PatientVioletBear0961

No, I haven't heard of it, but it might be a clue about your condition. Since you said the click has the same rhythm as your breathing cycle, it seems like it is probably produced by part of your airway. When you see your new sleep doctor, I think you should bring the sound recording with you as well as your sleep study results.

By the way, I am curious what app you used to record your breathing sounds during sleep, since I may want to do that also.

I am excited for you about your upcoming doctor's appointment! Since this doctor is an expert at EEG analysis, it seems like he should be in a good position to tell you whether your fatigue and cognitive impairments could be caused by sleep fragmentation or some other problem with your sleep quality.

In the mean time you could try experimenting with the use of nasal strips, sinus rinse, and decongestant nasal sprays at night to see if any combination of these makes a difference to the clicking sound that your breathing makes when you are asleep, or to how you feel the following day. Good luck! I hope that you will soon have a clearer answer to your problem!

Or you could try wearing a foam cervical collar around your neck to support your chin. Maybe this would be more comfortable for you than a chin strap.

Or you could try training your tongue to stay sealed against the roof of your mouth while you sleep, so that no air from the CPAP can get into your mouth. (A myofunctional therapist can help with this tongue training process. Just make sure the therapist knows that you have jaw joint problems and is super careful with your joints.)

I think you should try again setting your humidifier to the highest setting. Make sure that the temperature of your CPAP is also at the highest setting, since you will need the CPAP air to be very warm in order to keep all of that humidity in the form of water vapor. If the air gets too cool, the humidity will condense into liquid water. Your entire length of tubing needs to be kept warm too, so you should be using heated tubing if you are not already. It also helps to wrap your entire tubing in a material that insulates it from the cooler air in your bedroom. I use a Snuggle Hose for this purpose.

Another option is Chin-Up Strips:

http://www.chinupstrip.com/

That is good news that you have found a sleep specialist in Italy who is connected with Stanford! I hope he will be able to give you a conclusive diagnosis as to whether you have UARS. It seems to me that your deviated septum and enlarged turbinates could cause UARS, and the clicking sound when you sleep makes me even more suspicious of this.

As for myself, I have made a lot of progress with my CPAP usage. My tongue training efforts paid off and I am now able to sleep all night long with the CPAP mask on and the air pressure at the lowest setting, 4-7. This air pressure is not therapeutic for me, but it still feels like a huge breakthrough for me to be able to use CPAP with little enough disturbance to be able to keep it on all night. My next step will be to work on increasing the air pressure I can tolerate in the hope of finding a pressure that is therapeutic for me and relieves my insomnia and fatigue.

"Would you like a referral to sleep medicine?" That is the question I wish a primary care provider would have asked me.

For about 15 years I told every primary care provider I saw about the chronic fatigue I was having, that was severe enough to really make me miserable and undermine my ability to function normally, and that appeared to be caused by poor sleep. (I had also had some subtle signs of a sleep problem for a long time even before the fatigue had become a big problem for me.) Some of the primary care providers I spoke to ordered blood tests to check my thyroid hormone levels, iron status, and etc., which always came back normal. One doctor told me that I had mild depression and it would go away on its own after a while, a diagnosis that made no sense since I was one of the happiest, most enthusiastic, and most motivated people I knew in all ways other than being a bit unhappy about my chronic fatigue problem. Some primary care providers encouraged me to exercise, eat right, and practice good sleep hygiene, all of which I reported that I was already doing so much so that I had gained a reputation as a health fanatic. Some doctors honestly stated that they did not know what was causing my fatigue and did not have any treatment to offer me, others avoided responding to my fatigue complaint if I let them. Over time I became less vocal about the problem because it appeared that modern medicine just didn't have any way of helping me. No primary care provider ever offered me a referral to a sleep medicine specialist. But I couldn't hold back from continuing to search for a solution on my own, since the fatigue was really difficult to live with. Eventually I learned of the existence of the sleep medicine specialty through my own information gathering, and I assertively demanded a referral. It was only after seeing a sleep medicine doctor that my sleep apnea was eventually diagnosed and I am now in the process of being treated for it.

I think the reason why primary care providers did not offer me a referral to sleep medicine was because I did not look like a classic sleep apnea patient being a slender, young female who doesn't snore. But even so, shouldn't a possible case of insomnia, or some other sleep disorder, be referred to sleep medicine when the problem is causing major effects on the patient's life and is not easily solved with lifestyle modifications?! My experience seems like a really big fail on the part of primary care.

I have a bit of tinnitus too.

I can't help but wonder whether the same jaw and facial features that cause a narrow airway and increase the risk of sleep apnea might also increase the risk of TMJ disfunction, tinnitus, and other functional problems affecting the face and the area around the TMJ joints.