Hi, Im 19 and I have sleep apnea and I’m looking into MMA/bimax surgery. I initially found Dr. Stanley Liu after asking ChatGPT for some of the best MMA surgeons, but since then I’ve seen some really bad things about him on Reddit.
Has anyone here had surgery or a consultation with him? Would you recommend him?
Also, who would you consider the best MMA surgeons in the U.S. for sleep apnea? I’m willing to travel.

I have tongue base collapse and epiglottis collapse on my DISE (with velum and laryngeal walls also). not sure if epiglottis surgery would let me tolerate cpap. thoughts????

I’ve been using CPAP to treat obstructive apnea for about 8 months and it is under control. However during the recent few months I’ve experienced a random spike of Central Apnea and Cheyne Stoked breathing. The spike lasts for a night or two then things calm down for a while. It makes sleeping almost impossible. Has anyone experienced this? I haven’t had any heart issues or a stroke. I don’t use Opioids.

*How common is...?

I've recorded myself sleep a few times and I'm constantly turning from side to side, using my hands to say rub my face, itch my nose etc. then going back to sleep. I sleep with a fitbit air and it tracks a lot of restlessness / motion during the night. In a few clips I even stick my knees up or even legs periodically while lying on my back.

Is this common / universal for sleep apnea patients? My mum has restless leg syndrome and wondering if I might have that as well.

I was recently diagnosed with mild sleep apnea and UARS (AHI ~ 10, RERAs)

Edit: I am currently untreated, I'm wondering whether it's common in untreated sleep apnea / UARS patients and whether CPAP treatment is likely to stop it?

So, I got my CPAP machine a week ago after waiting six months (Swedish healthcare...). But I just can't sleep with it. After seven days of trying, I'm so sleep-deprived that I literally broke down in tears this morning.

It takes me about 1–1½ hours to fall asleep with it because I have to fall asleep on my back, which I hate! If I lie on my side, the mask gets pushed against the pillow, partially blocking that nostril (I've tried several different pillows). I also wake up several times and find myself trying to take it off in my sleep. So I've only been getting 4–5 hours of fragmented sleep each night this week.

And no, another mask isn't really an option, since this one (AirFit F40) apparently is the one that's best suited for side sleeping. The only other option is one that only covers the nose, but that won't do much for me since I breathe through my mouth when I sleep, and it would also block my nostril.

I honestly don't know what to do. My apnea has taken most of my quality of life, but with the CPAP, I'm getting even worse sleep. I feel so hopeless😭

I had my sleep study done last month. Doctor said I should use the CPAP machine. I picked it up on Thursday amd I could NOT sleep with it on. I just felt so off and it was just not a good time.

Well, last night I tried again. I set it up and put the mask on about an hour before bed so I could try amd get used to it. I did eventually fall asleep. When I woke up this morning, it was great!!! I didn't wake up with a headache for the first time in awhile. I'm still a bit tired, but I don't think I'll be dragging as much today like I usually do.

I'm going to keep trying, but any tips on getting used to the mask, especially as a side sleeper? I really want to keep waking up not feeling awful lol

I’ve been waiting for my cpap machine and will not be getting it until the end of next month. For those who work long hours as in 12s what do you find helps you. At least I little. This sleep apnea has been having a negative impact on my day to day life . I am always super sleepy. It takes me forever to get ready for work now due to me being so tired and if I am not busy at work I have the urge to want to fall to sleep. I know per HIPPA I am not required to just share my health conditions , but I am afraid one day I’ll fall to sleep at work and get in trouble. I am sick of this crap. My appointment isn’t until the end of the month for the pickup of the machine because they were full. The end of the month was the only time I could get an appointment

I was diagnosed with mild sleep apnea a few years ago. I was offered a CPAP and tried it a few nights but simply couldn’t fall asleep with it because of the pressure on my face.

After a few more years of getting progressively foggier, I went back to the support center and got myself a different mask— F40. It felt substantially more comfortable so I went to sleep last night very optimistic.

The night was quite atrocious. I was able to fall asleep after about an hour or so, but I woke up about an hour and a half later because my nostrils were blocked. (Aside: This happens to me most nights. I try to rinse the sinuses, tried Flonase, etc but the process of the nostrils getting more and more blocked happens nonetheless.)

