r/UARSnew

Could this still be UARS despite a very low AHI?

Hi everyone! I'm trying to figure out whether UARS could explain my symptoms.

I had a full polysomnography. My AHI was only 1.1/h, so I was told I don't have obstructive sleep apnea. However, I still have significant fatigue and unrefreshing sleep.

Some of my PSG results:

AHI: 1.1/h

Sleep efficiency: ~68%

Total sleep time: ~5.5 hours

N1 sleep: 24.4%

REM: 27.3%

Mean SpO₂: 96%

Lowest SpO₂: ~89-91%

Snoring: 363 episodes / ~30 minutes

PLMI: 46.4/h (255 limb movements)

Only 6 scored arousals in the entire study

The main problem is that my report doesn't include RERA, RDI or flow-limitation data, so I don't know whether UARS was actually assessed.

I also have a chronically mildly blocked nose and persistent Eustachian tube dysfunction/swelling. I've tried oral corticosteroids, intranasal steroids, antihistamines and mucolytic medications, but unfortunately none of them significantly improved my symptoms.

I've also tried psychiatric medications for my fatigue. Some of them improved my energy somewhat, but there was no major improvement in my overall condition, so I'm still trying to find an underlying cause.

The other interesting finding is the PLMI of 46.4/h. I'm planning to investigate this as well, including iron/ferritin and other possible causes.

So I'm wondering:

1. Does this PSG give any reason to investigate UARS despite an AHI of 1.1?

2. Could the low sleep efficiency, high N1 percentage and snoring fit with UARS?

3. Is it possible that RERAs/flow limitation simply weren't scored, meaning UARS could have been missed?

4. Would it be worth asking the sleep lab to re-analyze the raw PSG for RERAs, RDI and flow limitation?

5. Could a PLMI of 46.4/h alone explain significant unrefreshing sleep?

6. Has anyone here had UARS with AHI <5 that was initially missed?

I'd really appreciate hearing from anyone with a similar PSG or experience with UARS + PLMS.

Final update on my palatal expansion journey. I originally underwent the procedure with Dr. Kasey Li as part of my journey to improve my sleep apnea, but unfortunately my expansion was unsuccessful.

I recently had my TPD palatal expander removed and made a short video showing what things looked like before removal and how they looked/felt afterward.

Sharing my experience in case it’s helpful for anyone considering palatal expansion for sleep apnea, currently going through adult expansion, or dealing with a failed expansion.

I’m curious about this as I’m going to do an intake soon with Dr. Santiago in Washington, and I intend to do FME with her.

Im more optimistic about getting double jaw surgery covered since in looking at my insurance criteria I believe I meet them (going to do my due diligence on this of course!), but not too sure about expansion.

Thanks to anyone who shares their experience. This is a lot to make sense of.

He's said previously he has financial ties with Facegenics so I'm curious if he's still choosing MARPE over FME

I am heavily considering joining his online community (he calls it a coaching hub). It consists of: regular Q & A events, a private forum for case feedback, and 60 minutes of a live 1 on 1 annually. Price though, is steep: $700 annually (billed once not monthly).

For those who have a membership or knows someone who does, is it worth it? I could genuinely see the community and additional support being worthwhile (having additional perspectives on my case/palatal expansion and jaw surgery at large, etc), but it also a tough financial moment. Curious for your thoughts/experiences/perspectives. Thanks!