCT

Are there particularly types of these or particular details I should consider when getting this done?

Thanks

Also, I'm in the UK in the South, not far from London so any specific recommendations also welcome. Assuming NHS will not cover so I'm expecting to self pay

I'm still trying to make APAP work for UARS 12 months after starting. I'm currently at 9-16cm and subjectively, the results are about the same as anytime I've had settings of 8-9 minimum to 14-15 max. My 95% pressure is around 9.75, but was in the 10s at one point (~6m ago, settings about 9-15, but I've had a lot of setting changes since then).

For context, i had a titration study 3m ago which only took me up to 8cm and said they resolved all RERAs, but I still had 30 spontaneous arousals. My sleep med provider reviewed raw data and confirmed these were actually RERAs which were just not long enough to count. He said they greatly decreased at the 8cm point hence my current 9-16cm. He also diagnosed me with idiopathic hypersomnia and prescribed modafinil, but I don't feel good on it and don't want a bandaid for this problem.

I do not feel rested and have poor energy, adhd-like symptoms, almost daily headaches, and bruxism. The first few days after I started APAP last year, however, I felt euphoric. The regressed to a more manageable "really good", then closer to where I started but definitely not as bad.

Do I keep going up as long as i can tolerate it? Besides aerophagia due to needing higher settings, can someone explain to me like i'm 5 as to why bilevel helps with UARS more than APAP?

I know there is lack of research on this, but are there any "credible" sources I could cite if I end up asking my provider about going to bilevel?

Hi friends.

I am using BiPAP and getting a little bit of loop gain. Thinking of trying EERS but cannot order it in my country. I thought it would make sense to try to 3d print it. Is anyone aware if there are 3d model files available for download anywhere?

I’ve had breathing problems basically my entire life, largely due to allergies. My tonsils were removed at a very young age because they were always inflamed. I was eventually diagnosed with allergic rhinitis and hypertrophic turbinates. Medications never gave me lasting relief. Some would actually backfire after prolonged use and leave my nasal passages feeling completely closed.

My first surgery was a septoplasty with turbinate reduction. It didn’t really help much.

For my second surgery, I went to a different ENT who performed a partial turbinectomy, radiofrequency reduction, and turbinate outfracture. I was awake under local anesthesia.

I will never forget walking out of that procedure. During the radiofrequency treatment I could literally smell the smoke, but at the same time I could feel so much air moving through my nose. I remember thinking, “Is this what regular people feel like?” I was ecstatic. I prayed it would last forever.

It didn’t.

Eventually I went back to the same doctor. We decided to be more aggressive with another partial turbinectomy and radiofrequency reduction. We didn’t repeat the outfracture because that had already been done.

Again, I had the procedure awake under local anesthesia. Again, it worked initially. And again, I eventually returned to baseline.

At that point I genuinely started wondering whether I was going to need turbinate surgery every year just to breathe.
My doctor was surprised when I scheduled another appointment. When he looked inside my nose, he seemed even more surprised by how everything had healed and how obstructed I felt again. He referred me to a colleague whom he described as a “specialist.”

From my first conversation with this doctor, I didn’t like the direction things were going.

He recommended essentially the same turbinate procedures again, except this time under general anesthesia, and strongly pushed another septoplasty for “maximum results.”

I told him I had already had a septoplasty and did not want another one. He looked shocked and eventually told me that the first surgeon hadn’t done a good job because the posterior portion of my septum was still deviated.

What has always stood out to me is that at the beginning of these ENT consultations, they spray a decongestant into my nose. When they do that, I can breathe normally. To me, that has always been a pretty significant clue that inflammation and allergies are a major part of this.

When I discussed actually treating the allergies, I was told I could come in for weekly allergy shots that they would have to administer themselves. That would mean physically going to their office every week of the year, which is basically impossible for someone who actually has a job. (They don’t work Saturdays or Sundays either.) And after all of that, they told me I could STILL eventually revert right back to baseline!

So I’m supposed to rearrange my work schedule every single week, potentially for years, only to be told there’s still a possibility I end up exactly where I started.
So instead, I have repeatedly ended up being offered another procedure.

What has also bothered me is that through all of these consultations and procedures, nobody ever discussed my high vaulted palate and narrow maxilla or whether my skeletal anatomy could be contributing to the limited size of my nasal airway.

I’m now seriously researching palatal expansion, MARPE/MASPE, double jaw surgery & SAAT for my allergy issues, potentially combining allergy treatment with palatal expansion so I can address both the inflammatory and anatomical sides of the problem.

I have even considered a full turbinectomy out of desperation, although the potential consequences of permanently removing too much turbinate tissue obviously concern me.

The entire experience has severely damaged my trust in the medical industry. I’ve spent tens of thousands of dollars and gone through four procedures, yet I’m essentially back at baseline.

My experience has left me feeling that, for many people, the medical industry has become a way for doctors and the larger system to extract money and resources from patients. There are procedures and treatments used in Europe, Latin America, and Asia that can take years to become available or accepted here because of the bureaucracy surrounding medicine. Meanwhile, extremely powerful and potentially addictive medications for things like depression and weight loss seem to have no problem becoming enormous industries.

I also think many doctors become extremely comfortable operating inside the framework they were trained in. When something falls outside of that framework, it can be dismissed surprisingly quickly. The relationship between the width of the maxilla, the dimensions of the nasal cavity, and nasal breathing seems logical enough to at least investigate, yet not one of the ENTs who treated me ever brought up my narrow, high vaulted maxilla.

I’m not claiming SAAT or palatal expansion is definitely the answer. I don’t know yet. But after four procedures and thousands of dollars only to end up back where I started, I’m done blindly repeating the same approach and expecting a different outcome.

