CPAP vs. UPPP for a young person

[klv329]

UPPP didn't provide any benefit that I can tell. My obstruction are the muscles in my throat. The nasal drill helped using nasal pillows, so that had some tangible benefit. Eventually, and after many years, the CPAP didn't provide adequate therapy but I found via experimentation that the ASV machines did wonders for me. The downside of UPPP for me is that I have to eat more carefully so food won't get into the lungs -- this only happens rarely because I have learned to adapt.

[Saxatilis]

UPPP didn't provide any benefit that I can tell. My obstruction are the muscles in my throat. The nasal drill helped using nasal pillows, so that had some tangible benefit. Eventually, and after many years, the CPAP didn't provide adequate therapy but I found via experimentation that the ASV machines did wonders for me. The downside of UPPP for me is that I have to eat more carefully so food won't get into the lungs -- this only happens rarely because I have learned to adapt.

Interesting. Thank you. ASV machines? Sounds like I may be running into a similar problem though.

[Guest]

With all due respect, BULL****. Of course it isn't a barrier to the physical act of sex but it is certainly a relationship barrier.

You sound overly and extremely vane.

Who said anything about marriage anyway ;p

Ditto

You stand a better chance of hitting the lottery. Unless you already have a lot of money you will likely remain lonely.

I hope it is just the low O2 sat affecting the brain thought process. Start using a recording O2 meter to see where you at are before you loose it completely. At this point logic, reasoning, and making choices are not your strong suit. Not to mention you likely won't make those 40 yrs you mentioned earlier.

If you go in your sleep (cardiac arrest) it is painless, if you linger (stroke) it is not fun. Who will change your diaper? (have someone in mind?) And will they be using a cpap?

[reolhlains]

Saxatilis - dude, slightly off topic, and not the question you asked (so perhaps I am being the opposite of helpful!) - but... why don't we try to help get CPAP working for you (i.e. tips to fall asleep while scuba diving etc.) - see how that goes for a few months, and then have a think about surgery?
I've only been using it for about 10 weeks or something - and I was like the MOST CPAP averse person in the world (literally - I was sick at the thought of it), now I don't even think about it. Matter of fact, I end up having it on for 10-20mins after I wake up in the morning while checking facebook, emails etc. and then realise it's on...!
Maybe the pressure settings aren't right? Maybe the mask isn't the most comfortable?
There are sooooo many helpful people on here who would love to try and help you get it working - and then you can assess other options down the track.
I'm thinking am about the same age as you - and had (and still having) the thought of using it for more than half of my life - it's kinda a good thought now though - I'm a completely different person than I was this time last year (or even this time 3 months ago).
Just a suggestion

[Okie bipap]

I had UPPP surgery around 20 years ago. I had a badly deviated septum and could never breath through both sides of my nose at the same time. I had a sleep study done and was told I had OSA. They really didn't say how bad, but I had a hard time trying to use the CPAP machine the night of the study. The machines then were much larger than they are now, and my job required frequent travel by air. I was already carrying a nebulizer machine for my asthma, and did not want to lug around another, larger machine. I talked to an ENT surgeon who did my surgery. If you have trouble breathing through your nose, you may want to consider septiplasty and turbinate reduction. By having the surgery, I put off using a pap machine for several years. Now, I use a bi-level machine while sleeping. After losing around 25 pounds, I have gotten my pressure requirements down to where I could use a regular CPAP machine. Considering the options I had available at the time, I am not sorry I had the surgery.

If you wish to continue to think about the surgery, ask your ENT how much improvement he thinks you would get through the surgery. Some surgeons consider an improvement of 50% reduction a success. Depending on how high your current AHI is, a 50% reduction may still place in the situation where you will need the machine after the surgery. While I had several years of not needing a PAP machine, my nephew had the same surgery and had to go on the PAP machine as soon as he healed up and had a follow on sleep study done. I never had a follow up sleep study done after my surgery. When I had a knee replaced three years ago, the nurses noticed I was not breathing properly when sleeping, and my doctor scheduled my for a sleep study after I recovered from my surgery.

If you have any more questions about the surgery I can help you with, send me a PM and I will try to answer your questions.

[Saxatilis]

Saxatilis - dude, slightly off topic, and not the question you asked (so perhaps I am being the opposite of helpful!) - but... why don't we try to help get CPAP working for you (i.e. tips to fall asleep while scuba diving etc.) - see how that goes for a few months, and then have a think about surgery?
I've only been using it for about 10 weeks or something - and I was like the MOST CPAP averse person in the world (literally - I was sick at the thought of it), now I don't even think about it. Matter of fact, I end up having it on for 10-20mins after I wake up in the morning while checking facebook, emails etc. and then realise it's on...!
Maybe the pressure settings aren't right? Maybe the mask isn't the most comfortable?
There are sooooo many helpful people on here who would love to try and help you get it working - and then you can assess other options down the track.
I'm thinking am about the same age as you - and had (and still having) the thought of using it for more than half of my life - it's kinda a good thought now though - I'm a completely different person than I was this time last year (or even this time 3 months ago).
Just a suggestion

Well, I have by no means decided but why go through decades of treatment if you can fix the problem itself? It just seems inelegant, impractical, and expensive. Its not a simple decision though as obviously surgery has its own risks and I may likely still end up on CPAP anyway which would defeat the purpose.

