Sleep Apnea and Tonsils

[reastlack]

I'm still awaiting my sleep study in a few weeks, but I'm very symptomatic. (constant fatigue, headaches, dry mouth, nightmares) I read a few times that tonsils can have affect on it. I'm in very healthy shape. Could these bad boys be giving the apnea?

[Pugsy]

They probably aren't helping your breathing for sure but are they the sole cause for apnea? Dunno. You don't know for sure that you have sleep apnea yet without the sleep study. Even if you do end up with the diagnosis the tonsils may or may not be a factor.

Being in

very healthy shape

doesn't mean you can't have sleep apnea...it's not just for the old and fat and out of shape.

[LSAT]

Looks like a boss I had about 20 years ago....

[Wbferrara]

Assuming that this represents your normal condition (those don't look inflamed) I think a referral to an ENT specialist is in order. There us a subset of patients for whom chronically enlarged tonsils ("kissing tonsils") is the main contributor to obstruction. You probably still warrant a sleep study, but removal may have a substantial impact. They often repeat a sleep study after recovery from surgery to determine any residual obstruction.
Unlike the palatoplasty (which helps relieve symptoms but tends to regress after about 6 months) removing the tonsils is a permanent alteration.
Good luck!

[reastlack]

Assuming that this represents your normal condition (those don't look inflamed) I think a referral to an ENT specialist is in order. There us a subset of patients for whom chronically enlarged tonsils ("kissing tonsils") is the main contributor to obstruction. You probably still warrant a sleep study, but removal may have a substantial impact. They often repeat a sleep study after recovery from surgery to determine any residual obstruction.
Unlike the palatoplasty (which helps relieve symptoms but tends to regress after about 6 months) removing the tonsils is a permanent alteration.
Good luck!

Yes this is my normal condition! Not sick or anything. Do you think my sleep doctor will recommend me to an ENT on my first visit?

[Wbferrara]

If you are already scheduled to see a sleep doctor, I suspect they will recommend a sleep study first, which will at least provide baseline data (do you meet diagnostic criteria for OSA, how severe, etc.). Then as a treatment option, they might recommend the ENT evaluation prior to initiating CPAP. Large tonsils are more likely to be a cause of OSA in children, but there are adults for whom that might be a reasonable treatment. The main advantage would be possibly avoiding life-long reliance on CPAP, or being able to use significantly lower pressures. ENT folks also may recommend removal in patients with 4 or more episodes of severe sore throats or strep infections a year.

[Pugsy]

I would think that the first thing to do would be to establish the diagnosis of Obstructive Sleep Apnea first...with a sleep study and then if the diagnosis is confirmed then talk to an ENT about the removal of the tonsils and what the chances are of it helping with the OSA.
I wouldn't let them do anything else surgery wise ....none of that UPPP stuff...just the tonsils.

[palerider]

what a thing to find staring at you first thing in the morning! :shudder:

[D.H.]

You didn't say how old you, are but I suspect that you're over 21.

For children and very young adults, sometimes a tonsillectomy (and/or adenoidectomy) is the treatment of choice.

Otherwise, try CPAP first. I have very large tonsils too. My sleep doc said that he wanted to try CPAP first, and consider tonsillectomy if that didn't work. I was able to use CPAP without any major issue, so that's where I still am, some eighteen years later. BTW, my tonsils were chronically red at that time; they became pink a few weeks into CPAP and have remained so ever since.

[reastlack]

You didn't say how old you, are but I suspect that you're over 21.

For children and very young adults, sometimes a tonsillectomy (and/or adenoidectomy) is the treatment of choice.

Otherwise, try CPAP first. I have very large tonsils too. My sleep doc said that he wanted to try CPAP first, and consider tonsillectomy if that didn't work. I was able to use CPAP without any major issue, so that's where I still am, some eighteen years later. BTW, my tonsils were chronically red at that time; they became pink a few weeks into CPAP and have remained so ever since.

Thanks for the feedback. I turn 21 this Wednesday actually. Hopefully my sleep doctor suggests to remove the tonsils.

[Sleepy in Ohio]

I'm 40 now but had my tonsils removed (UPP surgery) at the age of 25. I had moderate sleep apnea and was mild when tested again a few years later. However, I was tested again in my 30's and diagnosed with severe sleep apnea and received my CPAP. Having my surgery was EXTREMELY painful. It took me a month to recover. If I could go back, I would've chosen not to do the surgery. Good luck to you.

[reastlack]

I'm 40 now but had my tonsils removed (UPP surgery) at the age of 25. I had moderate sleep apnea and was mild when tested again a few years later. However, I was tested again in my 30's and diagnosed with severe sleep apnea and received my CPAP. Having my surgery was EXTREMELY painful. It took me a month to recover. If I could go back, I would've chosen not to do the surgery. Good luck to you.

Thanks! That's what scares me the most is having the surgery and not being cured.

[D.H.]

I'm 40 now but had my tonsils removed (UPP surgery) at the age of 25. I had moderate sleep apnea and was mild when tested again a few years later. However, I was tested again in my 30's and diagnosed with severe sleep apnea and received my CPAP. Having my surgery was EXTREMELY painful. It took me a month to recover. If I could go back, I would've chosen not to do the surgery. Good luck to you.

Thanks! That's what scares me the most is having the surgery and not being cured.

I agree, try CPAP first. If it doesn't work or you can't tolerate it, you can try something else. Most surgery (certainly tonsillectomy) is irreversible!

[restlack]

I'm writing on personal experience from my son. When he was very little, around 4, he would have severe apnea. His tonsils looked just like yours. Whenever he would get severe strep, he would need steroids because the tonsils would swell and block his airway even more. He had his tonsils and adenoids removed and hasn't had a problem since. This was just our experience. My husband on the other hand had his tonsils and adenoids removed, soft pallet scraped, and deviated septum fixed, and here we are, just hitting one week into Cpap therapy. Hopefully, if the tonsils are the issue, removal will solve the problem. But personally, I don't think they're helping your situation. Best of luck

[Julie]

Had both out (T/A) at 8 - it made a big difference to my constantly having colds and ear problems, but not at all (far as I can tell) to having OSA.