Sleep apnea and deviated septum

[sleepcrapnea]

Seeking a bit of input and ideas please.

I have been having bad sleep problems for about 4 years now. Its been a hell of a time trying to identify the cause.

There are two issues. I think I do have sleep apnea and I definitely have a deviated septum. Im not sure which condition is responsible or both or what.

So 2 years ago I went to get a sleep test. At home one. And it showed 4.2 apneas per hour. So, the specialist said I dont classify as suffering sleep apnea, which has the threshold of 5 per hour for the lowest level of mild sleep apnea. But, I feel like I had a really shit sleep that night as in I did not fall asleep a lot. Maybe diluting the rate of apneas making it seem lower than it is.

Anyhow, sleep problems carried on. I tried using a special mouth guard. $350. It did nothing, Only made sleep worse really.

Then, I tried a cpap. It was horrible. It made my sleep worse. First, the claustrophobia. But then, my blocked nose stopped air getting in anyway. Then, the general discomfort. I didnt want to continue with it as I would have had to pay $1800 for something not working. I didnt want to buy a whole face mask as the anxiety and claustrophobia terrifies me. And I dont even know for sure if I have sleep apnea as major reason. Only suspect. Tests say no.

So, stuff carries on. I investigate my nose problem further. I have a deviated septum and resulting enlarged turbinates as well. This causes nasal obstruction. During the day I am used to it. At night, I get really blocked up. Due to gravity. Lying down.

I have been on a wild goose chase with my nose problem too. The doctors stuffed up diagnosis by not doing a proper scan. Saying septum is fine and its just turbinates. So, I have spent a fortune doing allergy shots for 2 years plus expensive air purifier, neither of which did anything. Because, doctors finally did a proper scan and the problem is structural. Deviated septum. Nothing to do with allergies.

I am scheduled for septoplasty and turbinates reduction. Surgery probably soon. Now I am getting worried what if that doesnt fix the problem. I guess at least it will improve my nose breathing which may help or reduce apneas?? And reduce the waking up in the night with sore throats and dry mouth from mouth breathing? And then at least I could try a nasal cpap again if the issues persist rather than a face mask which I cant bear the thought of?

Im also a bit puzzled about the notion of having sleep apnea. I am not overweight. I am a bit fatter than slim, This is a new development and I think the sleep loss is causing it. Finding it hard to keep weight off lately. Even though I exercise all the time. And eat nutrient dense food. I think I eat too much now due to sleep loss and less energy when working out than used to have. Less muscle growth at night. More hunger etc. Im 39 and male. But then, at other times during the last 4 years I have also had terrible sleep when I have been very slim.. Doesnt seem sleep apnea typical.

I record my sleep at night and it sounds awful. It doesnt really sound like the sleep apnea videos online of other people with apnea. I snore but not that often. My snore score on snorelab is generally about 10 on average. Which is very low. Considering the average is 25. And it includes mouth breathing loudly as a snore. Much of the time my breathing sounds like loud mouth breathing rather than snoring. And random breath speeds. Sometimes slow, sometimes fast, sometimes sounds too fast. Never even through the night. Then sometimes a bit of snoring. Then sometimes a gasp type sound. Sometimes a cough. Am single so have never bothered someone with my snoring in the last 4 years but my night time breathing, from listening to the app recording, is not the type of noise that would wake and irritate a partner. But, it does sound awful. Just so inconsistent through the night. Does not at all sound peaceful and restful. Breathing all over the show sounds like crap.

I also read that loosing a lot of weight could get rid of sleep apnea. Maybe I could just try and eat next to nothing and work out more. Im currently 189cms tall (6' foot 2 ) and weight 89 kgs. I weigh more than I want. But definitely far from overweight. I workout regularly and have high muscle density. My ideal weight is 80kg. I have been that weight 2.5 years ago, and still had really shit sleeps then. Maybe I should go hard trying to drop to 75khgs or something. Which is getting close to far too thin for my build and height. Who knows.

I am just so sick of this shit. I want to sleep. I feel so compromised. I wake up in the night all tine time. Usually early morning. And it gets to a point where I cant get back to sleep. Thats the problem. Then sometimes I have only 4/5 hours sleep. I never sleep until my alarm. Not possible. I will always be wide awake at some stage. If i take a sleeping pill I get get 8 hours sleep but that its. I feel like such crap when I have low sleep/. I dont have the type of apnea where you s;eep 8 hours then feel like shit. Its more like I sleep 5 hours then cant get back to sleep again after waking a couple of times.


Any ideas? What do I do? What should I expect in terms of results from the nose surgery?

