Sleep Apnea and Pregnancy Safe....Surgery? Help Please

CarrieS · Post by **CarrieS** » Mon Nov 05, 2007 5:44 am

Okay well I have thought about getting the surgery UPPP according to my ENT Im a good candidate for the fact that I have Mild Apneas (APAP stays under 10) and Im average weight. Although my tonsils arent over big he'd remove them, my uvual will be trimmed but it is fine now its my palate that shows a trim would be benefcial and in turn he will do the uvula as I guess the need will come with the palette trim. He will also widen my right sinus turbine(<sp?) some as I can surely feel a restirction in that airway - although I have had 3 polypectomies in the sinus as of late it is fine. I am going to get a 2nd opinion first. I really dont want the surgery but I dont want to sleep witha cpap forever if I dont have to and I surely cant imagine how fun it will be sleeping pregnant and with cpap.

Well that brings me to needing to make the decision soon as Im thinking about trying for our next kiddo. SO I need to decide soon if I want suregery before or not. If I did wait and have the surgery first would I still need to wear my CPAP anyhow for a year or so? I imagine it would be the safest to still wear it for wahile anyone for the safety of the baby and pregnancy right? SO on that note I should just maybe wait until after?

Okay and last but not least...are their risks to being pregnant when you have treated Sleep APnea? I mean in theory as long as I wear my CPAP EVERY TIME I should be fine right...this woule mean no naps without it. It alos has a leak alarm so that would helpw iht safety. However as all of us know CPAP isnt fullproof I still have days where I know I didnt get good treatment and feel like junk all day. Is it Russian Roulette to get pregnant with Sleep Apnea?

ozij · Post by **ozij** » Mon Nov 05, 2007 6:26 am

Carry,
Once you've had your uvula and pallette "trimmed" you may find cpap can no longer do its job to open obstructions caused by you tongue. You need those two soft tissues to seal the pathway from your nose to you mouth so the pressurized air can go down into your lungs.

Without them, you may find the air whooshing out of your mouth.

Sure, you're "good canditate" - with an AHI of 10 today, the UPPP may bring you down to an AHI of 5 -which is formally no longer considered sleep apnea. But that in not promised. And then, what if preganancy or age or weight or whatever cause you to obsturct more? Does the doc promise your AHI will remain low for the rest of your life?

By all means, have your tonsils take out and your trubinate taken care of. IF after those two procedures if you still need cpap -stick to if for the time it takes for you to get prenant and have a healthy you bearing a healthy baby - let's say - stick to it for a couple of years till the baby can spare you for the operation? Is that a bearable thing - two years on cpap for having a safe pregnancy and a healthy baby?

And then in 2 years, if you still need cpap and find the thought of using it for life unbearable look around learn some more about the status of UPPP at that time.

Bluntly, if anything in this story is Russian Roulette - it's having a UPPP. Once those tissues are out and you still have sleep apnea (or have it again) then you're up the creek without a paddle.

Whatever your final decision about a UPPP - wait till after you've had the baby.

O.

Guest · Post by **Guest** » Tue Nov 06, 2007 1:00 pm

Thanks I did some research and found out that CPAP treatment has been proven to protect the pregnancy .....that was one of my primary concerns - not what I want but what would be safest for a baby. I wasnt sure how guaranteed CPAP was for the baby since there are so many doumented cases of undiagnosed Sleep Apnea causing epilepsy, low birth weight and many other issues. Forunately CPAP treatment in pregnant women who have OSA or suddenly have onset of it due to pregnancy has proven successful.

socknitster · Post by **socknitster** » Tue Nov 06, 2007 6:46 pm

There was recently an very short article in Parenting Mag about pregnancy induced hypertension caused by sleep apnea. Drug of choice=cpap.

I totally get your fears. I get everything you said actually. I am in the same boat!

Here is what I did. My ENT said the same thing to me about UPPP, but my apnea is actually more in the severe range. I'm also slightly overweight. Do to the dismal success rate with UPPP--and I mean DISMAL, it has completely fallen out of favor. I told my doctor under no circumstances would I consider it.

