Just the title: if CPAP is more likely to be prescribed by Sleep Doctor at home test or if it’s more likely to get approved by an in person sleep medicine appointment at UPenn, likely an at home sleep test.

I hear some people argue that nervous system activation in UARS is primarily compensatory and any dysfunction of the nervous sytstem is driven by it being over-activated in a compensatory manner. So, to explain lower arousal thresholds, maybe one could argue the nervous system is primed rather than being independently dysfunctional. On this view, it seems that correcting for the airway would allow the nervous system to re-adapt afterwards. Recently, though, I've been seeing people argue that the nervous system is dysfunctional in a manner distinct from airway instability—that dysautonomia is an independent factor. I'd be interested in seeing what the different perspectives are here and why.

Every time I try to put my mask on I’ll wake up with it completely off of me (2-3 hours after sleeping) Like on the floor or something as if I threw it away.

I’ll put it back on, just to find it back off again.

I also mentioned how my nose might be the driving factor behind my UARS (breathing strips significantly helped my sleep) although I’ve seen two ENTs and have had no luck. (First one said I had enlarged turbinates and a slightly deviated septum and could consider surgery if sprays didn’t work, second one said I didn’t have either and didn’t recommend surgery) They were both honestly kind of dismissive so I don’t really know how I feel about trusting them.

This makes me think that perhaps I keep finding myself taking the mask off because it lowkey bothers my nose since it feels like it dries it up and perhaps causes some sort of irritation with my nose.
Sometimes I find myself breathing okay but I’ve noticed my nose breathing feeling more slow and sometimes like 80% blocked.

Anyone else have a similar experience? I saw someone reply to my post regarding this topic but it’s not letting me see it all I see is the notification.

After looking closely at the symptoms, I’m highly confident I have Upper Airway Resistance Syndrome (UARS) or a similar non-OSA sleep respiratory issue.

Because waiting for a quality specialist and a formal diagnosis takes considerable time, I’ve decided to start exploring self-treatment options in the interim. However, the sheer volume of conflicting advice is overwhelming, especially while dealing with severe cognitive impairment from the lack of sleep.

I keep hearing about completely different paths:

• PAP Therapy: Specifically BiPAP AutoSV (is this the gold standard for UARS?).
• Anatomical / Expansion: MARPE, SARPE, or surgeries like septoplasty for nasal obstructions.
• Conservative: Positional therapy and structural adjustments.

When you're cognitively drained, navigating this multiplicity of options is brutal. I just want to focus my energy and resources on the highest-probability treatment route first.

For those with UARS or who have deeply researched it:

1. Is a BiPAP AutoSV actually the most effective device to target UARS dynamically?
2. Based on your experience and what you’ve seen work for others, how would you prioritize these treatments to avoid wasting time and money?

Appreciate any insights or lived experiences you can share.

Wondering if CPAP helped resolve these problems for anyone: I have a minor tongue tie and am being recommended MARPE to expand palate, and am trying to find a reason to avoid doing this.

Airway dentist explained to me that CPAP, MAD, or Fixing right nostril obstruction would be more of a temporary band aid than getting to the root cause the way that MARPE. Have been told I have poor tongue posture and scalloping/when I say “ah” my tongue dimples in the middle and can definitely see some restriction in tongue mobility but nothing crazy.

I’m starting to think that any doctor I go to just has a default of what they are used to providing for services and even though I mentioned could CPAP help, he said it wouldn’t treat the root cause but I’m clenching and having Tmj related issues due to airway issues and mouth breathing specifically.

If I can provide more breathing through mouth via CPAP doesn’t that fix excessive mouth breathing and clenching?

FYI 25 year old male 5,10” 185lbs who used to love going to gym, athletic but now feels out of breath due to throat/tongue issues, and def has minor speech issues. Don’t have health insurance

Summary: is CPAP worth trying before I commit to Marpe if I have muscular tmj, night time clenching, and airway dysfunction in nose and throat?

For those of you that use an ASV with a flow limitation algorithm: I am curious to know how much your pressure changes in different sleep stages and does this pressure also increase as the night progresses?

Since my last turbinoplasty/septoplasty, that was pretty much botched (ik ik bad decision), my nasal valve collapse has been ridiculous (my joints are very hypermobile, so I think this adds to it). I used the strips for some time, but they never provided the structure that the dilators do. The only problem is that the dilators always fall out at night despite trying many different shapes and sizes.

I've also tried taping it to my nose (I think I pull it off in my sleep), and I also created a strap around my head, but the problem was that the plastic is too flexible, so it pulled apart my nostrils haha.

Does anyone have any tips? Also, has anyone tested nasal trumpets/stents?

curious if there’s been a watchpat posted here that looks like a true negative for UARS (that isn’t sleep apnea)

Hey everyone. I’ve been dealing with a brutal sleep issue for the last 2.5 years that is completely ruining my quality of life. Based on my research and reading through this sub, I strongly suspect it’s Upper Airway Resistance Syndrome (UARS)—it definitely feels like a breathing issue.

I’m dropping my symptoms, history, and context below to see if anyone relates, and to get your take on whether this fits the UARS profile.

My Sleep Pattern & Symptoms
The Pattern: I get decent quality sleep for the first 4–5 hours. Then I wake up, fall back asleep easily, but experience a series of frequent microarousals until I hit 7–8 hours total.
Morning Symptoms: I wake up feeling terrible. Heavy body fatigue, severe brain fog (feels like a demon subverting me), puffy face/eyes, irritability, and occasionally mild nausea.
Naps: Usually make things worse. On very rare occasions a nap resets and rejuvenates me, but usually I feel even more destroyed afterward.
The Alcohol Paradox: On the rare occasions I drink alcohol, if I hydrate well afterward, I actually get higher quality sleep, despite the interruptions.

