babyblueeyes wrote:

My breathing slows and then I have to fight for my breath and my oxygen drops below normal (hypoxemia). Not exactly sure what SAHS is but it was diagnosed as UARS (RDI averaged 130 total). When your airways narrow with apnea, what part of the airway actually narrows? I am aware that your throat collapses, but not aware of your airways narrowing. I have a problem causing this in my turbinate on one side of my nose. So kind of curious about it. My CPAP makes the pain/congestion worse from this condition so I can't even manage to use it much. Thanks...

SAHS: Sleep Apnea/Hypopnea Syndrome. It's preferred by some because hypopneas are considered to count as part of apnea.

And your throat is part of your airway. "Your throat collapses" is the same as "your airways narrow." In my case, it is my throat that collapses, but it doesn't have to be (for either SAHS or UARS, as far as I know)—it can be anything between your nose and your throat.

I'm still waiting on my final numbers because my sleep doctor wanted to re-score the data before he gave the report to me.

There is an article posted somewhere around here (on the news forum maybe) about the a new hypothesis that UARS may not actually exist, that the instruments used in the sleep study don't accurately measure hypopneas so people who have SAHS (OSA) but with more hypopneas than apneas are being mis-diagnosed as UARS instead (because the hypopneas aren't being recorded right). It's an interesting idea, because the one thing I haven't been able to figure out is the difference between a UARS arousal and a hypopnea except that hypopneas are more severe, but I don't see why that matters (I mean, an apnea is an apnea whether it lasts for 10 seconds or 60, so why is a hypopnea sometimes a hypopnea and sometimes a UARS arousal?).

My understanding is that a hypopnea is shallow breathing  but not delayed breathing .  Somebody posted that hypopnea is a central event---a neurological problem that is not as severe as central apnea.  I don't know if this is always the case or if hypopnea could also be a partial obstruction (but then it would seem to me to be UARS).

 UARS is partial blockage of the airways.  (If the blockage were complete it would be obstructive apnea).  Because the blockage with UARS is only partial, air still gets thru preventing desaturations.  However, because the airway is smaller than normal the body has to work harder to get the air thru which causes arousals.

I wonder if there is discrepancy in how dr. diagnose UAR & hypopnea----maybe some call hypopneas UAR where a different dr would not?  Either because of controversial diagnostic criteria, or varying levels of expertise, or perhaps even for insurance purposes re: treatment availability?

in summary:  I think UAR is a milder form of OSA and hypopneas are a milder form of CSA.

embryopathy wrote:

My understanding is that a hypopnea is shallow breathing  but not delayed breathing .  Somebody posted that hypopnea is a central event---a neurological problem that is not as severe as central apnea.  I don't know if this is always the case or if hypopnea could also be a partial obstruction (but then it would seem to me to be UARS).

 UARS is partial blockage of the airways.  (If the blockage were complete it would be obstructive apnea).  Because the blockage with UARS is only partial, air still gets thru preventing desaturations.  However, because the airway is smaller than normal the body has to work harder to get the air thru which causes arousals.

I wonder if there is discrepancy in how dr. diagnose UAR & hypopnea----maybe some call hypopneas UAR where a different dr would not?  Either because of controversial diagnostic criteria, or varying levels of expertise, or perhaps even for insurance purposes re: treatment availability?

in summary:  I think UAR is a milder form of OSA and hypopneas are a milder form of CSA.

Hypopneas are a reduction in airflow (min 30%) that leads to EEG arousal or oxygen desaturation of 3-4% (depending on the lab).

UARS is a resistance syndrome that shows no obvious signs of airflow reduction or oxygen desaturation, but is followed by an EEG arousal. I have been reading more and more than 15/hr. is enough to diagnose, however no standard criteria has been established (correct me if im wrong).

I am not aware of hypopneas always being affiliated with central sleep apnea. They can be (central hypopnea), but they can be obstructive in nature as well. It depends on the amount of effort that takes place. Based on most studies, or at least the majority, hypopneas are grouped in one single group, not into obstructive and centrals, however the scorer has the capability to score them as such.

babyblueeyes wrote:

Sorry but that is not true. I have UARS and my oxygen decreases to 84% (8.5 times hr in non-rem sleep and 39 times an hr in REM sleep).. The reason it wasn't diagnosed as apnea is obviously because I have hypopnea events and don't actually quit breathing. I was also informed that the only difference in UARS and apnea is that with UARS, you don't quit breathing. But my doctors still seem to consider this to be apnea even though my test results said UARS.

  

I think what you are describing in this post and your following post, is hypopnea (when you desat) and the times you struggle for breath without oxygen dropping you are having UARs....sounds to me like maybe you have both?...and insurance is more likely to pay for treatment of apnea.

Quote:

Now, what I don't get is why someone would even be diagnosed with UARS if their oxygen level didn't drop with it, there really would be no danger in your breathing slowing then. I just can't see how there would be a significant disturbance, if your oxygen sats is normal.

UARS is about the arousals it causes, which results in symptoms of sleep deprivation that are the same as those caused by arousals caused by apnea.   Even though the oxygen is ok, the sleep is so disturbed the individual can't get rested.....I read somewhere that some people think the daytime fatigue people with apnea experience is caused by the arousals, not by the oxygen desaturations.  

Is this right, RAM_sleep?

embryopathy wrote:

babyblueeyes wrote:

Sorry but that is not true. I have UARS and my oxygen decreases to 84% (8.5 times hr in non-rem sleep and 39 times an hr in REM sleep).. The reason it wasn't diagnosed as apnea is obviously because I have hypopnea events and don't actually quit breathing. I was also informed that the only difference in UARS and apnea is that with UARS, you don't quit breathing. But my doctors still seem to consider this to be apnea even though my test results said UARS.

  

I think what you are describing in this post and your following post, is hypopnea (when you desat) and the times you struggle for breath without oxygen dropping you are having UARs....sounds to me like maybe you have both?...and insurance is more likely to pay for treatment of apnea.

Quote:

Now, what I don't get is why someone would even be diagnosed with UARS if their oxygen level didn't drop with it, there really would be no danger in your breathing slowing then. I just can't see how there would be a significant disturbance, if your oxygen sats is normal.

UARS is about the arousals it causes, which results in symptoms of sleep deprivation that are the same as those caused by arousals caused by apnea.   Even though the oxygen is ok, the sleep is so disturbed the individual can't get rested.....I read somewhere that some people think the daytime fatigue people with apnea experience is caused by the arousals, not by the oxygen desaturations.  

Is this right, RAM_sleep?

Sounds like you nailed it.