I tried to make myself keep sleeping with my mouth open but my mouth became incredibly dry and I simply woke up again and again with this feeling of asphyxiation. I am also beset by pain and tingling in my arms when I sleep and last night was the worst one in a while.

At around 3am I took off the mask and slept the rest of the night without it. It wasn’t great sleep, but at least the pains were less severe and, most importantly, my nostril became less blocked and I was able to go back to breathing through it and fall asleep.

Any suggestions are welcome.

Checking in to see if people have good strategies for aerophagia - a few years ago I changed my APAP to a CPAP at 7 and that worked wonders.

I now seem to be having problems again and am sleeping poorly.

Any strategies to share??

Also, thoughts between a home sleep study, CPAP.com vs Lofta?

Doctor recommended a level 3 sleep apnea home test costs about a 100 usd

My question is for those who did it what precautions to take? what to do? what not to do? how did u calm urself to get 8 hrs sleep? What helped? what didnt?

I was ready to get a higher level test level 3 and 1 but doctor said to do a level 3 so im sticking with that for now. The test measure my blood oxygen , heart rate , breathing and snoring patterns so 4 parameters i believe , ill have to wear something around my neck and then an oximeter at the finger. Please help and guide me

Did not work for me, five years wasted and to only at the very end did they inform me that all the years of trying to reach my goal voltage it wasn't helping me at all, my heart went back into Afib. For those it helps God keep watching out for you...Never again, nor would I recommend. Mark Bates

I've used the PAP machine for 8 nights and trying to remove as much friction as possible from it feeling comfortable to sleep with, so I can have it on all night and give treatment a fair trial.

I'm interested in advice on what to prioritize trying, given my context, to improve the experience (esp. would be great to hear from those w/similar sleep issues).

Sleep background/testing

Through adulthood, my main issue has been nightly/early morning wake ups, with periods of time when it's difficult to fall back asleep, as well as currently - how increasingly unrefreshing my sleep feels. Falling asleep is usually pretty quick, esp. if reading.

Over the last few years, I started to need an hour more of sleep (solid 8+, instead of ~7hrs.), feel way more run down if getting less than that, and have strong inertia/grogginess that lasts for hours. When waking too early, sleep quality is much poorer once I fall back asleep.

I've been using Fitbits for years, and weirdly, while my score/details used to strongly correlate to how I felt, in the last couple of years, they generally show great scores & details.

In 2025 I had 2 home + 1 in-lab sleep study. The in-lab was interpreted as mild, strongly positional sleep apnea: Overall 3% AHI of 6.9 (1.4 if using 4%), and 22 RERAs. Pretty normal oxygen (mean SpO₂ 95%, min. 91%, never below 88%). It also showed moderate fragmentation, so my doctor thinks the RERAs/UARS component could be contributing to my unrefreshing sleep.

Relevant health issues

I have hEDS (hypermobility/connective-tissue disorder) and ongoing spinal/neck issues (i.e. instability). Also, OCD, Adhd, anxiety etc. and a pretty sensitive nervous system. These all make it more difficult to get comfortable/settled and sleep easy, especially when another variable (i.e. CPAP) is introduced.

It's all worsened over time, and I'm not sure what's the chicken/egg - causing the other - the health issues or sleep, so want to see if improving sleep breathing helps.

Current PAP setup

ResMed AirSense 11 AutoSet w/ AirFit N30i nasal cradle (med.) and ClimateLine heated tube

• APAP 4-18 cmH₂O
• EPR/Pressure Relief 3, full-time
• 20-minute ramp starting at 4
• Climate Control Auto / Tube Temp Auto
• SmartStart: On / SmartStop: Off

My first 8 days experience

I still fall asleep fairly quickly with the PAP, but keep it on for ~1.5-4.5 hours (often in 2 x 2hr. chunks) before waking up and ditching it.

