Month: November 2020

Surgery for sleep apnea – my story

I put this together just in case anyone else is considering or is booked in for surgery. I have written a condensed version of my story below – it is still long.

Summary:

Type of surgery: UPPP, Turbinate reduction, tongue base reduction (called a multilevel surgery)

If you want to see a before, immediately after surgery and recovery throat picture click here NSFW.

Results: Pre Surgery – AHI 40 report, Post Surgery – AHI 6.5 report (Both home tests)

Outcome: No side effects. Sleep good. Drs feel CPAP not required.

My sleep apnea story is a little odd in that I didn’t appear to have severe symptoms, in that I had no daytime sleepiness. What I did have was a lack of refreshment on a morning. This however did not impact on my daily functioning. I have for all of my life been a LOUD snorer. People in bedrooms in the other end of the home could hear me. It was my lovely wife, who first raised concerns as she observed apnea events. I went to see my GP, who referred me to a respiratory (thoracic) specialist, who instantly noted that my airway wasn’t great (specifically noting large tonsils), organised a sleep study and referral to an ENT. I guessed that given my lack of breakthrough symptoms and reasonable weight it would be mild at best. I was surprised that I was diagnosed with severe sleep apnoea (AHI 40).

At my ENT consultation I was informed I had a triple whammy of physiological concerns, a nose that was no good for breathing, a tongue that was too big for the container it was in (his words) and a compromised palate which he described as the combination of my soft palate, tonsils, adenoids and uvula all being massive and crowding my airway. So he booked me in for surgery, expressing that my physiology made me an idea candidate for successful surgery. He was up front that it may not cure it but he was confident in a positive outcome.

I was booked in for a multilevel surgery:

Sinoscopy, BILATERAL Inferior Turbinoplasty (Turbinate Reduction), Uvulopalatopharyngoplasty (UPPP), Radiofrequency Tongue (Tongue reduction)

Because I was in the public system, this took months. Between diagnosis, seeing ENT and then the wait for surgery was 18-24 months in total. In the meantime I tried CPAP. I was excited as this is the gold standard, unfortunately for me I didn’t get the kind of response others had. In fact I had the opposite, despite trying different machines, pressures, masks, tape etc, I slept worse with the CPAP in that I started to get daytime sleepiness and increased sleep disturbance. I persisted for about 16 months then stopped, happily my sleep improved so I simply waited for the surgery.

The surgery wasn’t bad at all; I had read the horror stories so was prepared. I had the surgery and stayed overnight in a high dependency unit (HDU). The surgeon (ENT) was very happy with the result and interestingly snoring stopped day one, which was surprising as they told me that due to swelling I would initially snore more. The recovery was rough but not horrible. I believe this was down to a good regime of pain medication (list here), gentle exercise (walks) and rest. The worst part of it was the narcotic medication, it zombifies you. I was able to reduce and stop the hard medication after about 10 days and managed comfortably on paracetamol. I expected to lose weight as I read that I would struggle to eat, so we made lots of slow cooked stews and soups which I ate luke warm and while this was uncomfortable, it was certainly tolerable, and indeed during the recovery I gained weight. The recovery was going very well, but I had a bleed from the tonsil bed on day 10 and had to present to the emergency department, if the bleeding hadn’t stopped I would have needed surgery to cauterise it, however it stopped but I had to stay overnight. After 4 weeks I was back at work and feeling OK, but I wouldn’t say and I was 100% until about 3 months post-surgery (i.e. back training regularly etc). Additionally, 9 months post-surgery I have had no side effects, other than a sinus infection at about 3 months.

So now the exciting part, 6 months post-surgery had a sleep study – I was concerned as I had just finished a heavy cold. I persisted with the sleep study as the wait times are horrendous. The follow up sleep study showed a reduction to 6.5 AHI which from 40 AHI is a significant drop so I was delighted. I am sleeping well, waking up less to urinate during the night, my wife hasn’t observed any apneas and she is delighted that I don’t know and describes me as a silent sleeper. Due to lack of symptoms respiratory specialist and ENT don’t feel I require further treatment with CPAP and I agree. So unless I significantly gain weight they feel that no further treatment is required and I don’t need to worry about the apnea. My ENT is going to follow me up for the next 24 months, but after being disheartened by my poor response to CPAP I am delighted with the surgery results.

In short I am happy with the outcome. Happy to answer any questions about the surgery and recovery. I do want to stress that while it didn’t work for me, CPAP is non-invasive and is the gold standard of treatment and should be tried before you consider surgery.

EDIT: Fixed links

submitted by /u/shaundennis
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Can someone audibly detect if you have sleep apnea?

I saw a video that compared normal snoring with sleep apnea. It’s very obvious they have apnea because you can easily hear the breathing stop for a little bit followed by choking and gasping for air.

I recorded myself and confirm that while I snore maybe 10% of the night, I definitely don’t have any gasping for air sounds. It’s a rhythmic breathing in and out.

Is there still some likelihood I could have apnea?

submitted by /u/Rcrez
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For those who have fixed your sleep apnea/UARS, How has life changed?

Whether it was through surgery, cpap, or alternative means. How has fixing your sleep disordered breathing changed your life?