What I’ve Tried So Far
Perfect sleep hygiene.
Various supplements and medications.
Gut health optimization.

My Experience with Sleep Studies (The Anxiety Trap)
In-Lab Polysomnography: Total waste of time and money. I had crippling anxiety about sleeping in the lab, barely slept, and the data wasn’t representative. The sleep doctor lazily blamed it on "poor sleep hygiene insomnia," which is complete BS for a thousand reasons.
At-Home Polysomnography: Still waiting on the results, but I had similar performance anxiety here due to the fear of ruining the study, which became a self-fulfilling prophecy. I’m skeptical the data will be useful.

Moving Forward
I am very tired (no pun intended) of sleep labs. If I can get confident enough that this is UARS, I am willing to take matters into my own hands and treat this myself.

Does this sleep architecture and symptom set (especially the morning puffiness, nausea, and the first 4–5 hour wall) resonate with anyone here?

For those who had failed or inconclusive sleep studies due to anxiety, how did you ultimately get diagnosed or move forward with treatment?

Appreciate any insights or shared experiences. I just want to enjoy life the way I used to.

Can someone help me. I believe I have a narrow palate, small mouth. I have always been mouth breathing my whole life. I cannot breathe out of my nose it feels difficult due to my deviated septum. At night I have to breathe from my mouth, i genuinely cannot breathe, my snoring disturbs others. In the day, my top lip is like subconciously forcibly left open, i don't even notice, and I feel like my whole body is just compensating for the fact that I have a narrow airway, with my lips, and my nostrils flaring just to breathe, maybe I was born with a recessed maxilla.

how I need help:

Who do I exactly go to fix these things?

- I went to my family doctor. I asked to be referred to a maxiofacial doctor, and orthopedic surgeon. Bc I genuinely believe I have a narrow airway and narrow palate and I want that functionally fixed. However the doctors were confused saying, "who told you you have a narrow palate?" , they asked me like 5 times this. And I simply replied, I researched online and I want help. Anyways they said I have a normal palate, and after hesitation 2 different general doctors told me, "you have a referral to see the ENT surgeon right ,see them and if they recommend it then we will see" (I have chronic allergies. the allergy specialist wanted to refer me to an ENT rule out any anatomical reasons causing it.)

So anyways I visit the ENT. he asks me the same question "who told you , you have a narrow palate", i replied same way. he checks me nose (as I have an obvious deviated septum to the point its the first thing multiple people notice and tell me of my nose deviation), and he tells me "you have a minor deviation, septoplasty is optional, you'll grow healthly anyways , I wouldnt recommend it blah blah" basically implying way too many risks and not worth it, and I should just deal with it bc its 'minor deviation' (i dont believe him). He also says "i dont know why you have allergies , i have no info", and just refers the same allergy medicine ive been taking. whatever.

He also says I have a normal palate. SO ok all these breathing problem I have are just in my head?? God. Now im stuck idk who to go to, as everyone thinks I'm fine , my palate is normal ,my nose is normal' while im dying here. I had my parents also call some random myofacial place(i'm 17 almost 18), and they said I need a referal from ortho.

anyways I believe ortho, who did my braces will also say, "everything is normal", and i believe even my family dentist, who has never pointed out the fact that i have a narrow palate, will say "all normal"

-ill point out I know its not extreme narrow. but my palate is at least SLIGHTlY narrow, and also it's definetly asymetrical. I took a picture and it's like the palate area where my tounge should be is all leaning to a certain place, if yk wim.

Help me:

-Who do i talk to now? where do I go? i Need referalls and theyre all saying "normal normal " is normal ideal? no. I don't want normal.

-What potential surgeries do i need? Lefort or double jaw idk, like as long as its insured I'm willing to do it to save my face and functional breathing.

-Or is it all in my head

Ok, so I got diagnosed last year with severs OSA (AHI 34). I've been on CPAP and then moved to ASV as I developed complex sleep apnea (TECSA) from the CPAP device - leading to central apneas, leading me to wake up every night.

Unfortunately, I can't tolerate ASV either, I still keep waking up, after which I can't fall back asleep with the mask.

I am wondering if I indeed have severe OSA or actually UARS. I never wake up gasping for air and my O2 ring shows few desaturations below 92%. Doc ordered another sleep study (as the previous was done in a different hospital).

Question is, even if the diagnosis changes from OSA to UARS, how do I actually treat it? I am contemplating using some light sleep medicine for two weeks to see if I can actually get used to ASV.

Funny thing is, I feel quite good when I don't use any device. I had turbinate reduction/deviated septum surgery, so perhaps that helped. I usually do puff air at night and snor according to my wife.

Any ideas what else I can try?

I have TMJD and struggle with my MAD oral appliance flaring up my jaw. I can’t tolerate CPAP. I have been trying to get the AirFit F30i to work but just can’t keep a seal, in spite of getting a smaller mouthpiece for my tiny nostrils. I have low AHI but very high RDI. Any tips appreciated!

We are flat-faced apes, with more bone development resources allocated to house a larger brain, and less resources (such as stem cells for bone formation) allocated for jaws -this is definitely not the whole story of why modern human skull formed this way.

As SDB is very common in those flat-faced dog breeds:

"Flat-faced (brachycephalic) breeds are prone to a condition called Brachycephalic Obstructive Airway Syndrome (BOAS), which can make breathing a constant struggle and can escalate rapidly into a life-threatening emergency."