Hello,
I have a case of a patient 39 male, 6 foot and weight 210 lbs. A sleep study showed : 61% sleep efficency 23 arousals/hr 13 arousals/r apnea/hypopnea 6.5 RERAs/hr REM & NREM AHI: 17/hr REM AHI: 43/hr
Drug induced sleep endoscopy :
https://youtu.be/VIX3GnVEbu0
https://youtu.be/rRoDzCjegek
Patient complaint of continuous sleep arousals and RERAs and not able to have deep sleep even with Bilevel therapy for past 8 months.
I am suspecting UARS as well as patient has narrow throat/light sleeper/small jaw and crowded teeth and cold hands/feet plus GERD and LPR/ fragmented sleep and extreme sleepiness and fatigue through the day. Symptoms started after sever GERD and then LPR, and was taking PPI plus started acid watch diet.
my theory is that my nervous system is so sensitive that any reduction in the airway trigger the sensors that watch for airway collapse and awaken my brain with RERAs.
Patient was also diagnosed with burning mouth syndrome after using invisalign for a month and not tolerate it.
After watching the DISE videos, problem seem in the soft palate and uvula.
I would like your opinion for adjusting biLevel therapy or surgical intervention.
Thank you
Thanks how do I get it through my dental office, my ENT referred me to a dental office in Manhattan ( Chase dental sleep care) how do I request it ?
for patients with primary snoring and UARS (RERAs) low pressure CPAP is very useful and should be the firs choice. Try with a pressure of 5 mbar and if your patient is compliment he/she will be happy. If the pat. does not tolerate CPAP you can try oral appliance as second line therapy. This not a product advertisement.
With DISE reconsidering, it looks like they can't tolerate the PAP machine because if the epiglottis not allowing the air in. Any treatment for that ?
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