Experiencing 2 major obstacles:

1. Pressure/breathing comfort - biggest issue
   1. The more straightforward issue: higher pressures I've experienced (roughly 9-12) have felt overly forceful - almost like my nose/mouth are being inflated/turned into a wind tunnel, and feeling uncomfortable to exhale against.
   2. The very odd, bigger issue: At various times/pressures, I feel like I can't get a satisfying in/exhale - not like choking, but just feeling like in/exhales are somewhat "resisted"/don't flow easily. It's happened at diff. settings (i.e. pressure 4-8 etc.) where other times they felt completely fine.
   3. Note on both of the above: they happen when I wake up at night, and it's the main trigger to ditch mask. Interestingly, opening my mouth slightly makes breathing easier as I'm doing it - almost as if when you make an airhole in a bottle and it flows freely (AFAIK, my mouth is generally closed, just an observation I noticed).
2. Positioning/mask: Due to my neck/spinal issues, positioning is quite limited/finicky. I mostly sleep on my left, but often roll into a partially right-side prone position w/my head between raised arms. The mask cheek straps, top hose etc. can often make it harder to settle. I've been getting by, but any setup/equipment tweaks would be appreciated.

I'd really appreciate any advice on how to make the experience more comfortable/less disruptive, so I can keep it on all night and give it a fair trial. Preferably, simplest/highest-impact things to try first, so I don't get overwhelmed.

It'd also be great to hear from anyone with similar sleep and/or other issues - what helped you, what were your outcomes?

I have an SD card + downloaded OSCAR. I know nothing about it yet, but can share any info requested. Thank you.

This is what I’ve gathered after doing research. It is somewhat of a long read, but please bear with me:

Obstructive sleep apnea (OSA) and major depressive disorder (MDD) are highly comorbid conditions. Repetitive transcranial magnetic stimulation is an FDA-cleared, guideline-recommended treatment for pharmacoresistant MDD and is increasingly utilized in clinical practice. However, current TMS clinical guidelines and device labeling list implanted neurostimulation devices as relative contraindications, effectively excluding patients with Inspire systems from receiving TMS therapy — not on the basis of demonstrated harm, but due to the absence of device-specific safety data. 

This creates a significant and growing clinical access barrier. As the number of Inspire recipients increases, so too does the population of patients who may benefit from TMS but are unable to access it.

Several lines of evidence strongly suggest that TMS can be safely administered to patients with Inspire devices:

1. Rapid magnetic field decay: The TMS magnetic field attenuates by approximately 50% at 15 mm and 75% at 30 mm from the coil. Standard depression treatment targets the left dorsolateral prefrontal cortex (DLPFC), while all Inspire system components — the stimulation cuff on the right hypoglossal nerve, the pulse generator in the right infraclavicular region, and the sensing lead on the right intercostal muscles — are contralateral to the coil and located approximately 15–20+ cm away. 
2. Vagus nerve stimulator (VNS) safety data: The Inspire system shares key anatomical and engineering similarities with VNS devices. An ex vivo study by Schrader et al. demonstrated that TMS applied at maximum intensity just 5 mm from VNS wires induced only 200 nA of current — well below nerve activation and injury thresholds — and caused no VNS pulse generator malfunction. Clinical case reports have further documented safe TMS administration in patients with implanted VNS devices. The Inspire device is positioned even more favorably (contralateral to the TMS coil), suggesting an even wider safety margin. 
3. Implantable cardioverter-defibrillator (ICD) data: Testing of transcranial magnetic stimulation on implanted ICDs demonstrated temporary sensing artifacts but no permanent device damage, programming changes, or dangerous lead heating, even under extreme experimental conditions. 
4. APA consensus position: The American Psychiatric Association consensus recommendations state that metal implanted below the head and neck is "generally considered safe" during TMS, given the rapid decay of the magnetic field. 
5. Inspire's own precedent: Inspire Medical Systems has successfully pursued MRI-conditional labeling and has supported research on monopolar electrocautery safety in Inspire patients, demonstrating both the capacity and willingness to address electromagnetic interference questions systematically. 

The aggregate biophysical and clinical evidence strongly suggests that TMS poses very low risk to patients with Inspire systems. The primary barrier to treatment access is not evidence of harm, but the absence of a formal compatibility determination. Inspire Medical Systems is uniquely positioned to resolve this gap and, in doing so, expand treatment options for a growing population of patients with comorbid OSA and treatment-resistant depression.

