Sleep study after surgery?

[jparson]

I had septoplasty/turbinate reduction surgery one month ago. I started using my cpap again about 2 weeks ago. I am as tired/fatigued as I was before I started using my cpap 6 months ago. It seems that I have gotten worse, not better with the surgery. Is this common? I have read some posts on here that suggest that my pressure settings need to be adjusted after surgery. Do I need to have another sleep study? Am I just being impatient with this whole process? Any suggestions or experiences would help.

I know, I know... I need to list my equipment. I just registered and don't know the specifics of it right off hand. I'll update it as soon as I can.

Thanks,
Jason

[Goofproof]

Surgery, may help in the long run, but usually it's not a cure. For the pain involved and the chance of a worse out come, I'd prefer not to buy the doctor another car or boat. I think it's better to get with the program and make non-invasive XPAP treatment work. I'd give it more time to heal up before buying into another sleep study. really, I'd get a data XPAP and the software and reader and by-pass the Sleep Study completely. Jim

[ozij]

I had septoplasty/turbinate reduction surgery one month ago.

That's the kind of surgery that may help - because it clears the nasal passages and the pressurized air can now stent the rest of the airway open. An obstructed nose is one way of making cpap therapy close to impossible.
It is quite probable that you now need less pressure that you did before. You can find your necessary pressure with either a PsG or a data capable machine.

O.
Typos edited

[jnk]

Also, you may still have some slight swelling and sensitivity from the surgery if it was only four weeks ago, and you may not have healed completely, so you may still be a little sensitive to air movement and moisture and lack thereof, etc. I would give it a few more weeks before I started figuring out where I stood with pressures.

Out of all the surgeries availabe, I think the one you had is the one I might be willing to have done, myself, one day. The other ones scare me.

[Snoredog]

One ENT (a good one) told me that the swelling from the surgery can take over a year to completely go down. But once things are healed up the inflammation majority of swelling should go down.

I haven't seen anywhere where having that surgery is supposed to lower your AHI or even reduce snoring. The object is to reduce congestion and breathing through the mouth. Therapy works better coming in from the nasal cavity as opposed to the mouth.

Results can vary patient to patient and surgeon to surgeon, reason it is always best to select a experienced surgeon.

Have you done any rhino rinses? Did the rinse come out clear or have signs of dried blood/scabs? Thing heal a lot slower in the moist environment. Look up your nose in a mirror, I bet it is still pretty inflamed and red inside.

[jnk]

One ENT (a good one) told me that the swelling from the surgery can take over a year to completely go down. . . .

Wow. That's good to know.

. . . I haven't seen anywhere where having that surgery is supposed to lower your AHI or even reduce snoring . . .

Further support of Snoredog's point . . .

Surgical success for OSA is often unpredictable and less effective than PAP (with the exception of tracheotomy). Surgical success depends on appropriate patient selection, the type of procedure performed, and the experience of the surgeon. . . . The goal of nasal reconstructive surgery is to improve nasal airway blockage caused by bony, cartilaginous, or hypertrophied tissues to restore normal breathing as well as to optimize nasal CPAP use. A patent nasal airway is important for minimizing mouth breathing, because mouth breathing worsens upper airway obstruction by forcing the lower jaw to rotate downward and backward and pushing the tongue into the posterior pharyngeal space. Nasal reconstructive surgeries include septal and/or bony intranasal reconstruction, alar valve or alar rim reconstruction, and turbinectomy. Radiofrequency treatments for turbinate hypertrophy may also be done in the outpatient office setting. These procedures are generally low in risk and successful at achieving nasal patency. However, by themselves, they are not likely to make a significant impact on moderate or severe sleep disordered breathing. Nonetheless, it remains an essential part of treating OSA, and more importantly, a means of improving nasal PAP tolerance and compliance.

http://pats.atsjournals.org/cgi/content/full/5/2/193

[jparson]

Thank you all for the info.

Surgery, may help in the long run, but usually it's not a cure.

My ENT made it very clear this was not a cure, it is only to aid with CPAP treatment. But with almost 100% blockage and nearly 6 months of very little relief on CPAP it was the next treatment option. I am extremely happy with the results. The moment the packing was removed I could tell a huge difference in air flow. It has only gotten better since. And for those of you considering this option with your ENT, I would highly recommend it. Everybody responds differently, but my recovery was not bad at all. No pain, just felt like a really bad cold.

Have you done any rhino rinses? Did the rinse come out clear or have signs of dried blood/scabs? Thing heal a lot slower in the moist environment. Look up your nose in a mirror, I bet it is still pretty inflamed and red inside.

Yes, I use a rinse. Everything has been clear since 1 week post op. My ENT was impressed at the speed of healing. He did say there is usually scabbing for about a month post op. I don't notice any swelling, but assume it is still there. Inflamed/red? Yes. Seems to be worse after CPAP use. Which is what prompted this post. Wondering if I am getting too much pressure causing irritation, in turn keeping me from sleeping well.

It has seemed a little better since I started following some advice I found on this forum. I am now using a hose cover and Ayr saline gel with aloe. These seem to be helping some.

You can find your necessary pressure with either a PsG or a data capable machine.

My machine is data capable. But it appears that I am unable to set it myself.