Has anyone here dealt with a similar experiences? Has anyone tried SAAT, MARPE/MASPE, another form of palatal expansion, or some combination of allergy treatment and skeletal expansion and actually experienced lasting improvement in nasal breathing?

Went to a an Orthodontist advertised as airway and breathing specialist, was immediately dismissed of UARS, was told that if my sleep apnea test is negative then I don’t have airway issues. I expressed that I experience intermittent and frequent wakening every night, chronic daytime fatigue, brain fog, chronic migraines / headache, snoring, mouth breathing / sore throat, TMJ / jaw ache, sinus and ear pressure issues and was not concerned at all. I also have a small palate, deep bite and recessed jaw. Was only told that my TMJ tension could be improved by fixing my bite with invisalign / braces but MARPE wouldn’t be advised as I don’t have a cross bite. I have had braces in my tween years so my teeth are only slightly crowed. Should I be concerned of airway issues and seek a second Ortho opinion, request CBCT? I’m not a confrontational person so I seem to get dismissed pretty easy. I saw a HNS surgeon for concern of my recessed jaw and TMJ and she just recommended PT….

I also saw someone comment in this subreddit that UARS is more common in ADHD folk, which I do have. I’m also a slim female in early 20s.

Wish me luck. I am paranoid about getting a false negative result. I really think I have it. That's all. Had major anxiety all day because my entire life is banking on this.

Like what settings change or what mask change or anything made it work suddenly for u nd made u stop removing the mask unconsciously at night?

Hi,

I recently started treating UARS with success, and I’d like to share my experience with you.

Symptoms

I used to sleep well, but over the past few years some symptoms started to appear: clenching my teeth, snoring, frequent awakenings, and gasping for air. I started making recordings with an app and often heard heavy breathing, as if my throat was being constricted.

During the day, I was often tired, had trouble concentrating, and generally felt foggy and unfocused. In the evenings after work, I was exhausted and had little energy left for hobbies, which does not seem normal for a 30-year-old.

Diagnosis

I went to the doctor, who sent me to a sleep lab. I had a WatchPAT at home sleep test, which showed an AHI of 2.5 and an RDI of 5.1. The sleep doctor said it was not sleep apnea because the AHI was well below 5. I was not convinced because of my symptoms, so I requested a polysomnography. That showed an AHI of 3.5; the RDI was not reported. The conclusion was therefore still that I did not have sleep apnea.

I had read a lot about UARS and suspect that this is what I have. In addition, my AHI during REM sleep was 8.5, which may also be contributing to my symptoms. I decided to simply buy a PAP machine to see whether it could improve my sleep. In the worst case, it would not work and I could sell the machine again.

Treatment

I bought an AirCurve, a heated hose, and an F40 full-face mask. The first few nights were very bad and I spent a lot of time awake. I was very aware of my breathing, and the mask and pressure felt unfamiliar. In the beginning I put the pressure fairly low at first to get used to it, actually too low, so I was still seeing many flow limitations and apneas.

Gradually, I increased the pressure a little. After a few days, I was able to sleep through most of the night reasonably well, and I already felt more alert during the day, despite the remaining flow limitations in the graphs. I read a lot online about how to titrate the pressure, so I started experimenting.

I have now been on bilevel therapy for about a month and have found settings that work very well for me. I now consistently get an AHI of around 1, and there is hardly any flow limitation visible. I have become very accustomed to sleeping with the mask and barely notice it anymore. I often sleep through the entire night without lying awake, and I clearly feel more rested and alert during the day. My girlfriend says I also seem much happier than before.

I did not expect the therapy to be such a success after only one month.

Got diagnosed with Mild Sleep apnea in 2024 (AHI of 5.7) via a home sleep study test. During that time, I was also diagnosed with environmental allergies through a skin prick test (dust mites and grass pollen had the highest reaction), which probably explains why I lost the ability to breathe through my nose efficiently. I never had issues sleeping growing up; I used to sleep like a log all the way up until I turned 21 (currently 26M).

I opted to get surgery to correct a deviated septum, nasal valve collapse, and enlarged turbinates. My ENT did mention that if my allergies were left untreated, the surgery would not be as meaningful as I had hoped it to be. He was right. I was just being very naive at the time and had a hard time believing that allergies were the culprit over my poor nasal anatomy. I will say, after my initial septoplasty, I was told that I do not snore anymore but still having issues with sleep quality and frequent wakings, usually 1-2 times at night, that result in just me needing to pee when I wake up, which I heard is related to sleep apnea and those who struggle to breathe properly

I am now treating my allergies through Sublingual Immunotherapy (Odactra and Grastek). My hope is for this to assist with the chronic nasal inflammation and, after some time, attempt to do an additional nasal surgery once I build up immunity to my top allergen triggers, and hoping the chronic inflammation resolves in due time. I genuinely feel like the root cause of my issues stems from nasal breathing.

Curious if anyone has had similar experiences like me and were able to cure it? I refuse to go on a CPAP, tried it and couldn't tolerate it after using it for two weeks consistently; it was driving me nuts.

I'm having a sleep study this Friday. It's a split night study: a regular polysomnography followed by a bilevel titration.

The sleep lab doesn't use humidifiers in their machines, which I find ridiculous, but I bet it's a cost cutting measure because they're cheap.

I've had a bilevel titration at this sleep center before, and I woke up after 3 hours with a burning feeling in my nose and couldn't fall back asleep. I need a humidifier. It's already hard enough for me to sleep in these settings.

Is there anything I can do? I'm debating cancelling the sleep study, even though I need it, especially because it'll be monitored/overseen by a doctor and not a sleep technician. Presumably, it'll be higher quality.

This sleep lab has a monopoly on all sleep labs in the area, including those associated with major hospitals, so I can't just go elsewhere.

Thank you!