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Permalink Reply by SaraLynn on July 1, 2010 at 12:08pm

You are not stretching it when you describe the understanding of UARS as being in its infancy. I just went to a neurology appointment with my daughter to address ongoing headaches. It was at a well-known large neurology clinic in a major metropolitan area. This clinic also has a sleep lab. The doctor is a very well-known and respected neurologist. On her health history, my daughter had indicated that both parents had a diagnosis of UARS. The doctor paused and asked what that was. I responded "Upper Airway Resistance Syndrome", and she replied, "Oh, like asthma." I just about fell off my chair.

j n k said:

Some experts place it on the continuum, and some don't.

I think understanding of UARS in still in its infancy.

Oral appliances make a LOT of sense to me for treating UARS. To my way of thinking, that is the one case where a trial on an oral appliance would make sense BEFORE trying PAP therapy. And a follow-up NPSG might show PAP therapy unnecessary.

But I'm just an opinionated patient, not a professional of any sort.

SaraLynn said:

I use a mandibular advancement device for UARS. I actually felt worse on CPAP. Upon awakening the first morning after using the MAD, I woke up and did not want to get out of bed, not because I felt unrested, but because I was so relaxed...my limbs felt both heavy and heavenly because I had not struggled all night to breathe. I had completely forgotten what that feels like...it has been years! I use my MAD every night and my sleep deprivation symptoms have gone away. It has been over a year now, and I would never choose to go to sleep without it.

Interestingly, my husband was diagnosed with UARS one year later. He has been using the CPAP religiously for a year now and feels no better. My dental device was approved through insurance without problem while 6 months later, my husband's prior authorization request to the same insurance company for the very same device and for the very same diagnosis was denied...after 4 appeal letters, it is being covered...he is anxiously awaiting the final fitting. So, the insurance piece, at least for UARS, clearly can be tricky.

Some sources have indicated that patients with UARS are less tolerant to CPAP use due to an increased sensitivity in the nervous system...I understand that UARS is placed on a continuum with OAS, and it is treated the same as OAS; however, there are some differences that I think need to be taken into consideration.

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Permalink Reply by dr. martin bassiur on February 17, 2011 at 1:28pm

I just read this note- dental appliances are very effective for mild to moderate apnea and for snoring- appliances may also be used as an adjuncitve therapy with CPAP and for patients who cannot tolerate CPAP all night or who are not CPAP compliant- there are practitioners who specialize in this therapy- I will be happy to provide you with names of practitioners in your locale- you may also reference the American Academy of Sleep Medicine or the AAOP

 

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Permalink Reply by Shelia Shafer on February 17, 2011 at 1:52pm

I've had my dental appliance for several months now and I am so pleased with it. Pop it in at night, pop it out in the morning into a container, pop in a partial denture cleaning tablet and off to work.  Recently had a death in the family and had to travel quickly.  Rinsed off my appliance, put them in the little travel case, put the case into my purse (freezing temps outside and didn't want to leave it in the car) and off I went.  I am sleeping better than I ever have.  Can sleep in my chair, on the couch, in the bed on my back or on my side with no problem. I know they don't work for everyone but I am very pleased with mine.

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Permalink Reply by bkp on February 19, 2011 at 11:12am

Dr. Bassiur,

 

Thank you for your reply.  I am a member of the American Academy of Dental Sleep Medicine.  I was just inquiring on this site why there wasn't more mention of oral appliances.  I feel like our profession has much work to do in education.....

dr. martin bassiur said:

I just read this note- dental appliances are very effective for mild to moderate apnea and for snoring- appliances may also be used as an adjuncitve therapy with CPAP and for patients who cannot tolerate CPAP all night or who are not CPAP compliant- there are practitioners who specialize in this therapy- I will be happy to provide you with names of practitioners in your locale- you may also reference the American Academy of Sleep Medicine or the AAOP

 

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