As of right now CPAP is causing more problems than it solves. I am trying to get a new mask but it takes a while so im stuck with this one that makes me feel like im suffocating because I cant get enough air through my nose.

Thank you for trying to help.

[Goofproof]

Saxatilis - dude, slightly off topic, and not the question you asked (so perhaps I am being the opposite of helpful!) - but... why don't we try to help get CPAP working for you (i.e. tips to fall asleep while scuba diving etc.) - see how that goes for a few months, and then have a think about surgery?
I've only been using it for about 10 weeks or something - and I was like the MOST CPAP averse person in the world (literally - I was sick at the thought of it), now I don't even think about it. Matter of fact, I end up having it on for 10-20mins after I wake up in the morning while checking facebook, emails etc. and then realise it's on...!
Maybe the pressure settings aren't right? Maybe the mask isn't the most comfortable?
There are sooooo many helpful people on here who would love to try and help you get it working - and then you can assess other options down the track.
I'm thinking am about the same age as you - and had (and still having) the thought of using it for more than half of my life - it's kinda a good thought now though - I'm a completely different person than I was this time last year (or even this time 3 months ago).
Just a suggestion

Well, I have by no means decided but why go through decades of treatment if you can fix the problem itself? It just seems inelegant, impractical, and expensive. Its not a simple decision though as obviously surgery has its own risks and I may likely still end up on CPAP anyway which would defeat the purpose.

As of right now CPAP is causing more problems than it solves. I am trying to get a new mask but it takes a while so im stuck with this one that makes me feel like im suffocating because I cant get enough air through my nose.

Thank you for trying to help.

Usually not being able to get enough air, is caused by using the ramo, set incorrectly too low. Little need to use the ramp at all ormachine pressure set too low. 4 cm is way too low on APAP 2 cm under CPAP AND 2 CM over work best to start. ?Jim

[OkyDoky]

As of right now CPAP is causing more problems than it solves. I am trying to get a new mask but it takes a while so im stuck with this one that makes me feel like im suffocating because I cant get enough air through my nose.

We can help with this. Start by filling in your equipment in your profile that way it will show in each of your posts. wiki/index.php/Registering_Equipment_in_User_Profile What mask are you using? What are your pressure settings? Do you have your machine's clinical manual? Sometimes the suffocating feeling is because of low ramp or starting pressures.
Here is a link telling about UPPP with a video of surgery. The 70% success rate may be for snoring but sleep apnea success rate is less as explained in the article. http://www.sleep-apnea-guide.com/uvulop ... lasty.html

[49er]

I wanted to apologize for my previous post in which I said you hadn't tried the cpap yet when you had. But I would still follow the advice to let the forum help you troubleshoot all issues. I again would strongly urge you to look into having a septoplasty/turbinate reduction as that alone might be the difference regarding your pap therapy comfort although obviously, there aren't any guarantees.

Best of luck to you.

49er

[ChicagoGranny]

UPPP - Bad idea!

As of right now CPAP is causing more problems than it solves. I am trying to get a new mask but it takes a while so im stuck with this one that makes me feel like im suffocating because I cant get enough air through my nose.

Thank you for trying to help.

First step is to problem solve your CPAP therapy and get it working well. You have convinced yourself it won't ever work well, yet you have not educated yourself and worked on optimizing your therapy. The forum can be of great help in this process.

Nose, throat, tonsils, adnoids, palate, deviated septum

I would get a second opinion from a trusted ENT on surgery to remove adenoids and tonsils, turbinate reduction surgery, and correction of the deviated septum. If these things are corrected, at best, you might be cured of obstructive sleep apnea, or at worst, you would find CPAP much easier to use.

Palate: No touchie with cutting instruments.

[ChicagoGranny]

You sound overly and extremely vane.

[library lady]

Where as CPAP may ensure I will be single my whole life. Yay.

I am mostly joking but I would be lying if I said I wasn't taking my dating life into consideration.

I know a number of married people with a spouse that uses CPAP... after 50 years, they haven't gotten divorced.... I really don't think you should look at as a barrier to dating/marriage. Having sex doesn't require wearing your mask. If you are both sleeping, what difference does it make if you use your machine/mask? Not using your machine can lead to a stroke or dying in your sleep. Do you want your partner or kids to lose you while they are still young?

It took me about 3 months to fully acclimate to CPAP therapy, and for a while after that I would wake up to find that halfway through the night I had taken the mask off with no recollection of doing it. These days it stays on all night. I think you should really think the issue through, and forget about UPPP. You could certainly consider seeing an ENT for possible repair of your nose issue, but it won't be necessary if you can adapt. It might just be a question of switching to a different mask. Every mask is different, and many people have to experiment to find out which mask is comfortable for them.

