WED, Heartburn, and GERD

[Rustsmith]

My sleep test included the esophageal pressure measurement via a tube inserted through my nose and into my throat. This was probably the most uncomfortable part of the test.

When they reviewed my results, they said that if they use a normal OSA criterion that I would have a pressure setting of 7.5 to 8. However, the esophageal pressures were still quite ragged and that I needed 9cm to clear them up. So my prescription says a CPAP setting of 9. I have my aPAP set for a range of 9-13 and I can tell that on the good nights, it never leaves 9, but on my rough nights there well be one or more ramps that can get up to 12 for about a half hour.

As for UARS info, you might check what this guy has to say. I do not endorse him nor do I complete buy into everything he says, but he does have a lot of good info and might give you some ideas about your GERD.

http://doctorstevenpark.com/sleep-apnea-basics/upper-airway-resistance-syndrome

[badnights]

I always read your information about UARS with interest. My first sleep study said I had it; my second at a different clinic said I didn't, but neither clinic had the equipment to measure esophageal pressure. I used a CPAP for 3 months then gave it up as not helping me, but that was before the WED was fully under control (if it ever is hahha).

I have never been able to swallow pills properly and lately they can get painfully stuck. I feel that my recently developed (last 6-7 yrs) asthma is related somehow to breathing problems at night - it feels the same. Even my asthma is not normal - it involves obstruction of the larger, upper airways rather than the smaller, lower airways.

However, I don't have GERD. I had occasional severe stomach pain that responded to antacids, once I learned to take them, but that hasn't happened since I changed my diet.

I am not sure if the UARS angle is worth pursuing. How might my life change for the better with a positive diagnosis in hand? I could buy another CPAP machine (I gave mine to my dad for a spare), get it properly set, and see if it helped me feel refreshed after sleeping, I suppose.

[Rustsmith]

There has been an interesting development for me since I posted this. I went through the interviews to join the Johns Hopkins study and in the end Dr. Allen decided not to select me because of my UARS. I sent him my sleep study and he was rather critical of the fact that they did not repeat the first night of the study after I went onto pramipexole to treat my WED. He said that without doing that, it was impossible to differentiate my arousals caused by WED and UARS. Further, he said that he would not have suggested CPAP based upon my results, but then again we did not get into the OSA vs UARS discussion.

So I tried sleeping without the machine after using it for a year. I could tell that there was a little bit of difference, but not much. I was considering dropping it when my wife told me to keep using it because it stopped my snoring. I try to be a good husband, so I will do what she asked because it makes her happy. It is also useful because that machine tracks my hours of sleep and provides me with some feedback about how well I slept, which is useful as far as having another measure of how good or bad I am doing.

[debbluebird]

Steve, what was the result of the sleep study? In other words, how many times did they say you woke up? Also what is your pressure setting. Just curious.

[Rustsmith]

The AHI in my study was 8, but the RDI was 26. That means I was having microarousals 26 times per hour or about every 2.3 minutes. In retrospect, many of these were probably due to PLMs, but without the second test I just don't know what was PLMs and what was UARS. With the RDI at 26, no wonder I didn't feel rested after 8+ hrs of sleep.

As for my setting, my prescription is for 9. I have my machine set for 9-12 and it stays on 9 most of the time.

[debbluebird]

Ok, I was waking up 90 times an hour. They wanted it set at 20, but I just couldn't tolerate it. They set it at 16. I never had another test done either. Now after 5 years and a new machine that tells you where you should be, it's set now 8 to 16 and mostly I'm at 13. Interesting. I'm finally feeling rested after all these years. Also since my legs are better after the joint replacements. I usually only wake up a couple of times at night. The only thing that could mess me up now, is my back, if the arthritis continues to get worse. My hip doctor could see part of my lower spine and just shook his head.