"please keep me updated about oximeters "
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Interesting article on UARS
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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Could Chronic fatigue syndrome and fibromyalgia be physical or psychological manifestations of sleep disorders?
http://www.endfatigue.com/articles/Article_uars.html
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Permalink Reply by Steven Y. Park, MD on
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Thanks, Rock. This is an editorial by Dr. Guiileminault on Gold's 2003 article on upper airway resistance syndrome and functional somatic syndromes. My opinion is that the vast majority of chronic fatigue and fibro patients have narrowed upper airways. I see this consistently during endoscopic examination. I an unofficial poll I did on a chronic fatigue syndrome forum, there's was an excessively high number of people with multiple dental extractions or headgear use. This leads to smaller oral cavity volume, and less space for the tongue. People with UARS have intact or hypersensitive nervous systems which causes numerous arousals with even partial obstruction, whereas OSA patients stop breathing for prolonged periods, leading to hypoxia. Here's an article I wrote on UARS.
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Who said Christmas was over! Thanks Dr. Park.
Steven Y. Park, MD said:Thanks, Rock. This is an editorial by Dr. Guiileminault on Gold's 2003 article on upper airway resistance syndrome and functional somatic syndromes. My opinion is that the vast majority of chronic fatigue and fibro patients have narrowed upper airways. I see this consistently during endoscopic examination. I an unofficial poll I did on a chronic fatigue syndrome forum, there's was an excessively high number of people with multiple dental extractions or headgear use. This leads to smaller oral cavity volume, and less space for the tongue. People with UARS have intact or hypersensitive nervous systems which causes numerous arousals with even partial obstruction, whereas OSA patients stop breathing for prolonged periods, leading to hypoxia. Here's an article I wrote on UARS.
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Permalink Reply by Rette Tyrrel on
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Wow, Thanks Dr Park and Mike. You've hit the nail on the head with me. Always cold, B/P at rest about 90/40, sometimes lower, etc. In the article it stated that UARS is usually protective against OA, I have both. I can't breathe easily 99% of the time, sitting up or lying down, and many times use a BreatheRite strip with my CPAP at night, hating to take the strip off in the morning.. The ENTs that I've seen have given me all kinds of nasal sprays, po meds, etc. I can take them for about a month then have miserable side effects. I was referred to an ENT surgeon who, when I asked him if he would have his recommended surgery himself, under the same circumstances, he said no. So much for that. Wish I was in the NY area.
Steven Y. Park, MD said:
Thanks, Rock. This is an editorial by Dr. Guiileminault on Gold's 2003 article on upper airway resistance syndrome and functional somatic syndromes. My opinion is that the vast majority of chronic fatigue and fibro patients have narrowed upper airways. I see this consistently during endoscopic examination. I an unofficial poll I did on a chronic fatigue syndrome forum, there's was an excessively high number of people with multiple dental extractions or headgear use. This leads to smaller oral cavity volume, and less space for the tongue. People with UARS have intact or hypersensitive nervous systems which causes numerous arousals with even partial obstruction, whereas OSA patients stop breathing for prolonged periods, leading to hypoxia. Here's an article I wrote on UARS.
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I can recommend some therapeutic options to suggest that might spare Rette a trip to New York. I've just entered this sleep-breathing disorders world via efforts to address chronic pain. In a nutshell, therapies that enlist the tongue to change facial posture to move the jaws forward seem the most promising; surgery and CPAP seem very likely to have counterproductive complications because they ignore and/or risk interfering with the tongue & swallow mechanism. I am being treated for UARS by Dr. David Lawler in Bloomington, Indiana with an Oral Systemic Balance device, about which more information can be found on Lawler's Center for Sound Sleep website and via expert interviews on Dr. Park's excellent site. The OSB device is as amazing as advertised. Were it not caught up in the unfortunate franchise model of medicine/dentistry, I suspect it could be used to safely study -- and quickly prove -- most of Dr. Park's ideas about the links between airway constraints and other chronic health issues. The process of being fitted for the device has shown me that minute shifts in tongue posture make an enormous difference to my overall body posture and to the symptoms of just about every physical or mental complaint I have every had. With the OSB device adjusted correctly, my body instantaneously unwinds into a posture I have been fighting to attain for years via yoga and physical therapy. The only draw back is that the device can require quite a bit of adjustment as your body resets its equilibrium, and this is a significant part of the reason for its hefty price tag. I have just begun complementing this therapy with acupuncture, and have ordered Janet Bennet's IJustWantToSleep tongue exercises. These may prove to be more economical ways to achieve the same effect; I learned about both via Dr. Park's website and podcasts. (I should note that I had already addressed nasal breathing issues w/ sinonasal surgery that corrected a deviated septum and enlarged turbinates, allergy shots, nasal lavage, breathe right strips and the usual assortment of pills and sprays. What really cleared up my nasal congestion, however, was prevacid prescribed for a hiatal hernia, a connection I did not make until I encountered Dr. Park's website.) If this thread is still live in a few days, I'll follow up with a way to briefly simulate the effects of OSB that might help you assess whether it is something to pursue. My computer use is still limited by neurovascular problems related to UARS.