[booksfan]

First of all, thin people can have sleep apnea too. It is airway obstruction, not weight, although overweight people have sleep apnea. Muscle laxity (which comes with age...I know doesn't apply to you!) can also be a contributing factor. Some people have positional sleep apnea...they are fine (below threshold) if they sleep on stomach or side, but put them on their back and boom >5 AHI! Same with REM sleep...once they go into REM, AHI goes up. It can be very complex and others here can explain it much better than I.

As far as septoplasty and turbinate reduction, I had both done several months before my sleep study. SO glad I did! What a wonderful feeling to be able to breathe so easily! Even immediately after surgery, with splints in my nose, I was shocked at airflow. When the splints finally came out, it was almost scary! A revelation even. But, 4 months later, I was still diagnosed with sleep apnea, much to my disappointment. However, I can breathe so...a win.

I, too, am somewhat claustrophobic and was concerned about masks. That was the hardest part of adjusting to CPAP for me. I had a terrible time finding a mask that really worked me. It took about 14 months and I tried well over 15 masks, some several times (my husband, also a PAPer, insisted I try his fave several times, as "it's the BEST!"). Finally the Bleep came out and I found my mask! I think it is great for someone who is worried about feeling claustrophobic as there is no headgear. It is pretty much as minimal as you can get. It attaches with adhesive to the outside of your nose (nothing even remotely enters your nose) and that's it! And if you have ANY issues with it, the CEO of the company, Stuart, is absolutely fabulous! He is available and will help you out to resolve any problems/stumbling blocks you are having. He takes customer service to the next level.

Good luck with your surgery and next steps. Keep us posted!

[sleepcrapnea]

@booksfan thanks for your feedback.

Im so pleased to hear that your septoplasty went so well. And amazing even right after the surgery you felt better. I am expecting to feel worse immediately after for the first week. Kind of dreading it. But needs to be done. Although your sleep apnea remained, do you feel that it was reduced by the septoplasty?

It sounds like you got a great mask. Do you mind sharing what brand and model it is?

I have been reading that a deviated septum/ nasal blockage can significantly contribute to sleep apnea. Due to forcing you to breathe through your mouth which puts your tongue in the position of falling back to block your throat airway. I read a test was done with a normal guy who purposefully blocked his nose at night for 10 nights and it had dramatic effects on his sleep quality and blood pressure and caused significant sleep apnea. Also I think my nasal obstruction is causing a lot of sore dry throat, mouth, lip and cough issues which may be causing me to awake in and of themselves.

I think this is all going to be a bit of a journey. Regardless of whether I have sleep apnea, of which I am unsure, I think that septoplasty is going to be a necessary part of the journey. If that doesnt work I will need to focus heavily on weight loss and using a CPAP. At least I will be able to breathe through my nose on a CPAP after that.

[Physician]

A buddy had this same nasal obstruction.

His doc told him In order to determine what percent of the problem is due to turbinate hypertrophy, try over-the-counter Afrin nasal spray which has oxymetazoline. Proper use is important. Blow your nose completely then one-two sprays each nostril. Wait 1/2 hour and spray once each nostril again and don't blow your nose for another half hour. This will shrink down the nasal turbinates well, but won't change a deviated septum. Think of surgery as a last resort.

If the Afrin works, then there are sprays and injections for a more long term solution.

[sleepcrapnea]

@physician thanks for feedback.

I have tried using Afrin before. It clears up my nose for sure. But then rebounds badly the next day even more blocked than the first time. Even after using it once. So I dont use it at all.

[Physician]

@physician thanks for feedback.

I have tried using Afrin before. It clears up my nose for sure. But then rebounds badly the next day even more blocked than the first time. Even after using it once. So I dont use it at all.

Then use it concommitantly with Flonase** or Nasocort, and stop the Afrin after five days, and continue the Nasocort. Turbinate injections are another alternative. Rebound nasal congestion (reactive hyperemia) after oxymetazoline vasoconstriction is indeed a problem, but not usually seen if Afrin is limited to under a week.

When I have allergic rhinitis, I use Nasocort six times a day, much more than recommended, and get relief that same day with no adverse effects. OTC directions approved by the FDA are conservative and sometimes sub-therapeutic.

If Afrin did cure your problem, no matter how temporary, it is unlikely you'll require surgery.

** Flonase smells too floral. Yuck.

[jimbud]

by Physician » Sun Mar 28, 2021 4:31 pm

Quack Alert!

If it walks like a duck, talks like a duck and gives advice like a duck.

It is a Quack.

JPB

[jimbud]

do you have any relevant, sage, useful, on-point, constructive suggestions for him (sleepcrapnea) which will improve his condition ?

Yes.

"Do not listen to anything this Quack says."

JPB

[sleepcrapnea]

Then use it concommitantly with Flonase** or Nasocort, and stop the Afrin after five days, and continue the Nasocort. Turbinate injections are another alternative. Rebound nasal congestion (reactive hyperemia) after oxymetazoline vasoconstriction is indeed a problem, but not usually seen if Afrin is limited to under a week.