  • Are you less anxious?
  • Is your ADHD gone?
  • Is your depression gone?
  • Are you doing better in school/work?
  • Is the chronic pain gone?
  • Is the acid reflux gone?
  • Are you confident for the first time in your life?

I’ve noticed that on these subreddits I hear a lot from people who are currently going through it but it’s rare to hear from those who have recovered completely. I want to know their story. What treatment fixed your sleep disordered breathing and how has life changed for you?

submitted by /u/dannydawiz
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Could this episode be Sleep Apnea

I had a very strange episode happen to me the other day. My husband woke up at 7:30am to find me breathing strangely, taking a quick short breath in followed by a long, noisy around 7 second breath out and I was unresponsive to him trying to wake me. After about 20 mins and calling for the paramedics he was able to get me to respond but my arms were flailing around and I was asked if I knew where I lived and got the town wrong and couldn’t remember what year we are in. The paras arrived and did the Stroke assessment test and said it didn’t appear I’d had a stroke. I was taken to the A&E where I spent the day. I don’t remember much about what happened due to being in and out of consciousness I think? I had an MRI that I remember and was allowed to leave the hospital as the results of the MRI were clear. I had an echo cargiogram the next day and my dr said the results of that were good, no structural defects of the heart and no evidence I’d had a heart attack, So no stroke or heart attack. My dr said it could have been a TIA (mini stroke) or sleep apnea. My next test in a couple of weeks is a home sleep apnea test. I do know that for a few years I’ve had many experiences of waking up usually after half of hour of falling asleeep being suddenly woken up by the feeling of not breathing. I usually jump up and it feels like my heart has stopped beating and I can’t get my breath then I can breath normally once again. This can happen once during sleep or sometimes several times during sleep. I can go months without waking up or it continues for weeks at a time. Has anyone EVER experienced this type of episode and has sleep apnea? I’m scared of having another incident. Thank you.

submitted by /u/Afraid-Watercress974
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Advice on Mask Discomfort

Sorry if this is asked all the time and I’m sure there isn’t a “one size fits all response”. I need CPAP and I’m having trouble with compliance because masks drive me nuts. I temporarily have a Resmed Airsense 10, heated tube, humidifier, variable pressure, all the bells and whistles. I started with an AirFit P30i mask. It has little parts that stick up your nose. Woke up in night feeling like I’d not quite been punched in the nose. Have switched out the piece that goes under your nose for one that is flat. I feel claustrophobic with something strapped on my head, the mask going down the sides of my face drives me nuts, and I don’t like the pillows pushing in my nose. I wake up in the night and feel like I’m in a horror movie and take the mask off – it’s just damned uncomfortable. Would I be better off with a full nose covering mask? Full face? I’d stayed away from those because I just don’t like stuff strapped on my face. Any ideas on what to do here?

submitted by /u/imalotoffun23
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Science Article: Sleep deprivation impairs the suppression of unwanted thoughts and memories which enter conscious awareness when individuals confront reminders. Sleep-deprived people experienced significantly more intrusions and unsuccessful suppressions of unwanted thoughts.

https://journals.sagepub.com/doi/full/10.1177/2167702620951511

Losing Control: Sleep Deprivation Impairs the Suppression of Unwanted Thoughts
By: Marcus O. Harrington, Jennifer E. Ashton, Subbulakshmi Sankarasubramanian, …

Clinical Psychological Science
First Published October 15, 2020

Abstract
Unwanted memories often enter conscious awareness when individuals confront reminders. People vary widely in their talents at suppressing such memory intrusions; however, the factors that govern suppression ability are poorly understood. We tested the hypothesis that successful memory control requires sleep. Following overnight sleep or total sleep deprivation, participants attempted to suppress intrusions of emotionally negative and neutral scenes when confronted with reminders. The sleep-deprived group experienced significantly more intrusions (unsuccessful suppressions) than the sleep group. Deficient control over intrusive thoughts had consequences: Whereas in rested participants suppression reduced behavioral and psychophysiological indices of negative affect for aversive memories, it had no such salutary effect for sleep-deprived participants. Our findings raise the possibility that sleep deprivation disrupts prefrontal control over medial temporal lobe structures that support memory and emotion. These data point to an important role of sleep disturbance in maintaining and exacerbating psychiatric conditions characterized by persistent, unwanted thoughts.

submitted by /u/godzfirez
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My eyes burn with the fire of 1000 suns

I really want to like the p10 mask, or any mask really but the nasolacrimal regurgitation (air coming out my tear duct) makes my eyes feel like they’re melting out of my head and I also rip the mask off every night. I feel like some nights the p10 has no issues and is the best mask I have tried so far, but I would love to not have to worry about it. The only other issue is it can be a little uncomfortable in one of my nostrils.

So i’ve tried, AirTouch F20, Airfit f20, p10, n30i, dreamwear full face…. any other options? My last resort is the total face mask but I really dont want to go there.

submitted by /u/layonthebeech
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Dad has sleep apnea but won’t go to doctor

How do you all recommend I try to convince him? I can tell how it’s affecting his life but I can’t really force him to get it treated… I feel as though I need to convince him why he should go get it checked with things other than my opinion. He may just be scared of having to use a cpap forever, and I’m sure everyone here gets why it’s worth it, but how to convince him it is without knowing what treatment literally feels like?

submitted by /u/sandrtom
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