UPPP Surgery and High CPAP Pressure

[BigGayBert]

I was diagnosed with OSA in June 2004. Because I had very enlarged tonsils and had been having tonsilitis 3-5 times a year, my insurance company approved a tonsillectomy and UPPP. I had the surgery in January 2005. I had no complications from the surgery, and it cured my horrible snoring. I am a totally silent sleeper now. And, I've been having tonsilitis a lot less, too.

Unfortunately, I still have sleep apnea. And worst of all, I went from a pressure of 12 cmH2O pre-surgery to 20 cmH2O post-surgery. Consequently, I had not been using CPAP at all; 20 is a very, very uncomfortable pressure. I have made a New Year's resolution to be 100% compliant. So I went to my neurologist, who scolded me and sent a RT to my house, and she fit me with a cool Activa mask (I LOVE it) and set the C-Flex and ramp features up properly on my Remstar Pro (C-Flex is amazing!). I am proud to report that I have now been using the CPAP consistently for the past 6 nights!

Has anyone else here had the UPPP surgery and still have to use CPAP? Did your pressure go up instead of down? My RT said that it is very common for people who have unsuccessful UPPP's to have to go up to very high pressures. I think that's weird. I am going to get another sleep study done; I was on different medication then and it may have skewed the results of the study. I hope so because I would love to get my pressure lowered. And, if it goes higher, I will have to get a new machine because the Remstar Pro maxes out at 20.

Thanks to everyone for all of the wisdom and knowledge you share here on cpaptalk.com. Happy sleeping!

[Sleepy Dog Lover]

Wow, that is a high pressure. Sorry, no experience with the UPPP, but it seems like such a high pressure would warrent a bi-pap so you could have a much lower exhale pressure. Hope somebody else comes on and has some other suggestions.

[Snoredog]

UPPP just makes a bigger hole for your tongue to lodge into, then it becomes harder to dislodge from the hole (reason for higher cpap pressure being needed).

you should try sleeping on your side, if you were using a autopap machine, you'd probably notice a lot less pressure being needed while sleeping on your side.

for 20cm pressure, your Neuro should have switched you to a Bipap, better yet a Bipap auto then when you slept on your side it would automatically drop the pressure down for greater comfort.

[wabmorgan]

I evaded UPPP surgery due to Snooredog's comments.

Actually, I glad I read his comments... and from everything I have read and my pulmonlogist says UPPP would most likely not work for me.

As other have stated, with a cpap pressure on 20.... you should probably be on an Auto BiPap.

[jonlevine]

I'm glad I stumbled onto this thread. I, too, recently (Nov 28th) had a tonsillectomy (though, no UPPP) and since the surgery have had the worst sleep I've experienced since being diagnosed with OSA in October of 2006.

I had been using a C-Flex machine for 14 months with a pressure of 6cm, but it had only been about 60% effective. It was decided that I should have my tonsils removed as they were enlarged, as a way to treat the OSA.

For the last four weeks since the surgery, my sleep has been horrible. I tried different sleeping positions (even on the couch), a variety of different masks, and even no machine at all, but to no avail.

I called the doctor and he wants to do another sleep study, but he informed me that it cannot be done for another six weeks! He needs to ensure that my wounds have healed fully before I undergo another study. Seeing that there is no way I can go another six weeks without sleep, I started to examine the issue.

Then it dawned on me the other night: if my airway was collapsing due to the OSA and my tonsils were there, they would act as a 'prop' to keep the passageway partially open, hence the need for the low pressure setting. Removing the tonsils would allow my airway to completely close, rendering the lower pressure setting obsolete. I was also experiencing 'puffing', which had never occurred before. I hypothesized that this was because the pressure was meeting the blockage and had nowhere to go than back up and out of my mouth.

The night before last, I increased the pressure from 6cm to 8cm and you know what? I slept better. Not amazing, not fully rested, but better than I had been. I slept through the night without waking up and with minimal movement.

Last night, I upped the pressure to 9cm. This was even better still. Again, still not 100% or even 80%, but on the rise. Of course, I'm going to keep upping it and seeing how I feel.

Of course, I do not recommend to anyone that they do any self-diagnosis, I just wanted to impart my experience. Had I been able to have another sleep study immediately, I wouldn't be doing this. But, desperate times call for desperate measures, someone much smarter than me once said.

[Goofproof]

Your survey left out two answers.

1. I'm in deniel.

2. I no longer need XPAP, but I am not being test regular to make sure or know. Jim