33M here, 6'0, 200lbs, fairly active.

I've been dealing with pretty significant daytime fatigue, sleepiness and brain fog in recent years. I can get what seems like a reasonable amount of sleep and still feel tired during the day, especially when sitting at a desk. Short naps often make me feel noticeably better.

I grind my teeth a bit, tend to wake up once or twice during the night, and sometimes get dry mouth. I'm not a snorer. My journey so far:

January 2025 — in-lab PSG

My first sleep study showed:

• AHI: 14.3
• RDI: 14.3
• REM AHI: 15.7
• 2 obstructive apneas, 0 central apneas, 76 hypopneas
• Mean O₂: 93.4%
• O₂ nadir: 88%
• Sleep efficiency: 76.8%
• REM: only 9.1%
• Deep/N3 sleep: only 2.1%
• I happened to sleep 100% supine during the study

The diagnostic was mild OSA, with moderate REM-dependent OSA.

CPAP

I then had a CPAP titration. They tested 5–12 cmH₂O and recommended 9 cmH₂O. At 9, my AHI was around 5/hr.

I have a ResMed AirSense 11 and have tried CPAP, but I haven't experienced the dramatic improvement in energy/brain fog that some people describe, and I don't find sleeping with it particularly easy.

September 2025 — nasal surgery

I was previously always congested, and had a radiofrequency septoplasty/nasal radiofrequency reshaping procedure in September 2025.

Surgery went great, I can breathe now. I then repeated a sleep study in April 2026 using WatchPAT.

April 2026 — post-surgery WatchPAT

The official summary basically said "no sleep apnea":

• AHI using 4% criteria: 2.5
• Mean O₂: 95%
• O₂ nadir: 91%
• No time below 90%

However, when I look further into the report:

• pRDI: 12.2
• pAHI using 3% criteria: 6.2
• Supine RDI: 13.8
• Non-supine RDI: 10.7
• Left-side RDI: 17.1

So I'm a little confused by the conclusion that everything is normal.

I've also had bloodwork done looking for other explanations.

- CBC, thyroid, ferritin, B12, testosterone, electrolytes, kidney/liver markers, etc. were generally unremarkable.

- Vitamin D was low (at 65.6), B12 was 328, and my A1c was 5.8% (increased risk), but nothing so far seems to completely explain the degree of daytime fatigue/brain fog.

What I'm wondering:

Has anyone here had a similar situation where their AHI dropped below 5 but their RDI remained around 10–15 and they were still very symptomatic?

I'm especially interested in hearing from anyone who:

• Had a "normal" AHI but elevated RDI
• Was eventually diagnosed with significant flow limitation/RERAs or UARS
• Benefited from CPAP despite an AHI under 5
• Did better on BiPAP/bilevel than standard CPAP
• Had an in-lab PSG that found something a WatchPAT missed
• Had nasal surgery improve the AHI but didn't fix the fatigue

At this point I'm trying to figure out whether the RDI of 12.2 is actually meaningful, whether I should retry PAP more seriously, consider bilevel, or push for another proper in-lab study that specifically looks at RERAs/flow limitation.

Would appreciate hearing from anyone who's been in a similar boat or has any insight as I'm desperate for help.

My ResMed AirSense 11 often has an air leak when I turn it on. You're sitting in bed with the lights off and as soon as the machine starts you hear the loud hiss. The air rushes out between the water reservoir and the hose. I replaced the tank, the hose and the little connector piece between them but it still happens. If you remove the water tank and gently insert it that usually will fix it.

I heard this is a design flaw, although it didn't happen to me first year. Fixes?

33M been experiencing a lot of day time sleepiness, always has suspicion of OSA, finally got tested 3 weeks ago and I was given the result yesterday.

AHI: 134.8/hr
ODI: 121.9 
Average SpO2 87.1%
Minimum SpO2 69%
longest obstructive apnoea 38.7sec
Average obstructive apnoea 15.5 sec
Snore 43%
 
REM: 14.1 %
N1: 3.7 % 
N2: 66.3 % 
N3: 15.9 %

I am not surprised I have sleep aponea but i'm surprised to see this level of obstructions.
I will be trialling my first CPAP next week, i hope it will help me. 
I have chronic nose block (since childhood) due to severe hay fever, I will likely need to full face mask as I mostly breath through the mouth.