If Afrin did cure your problem, no matter how temporary, it is unlikely you'll require surgery.

Thanks. I havent actually. tried those other producst. What is their general nature? Are they decongestant or streroid or what? Im not in USA so dont know the brands. But know Afrin is decongestant because I have seen it spoken of and just used an equivalent here.

I actually get rebound effects after even only one use. Its awful and makes the congestion even worse the next day. Put me off using it.

I have been using steroid sprays daily for years but they do not fix the problem.

Why do you think surgery would not be required if decongestant worked once? The problem is not just turbinates its a deviated septum which is likely also causing the swollen turbinates.

Re your username are you a physician?

[Dog Slobber]

Then use it concommitantly with Flonase** or Nasocort, and stop the Afrin after five days, and continue the Nasocort. Turbinate injections are another alternative. Rebound nasal congestion (reactive hyperemia) after oxymetazoline vasoconstriction is indeed a problem, but not usually seen if Afrin is limited to under a week.

If Afrin did cure your problem, no matter how temporary, it is unlikely you'll require surgery.

Thanks. I havent actually. tried those other producst. What is their general nature? Are they decongestant or streroid or what? Im not in USA so dont know the brands. But know Afrin is decongestant because I have seen it spoken of and just used an equivalent here.

I actually get rebound effects after even only one use. Its awful and makes the congestion even worse the next day. Put me off using it.

I have been using steroid sprays daily for years but they do not fix the problem.

Why do you think surgery would not be required if decongestant worked once? The problem is not just turbinates its a deviated septum which is likely also causing the swollen turbinates.

Re your username are you a physician?

I doubt the member Physician, is an actual physician.

I suggest you do a search on his posts, especially the one where he thinks using a CPAP device during covid, during dental treatment is a good idea. He doesn't understand why it's a bad idea, even when pointed out to him.

If he is a physician he's a poor one.

Regarding his idiotic test to determine the probability of needing surgery.

I was experiencing the exact symptoms as you.

Steroid based nasal sprays (Flonase, nasacort) didn't help.
Oxymetazoline (Afrin) gave me considerable relief, but rebound prevented me from using them for any long term. And I was using it with a corticosteroid.

My only solution was a Septoplasty and Turbinate reduction. His bullshit test would have suggested I likely wouldn't need surgery.

Don't thank him, he's not helping you.

[Pugsy]

Enough with the bull shit back and forth.

Stay on topic or posts will be removed. Everyone knows I only give one warning.

[sleepcrapnea]

I was experiencing the exact symptoms as you.

Steroid based nasal sprays (Flonase, nasacort) didn't help.
Oxymetazoline (Afrin) gave me considerable relief, but rebound prevented me from using them for any long term. And I was using it with a corticosteroid.

My only solution was a Septoplasty and Turbinate reduction.

Thanks for this. How did the surgery go for you? How were the results if you dont mind my asking? Do you feel the surgery helped reduce your sleep apnea? Are you using a nose breathing based CPAP now?

[Architect]

I always wondered if masks cause deviated septum, due to all the pressure around the septum. Past 2.5 years I developed sinus infections every other month, after persistent sneezing. I have non allergic rhinits, allergist tried many prescription oral meds/nasal sprays that did not work for severe congestion, only caused severe dry eyes. 3 sinus ct scans revealed nothing.

Anyway, he instructs me to use baby soap and baking soda in my nasal rinse, gave me Arm/Hammer Simply saline, and amazingly past 3 months, along with follow up, I haven't have any congestion

[Physician]

Reminds one of the famous quotes, consistent with surgeries done, sometimes needlessly:

A chance to cut is a chance to cure

The patient won't heal without the steel

So hydrate and operate

[Dog Slobber]

I was experiencing the exact symptoms as you.

Steroid based nasal sprays (Flonase, nasacort) didn't help.
Oxymetazoline (Afrin) gave me considerable relief, but rebound prevented me from using them for any long term. And I was using it with a corticosteroid.

My only solution was a Septoplasty and Turbinate reduction.

Thanks for this. How did the surgery go for you? How were the results if you dont mind my asking? Do you feel the surgery helped reduce your sleep apnea? Are you using a nose breathing based CPAP now?

The surgery was probably the best decision in my life.

Because of how severe my deviated septum and enlarged turbinates were, nose breathing was no longer possible for me. I couldn't use my CPAP at all.

Immediately after surgery the difference was incredible, I use my CPAP every night, with nasal pillows. One thing you seem to under the impression that the role of septoplasties and T. reductions is to solve sleep apnea. Perhaps for some it is, but the major role of this surgery is to allow proper breathing.

Around here, quite a few have had the surgeries, I can't recall any who were unhappy but none of them had the impression going in that it would solve their sleep apnea.