Hi, Im 42m have an AHI of 16 (7hr sleep study, i think it’s actually higher than this because i wasnt alseep the whole time. Mixture between apneas and hypoapneas). After a home sleep study I was on cpap for a while but it wasn’t working so I managed to get a DISE done (sleep endoscopy). It clearly showed that I have a very large tongue base that pushes back on the epiglottis causing what is known as floppy epiglottis where the airway closes when breathing in (cpap made this worse) after the epiglottis is forced back. Positional therapy showed no real changes. However i have been trying to sleep sitting up in bed but doesnt seem to help. They found that during the DISE if my mouth was kept closed then the issue seems to resolve itself the tongue moves forward again. However, i have found it impossible to keep the jaws tightly closed (also still wake up feeling bad, ive tried straps, belts, surgical collars, bandages, tapes) so I got a dental device (over 1000 euros, very expensive), but I still wake up during the night 2-4 times that I remember to go to the toilet (i saw a urologist who said i had no issues) and always get up in the morning with a hangover. Im 42 years old and have probably had apnea for 10 years or more. It took a long time to get diagnosed because i dont snore and am normal weight and so no one thought it was a problem. And I started with lots of other issues that eventually allowed me to get a sleep study. My concern is that the dental device is not working and should I try to get another DISE with it in to see if there are any other collapses? During covid in my country its easier and faster to get a dise on my health insurance than a home sleep study with my insurance, no idea why. Should I consider some kind of surgery? My epiglottis is huge and reaches above the tongue. I mouthed breathed until around 19 years old when i got my first septoplasty. I had another one around 5 years ago. My nose blocks up when i lie down so maybe i need another surgery/turbinate reduction too. Im a bit lost to be honest because i cannot use cpap. So i dont really know where to go from here. Any one have any experience with this type of thing? Any advice? I have seen MMA surgery but i really cant afford it and would like something less extreme if possible. I dont consider that my jaws are recessed or anything. Thanks.

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