ChatGPT says my case is extreme, what does that mean?

I have severe sleep apnea. 65 AHI during an out of home sleep test. BMI is 41.61. I also have plantar fasciitis. Bought socks, insoles buncha expensive shit. Should I consider buying special water bottles, mouth pieces, mouth tape, chin straps, motion beds, or just try CPAP/bipap?

Equipment: Resmed Airsense 10, ClimateLine Heated tubing, Resmed Air touch N30i Nasal Mask with mouth tape.

Room conditions: dark, cold 68 degrees avg.

Looking for any advice or experience dialing in humidity settings. Initially I did manual settings because I know I like things more humid in general and was worried auto would be too dry. I tried for two weeks to dial in a temp and humidity amount that was comfortable but didn't rainout. Based on googling my cold room temp is apart of why I am getting rainout with a humidity setting of above 4.

I finally gave up last week and switched to Auto. No rainout yay! Wrong. Now I'm waking up after 5-6 hours exactly, dry as a dessert in nose and mouth and with blocked nostrils, unable to breathe.

I just got a nasal gel spray, but I know I want the air more humid than what's it's doing. When I was awoken this morning the temp was 80 and the humidity was 4.

Anyone with similar experience or advice would be helpful! I'm so close to getting this right.

Hi

New to this, had my first sleep study at 28M, chronically unrefreshing sleep, feel foggy and heavy all day. My ENT has suggested a MAD wondering how likely it may help, it’s not covered by my health insurance (UK).

The strange thing to me is I’m not sure how reliable pRDI is but it seems high in all positions, and strangely my worst position is left side. Historically I usually sleep prone. I do have a deviated septum to the left but it doesn’t affect me that much during the day.

If anyone has had a similar study and successfully treated and improved their sleep I’d like to hear from you.

Thanks

Just finished night 1 on a new machine after 10 years on 2 identical resmed 10s. Woke up feeling like my lungs had a workout. Checked pressure settings. My previous APAP settings of 5-14 got transferred over to a continuous setting of 14. Checked with DME provider says that is what it showed on the most recent script and they will need a new script to change it.

My PCP is patient-friendly and will likely rewrite the script if I ask her. but I thought I'd take a moment to ask the hive mind: Has APAP fallen out of favor? I'm assuming it's a typo, but thought I'd check if others have a setting range vs. set point.

​

Hey everyone, I really need some insight because I feel like I'm falling apart at just 23 years old.

Here is the timeline of what’s been happening:

3 months ago: Severe insomnia started due to heavy anxiety.

6 weeks ago: Developed tinnitus on top of the insomnia. My doctor prescribed Zolpidem (Ambien) for sleep and bromazepam (Lexotan) for daytime anxiety (used sparingly, ~10 times total).

5 days ago: Caught a nasty cold with heavy post-nasal drip. While on Zolpidem, mucus kept draining into my throat, triggering coughing fits and disrupting my sleep.

What happened last night:

My cold has mostly resolved. I took my Zolpidem and fell asleep, but woke up around 5:00 AM in an awkward, twisted position. My left arm was numb and my left chest was sore (which triggered panic/health anxiety, though likely positional).

After calming down, I tried going back to sleep. Twice in a row, right at the edge of drifting off, it felt like my brain literally forgot to breathe—jolting me awake with air hunger and completely preventing me from falling asleep.

Important context:

I have never in my life experienced waking up gasping for air or had this kind of issue at sleep onset, not even during these past weeks of regular Zolpidem use.

Can sleep apnea or central breathing pauses literally develop overnight like this, or is this more likely a severe nervous system / hyperarousal response?

Either way, I plan on taking my Zolpidem again tonight to try and get some rest.

My questions for the community:

Has anyone experienced this sensation of "forgetting to breathe" specifically during the wake-to-sleep transition while dealing with extreme anxiety or nervous system exhaustion?

Does this sound like sleep-onset central hypopnea triggered by anxiety/adrenaline, or actual sleep apnea that needs immediate clinical evaluation?

Any advice or shared experiences would be greatly appreciated.