In the mean time: 1) Are there any patient advocacy groups associated with UARS? I have a stack of insurance claims six inches high from the past 3 years alone; if UARS and the structural issue with my jaw that underlies it been recognized and addressed years ago, all this misery and expense could have been avoided. 2) Is Dr. William Hang making in headway in his efforts to get the orthodontic profession to own up to their role in these issues?
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"surgery and CPAP seem very likely to have counterproductive complications because they ignore and/or risk interfering with the tongue & swallow mechanism."
I think your wording might be a little misleading. SDBs are pt specific. Meaning that it is different for each individual and should be treated as such. I too have high hopes for this device as well as the treatment options. The oral device will not work for everyone. One treatment might cause complications while another may work. Knowing all of the options and having a good team in your corner are the key to getting good sleep.
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Thanks Kirsten, it's great to know that there are other venues to explore. Appreciate your input.
Kirsten Sword said:
I can recommend some therapeutic options to suggest that might spare Rette a trip to New York. I've just entered this sleep-breathing disorders world via efforts to address chronic pain. In a nutshell, therapies that enlist the tongue to change facial posture to move the jaws forward seem the most promising; surgery and CPAP seem very likely to have counterproductive complications because they ignore and/or risk interfering with the tongue & swallow mechanism. I am being treated for UARS by Dr. David Lawler in Bloomington, Indiana with an Oral Systemic Balance device, about which more information can be found on Lawler's Center for Sound Sleep website and via expert interviews on Dr. Park's excellent site. The OSB device is as amazing as advertised. Were it not caught up in the unfortunate franchise model of medicine/dentistry, I suspect it could be used to safely study -- and quickly prove -- most of Dr. Park's ideas about the links between airway constraints and other chronic health issues. The process of being fitted for the device has shown me that minute shifts in tongue posture make an enormous difference to my overall body posture and to the symptoms of just about every physical or mental complaint I have every had. With the OSB device adjusted correctly, my body instantaneously unwinds into a posture I have been fighting to attain for years via yoga and physical therapy. The only draw back is that the device can require quite a bit of adjustment as your body resets its equilibrium, and this is a significant part of the reason for its hefty price tag. I have just begun complementing this therapy with acupuncture, and have ordered Janet Bennet's IJustWantToSleep tongue exercises. These may prove to be more economical ways to achieve the same effect; I learned about both via Dr. Park's website and podcasts. (I should note that I had already addressed nasal breathing issues w/ sinonasal surgery that corrected a deviated septum and enlarged turbinates, allergy shots, nasal lavage, breathe right strips and the usual assortment of pills and sprays. What really cleared up my nasal congestion, however, was prevacid prescribed for a hiatal hernia, a connection I did not make until I encountered Dr. Park's website.) If this thread is still live in a few days, I'll follow up with a way to briefly simulate the effects of OSB that might help you assess whether it is something to pursue. My computer use is still limited by neurovascular problems related to UARS.
In the mean time: 1) Are there any patient advocacy groups associated with UARS? I have a stack of insurance claims six inches high from the past 3 years alone; if UARS and the structural issue with my jaw that underlies it been recognized and addressed years ago, all this misery and expense could have been avoided. 2) Is Dr. William Hang making in headway in his efforts to get the orthodontic profession to own up to their role in these issues?
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Thanks for catching this. My point is that if CPAP (and similar devices) are not working - or even not working 100% - take a look at tongue and jaw position and also swallowing issues. And definitely explore all the non-invasive options before attempting surgical ones. A prosthesis like the OSB device can be fine tuned w/out damage to the patient; post-surgical corrections aren't so easy. I don't know about other appliances, but OSB/OSA can also be made to work with C-PAP (there is an earlier thread on this.) I'm about to test the theory on my parents, both of whom have sleep apnea and the full array of related health problems, which C-Pap only partly addresses. UARS, moreover, is a 24 hour a day problem.
Rock Hinkle said:
"surgery and CPAP seem very likely to have counterproductive complications because they ignore and/or risk interfering with the tongue & swallow mechanism."
I think your wording might be a little misleading. SDBs are pt specific. Meaning that it is different for each individual and should be treated as such. I too have high hopes for this device as well as the treatment options. The oral device will not work for everyone. One treatment might cause complications while another may work. Knowing all of the options and having a good team in your corner are the key to getting good sleep.
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