Give it plenty of time, so your brain can adapt to the alien on your face.... Good luck!

[RokMartian]

I had a tonsillectomy when I was 32 because I had extremely large tonsils (they were overlapping and I was constantly choking). At the time, I had severe sleep apnea and the tonsillectomy helped tremendously.
My doctor wanted to give me a UPPP at the time, but my insurance wouldn't allow it -- only the tonsillectomy.

Your situation may not be as extreme, but If you will ever need that done, I would highly recommend you get it as early as possible. It took me over two weeks to recover from it at 32, but I would do it all over again.

Having said that, it is now 17 years later and I just started on cpap about 3 months ago.

[kteague]

People who have had success with that surgery would likely not be here. What you're going to get here are those whose surgery did not resolve their need for CPAP. If my apnea was mild I could be hopeful about some combination of procedures resolving my sleep apnea. We don't know much about your condition, but I've seen many on here glad to have made corrections in their nose and even tonsils and adenoids. I've never read of anyone being glad about having the other stuff done, but like I said, they wouldn't be here. In real life, 3 friends have had what you are considering, saying they simply couldn't or wouldn't use CPAP. One now snorts liquids up his nose. Another one says the surgery fixed his problems, yet every time I'd see him he was dozing off even in a crowd. All 3 have since had a heart attack. Maybe they would have all had heart trouble anyway. Who knows. They all lived reasonably healthy lifestyles and appeared in decent physical condition.

There are other medical interventions on the horizon for OSA. Using a CPAP at any point does not have to be a life sentence. I can't help but think some of the problems you are having with CPAP could be addressed with help from people here. How things are going now does not mean it will always be this hard. At 5 months in I was ready to quit because my doctors had not been able to help me. It was maddening. That's how I ended up here, and with following a couple suggestions, started to see an almost immediate turnaround in my ability to use the treatment without great distress. If it turns out you are one of the few who really can't adjust, I can't help but wonder if a select combo of procedures (none messing with your tongue, soft palate or uvula) along with a dental device might be better than no treatment at all. But I really hope you'll not do anything in haste. You've got the rest of your life to make a decision for UPPP surgery. Making a decision while you're struggling to adjust is not the best time. I'd love to see you deciding between successful CPAP therapy and surgery, thus having more full information upon which to make your decisions.

Just curious, would the doctor recommending the surgery be the one performing it?

[ewoods]

I'm mostly a lurker here, but I had to respond to this one. I can sympathize with what you're going through. I was in my early 30's when I was diagnosed with sleep apnea, and it fundamentally altered the way I was able to live my life. The CPAP machine was like an anchor chaining me to my bed. Many of the things that I loved to do were made more complicated, or rendered impossible, and it certainly did complicate dating (not everyone who I share a bed with is someone I'm looking to marry, or even someone I'm looking to have a serious relationship with).

I struggled with a CPAP machine for three years, and had UPPP and tongue base reduction surgery recently, and the results of my post-surgery sleep study showed no significant obstructions. The same sleep doctor who prescribed me my CPAP machine told me that my sleep apnea has been cured. I was so happy I cried in his office at the thought of not having to use that machine anymore. I've been sleeping without a mask, apnea-free, for three months now. My blood pressure is now normal without taking daily medication for it, I've lost 20 pounds, and where I choose to sleep each night is no longer dependent on whether or not there's a power outlet nearby (I can go backpacking again!).

Many of the comments here are absolutely right. Give CPAP a good, solid try before deciding whether or not to get the surgery. I gave it three years, which was probably two years too many, but I'd recommend spending a lot of time really trying to make it work. It's also entirely possible to come out of the surgery and still have sleep apnea. My surgeon was very thorough and we did several months worth of tests to try to determine where exactly the problem might be. Make sure yours is too, if you decide to go forward with it. The tissue they remove could also grow back. This is fairly common, actually. My personal feelings, having gone through it, is that I'd rather have the surgery every few years than use a CPAP machine again. But with that said...it's an EXTREMELY long and painful recovery. I can't overstate this. It hurts, a lot, and it hurts for weeks. And there are potential complications. For a few months, every time I took a drink, liquid would go up my nose. This mostly goes away as your soft pallet strengthens, but it still happens sometimes, especially with shots of hard alcohol or really citrusy stuff. The first post-surgery shot of whiskey I took went straight up and out my nose. That was still less painful than some of the recovery days I had... My sense of taste was also severely diminished. This too comes back over time, but there was a period of time when some foods literally tasted like nothing. On a more positive note, one unexpected side-effect has been that cardio-based exercise has become easier. It takes me longer to run out of breath when breathing through my mouth, and I can catch my breath much faster than I've ever been able to. Overall, for me, the things I gained far outweigh the things I lost. I'm happier and healthier than ever, and I feel like I have my life back.

Hope this comment helps with your decision.