BUT. I did have my tonsils out. Yes I did. They didn't touch anything else at all. And you know what--a couple of great things happened. My pressure needs were cut nearly in half. From bipap 16/12 now down to 10/6, sometimes 9/6. I just had a 3 month follow up and he said as it healed, my palate seemed to tighten up some--he wouldn't even consider me for UPPP now! (Not that I would ever consider it, but hey! That is something!) The tonsil beds lay on the palate. When they are taken out, the scar tissue can tighten the whole thing up without removing anything.

I don't know if I'm unique, because I have never met anyone else who had a tonsilectomy for OSA. My tonsils were huge--I've wanted them out for years because they bothered me (gagging when they got large during allergy season--lots of bouts with strep throat--bacteria and viruses can hide in the crevices of the tonsils).

I have no idea of your age, but if you are like me (35) you are going to have to make a decision soon before your fertility fades and getting pregnant takes serious work and serious cash.

My best advice to you is to get the tonsilectomy. Let the rest wait because it might not be needed. Perhaps the success stories you occasionally hear from UPPP might have had the same outcomes with a simple tonsilectomy.

That isn't to say it isn't painful. It is a rough two weeks. You can do a search on my screen name. I basically blogged it all. My son just went thru it too about 4 weeks ago (he's 4).

So, if all that sounds too scary, just get preg and use cpap and decide later. I'm still on cpap. Not cured, but cpap is soooo much more tolerable. Maybe you will have a similar experience?

Jen

Guest · Post by **Guest** » Thu Nov 08, 2007 11:28 am

Sock
Yes I have decided to put it off for now and maybe permantly. Im 29 but my hubbys 39 so fertility and more importantly baby health is getting more fragile due to his age. We will be trying soon and I will just use my APAP since its deemed successful. Do you have a CPAP or APAP I read many pregnant womens pressures go up so Im thankful to have my APAP to watch me. Thanks and good luck with your plans!

Guest · Post by **Guest** » Thu Nov 08, 2007 1:54 pm

i had the uppp surgery and a deviated septum fixed roughly 5 years ago and it did stop my snoring and i think to a certain extent cleared up my sleep apnea . i was also in pretty good shape at the time but now 5 years later and 80 pounds overweight its like i had never had the surgery done.

i would actually recomend it to and have had friends that had it done that have all said that they feel much better afterwards and if i can ever motivate my self to get back into some kind of decent shape ill be thankful once again that i had did it

socknitster · Post by **socknitster** » Fri Nov 09, 2007 3:22 pm

Carrie,

I'm on auto bipap. I am with you on your thought process. I believe my osa will worsen with pregnancy too. I don't see how it couldn't!

I think you are making the right decision. I don't think we will be hearing too much about UPPP in the future as better treatments and surgeries are developed. I mean, look at us! When people our ages are being diagnosed, we aren't going to take this lying down (sorry for the bad pun) and expect better outcomes than are projected for that surgery. I have no doubt there are a few people it has helped, but its rate is dismal compared to an informed cpap user.

And most people who get the UPPP surgery--ever notice how their comments are always anecdotal--they never seem to go for a follow up PSG to determine if their apnea is really gone or not. That is sloppy medicine! Feeling better is subjective. AFter going thru the hell that surgery entails, I would say I felt better by comparison too.

CPAP has side effects (aerophagia comes to mind) but if you can tolerate it, it is probably the safest and most effective thing you can do for yourself and the baby.

So, go jump on that husband! (And take some folic acid if you aren't on prenatals already!)

jen

mch441 · Post by **mch441** » Fri Nov 09, 2007 4:18 pm

And most people who get the UPPP surgery--ever notice how their comments are always anecdotal--they never seem to go for a follow up PSG to determine if their apnea is really gone or not. That is sloppy medicine! Feeling better is subjective. AFter going thru the hell that surgery entails, I would say I felt better by comparison too

i still see the same specialist today that performed the surgery 5 years ago and he did warn me that it may not be the end all be all cure for my sleep apnea but would make cpap therapy much more tolerable if i needed it.
and yes socknitster the month of pain after surgery was pure hell but ild still do it again