Why not just get the operation for OSA?

[ProblemSleeper]

The doctor told me about various surgeries including some newer one where they pull your tongue forward (or something like that). He mentioned that at least some of the surgeries are 80% to 90% effective, then told me they "gingerly break your jaw...."

I'm not sure I like 80% - 90%. But I had back surgery before and there was no guarantee of that either.

Is surgery just not good enough right now to consider it?

[BlackSpinner]

The doctor told me about various surgeries including some newer one where they pull your tongue forward (or something like that). He mentioned that at least some of the surgeries are 80% to 90% effective, then told me they "gingerly break your jaw...."

I'm not sure I like 80% - 90%. But I had back surgery before and there was no guarantee of that either.

Is surgery just not good enough right now to consider it?

While the surgery maybe a success it may not reduce your AHI enough or it may only be temporary. Surgeons and sleep doctors and patients have different measures of success.

However a tracheotomy is 100% successful surgery for OSA

[ProblemSleeper]

The doctor told me about various surgeries including some newer one where they pull your tongue forward (or something like that). He mentioned that at least some of the surgeries are 80% to 90% effective, then told me they "gingerly break your jaw...."

I'm not sure I like 80% - 90%. But I had back surgery before and there was no guarantee of that either.

Is surgery just not good enough right now to consider it?

While the surgery maybe a success it may not reduce your AHI enough or it may only be temporary. Surgeons and sleep doctors and patients have different measures of success.

However a tracheotomy is 100% successful surgery for OSA

I saw that. I'll take the machine over a hole in my neck.

[BernieRay]

...
I saw that. I'll take the machine over a hole in my neck.

And I'd take the machine over a broken jaw, no matter now gingerly it's done!

[jonquiljo]

He mentioned that at least some of the surgeries are 80% to 90% effective, then told me they "gingerly break your jaw...."

Surgery in general is something one should avoid if at all possible. Many surgeries are done needlessly and end up harming the patient more than hurt them. These are the people you never hear from again. They have bigger problems than to go onto boards and complain. My wife's pain Dr. has told us that lots of surgeons really believe that they have cured patients that they never see again. What he says is usually the case is that these patients go somewhere else or can't even get out of the house any longer. So these "success rates" are not accurate numbers at all. Of course, there are good reasons for surgeries - but "curing OSA" is not one of the top ones. You have to be selective or you will end up a statistic.

My wife has been ruined from back surgery at a time in life when we were stupid enough to believe that surgery would fix things - and because things were bad enough we thought it couldn't get worse. Well, things can get worse. I had a simple foot surgery a few years ago which clearly has caused more problems than it fixed. Lots of these things cannot be reversed. I will continue to hobble around, but never ever be the same again.

Just use a CPAP machine and be glad they don't totally ruin you by a bad surgery. CPAP works well for lots of people - and rarely, if ever, can it do harm - certainly irreversible harm.

[TmjTerri]

I had to have a bilateral total joint replacement because my jaw got broken in an accident back in 1994. Since then I got severe osteoarthritis and had to have 3 major surgeries not including my total joint replacement in 2002. I now have to take morphine for the rest of my life because of the severe jaw/face pain that I live with and will have to live with for the rest of my life. If it were me I would never allow someone to break my jaw. You cannot ever go back to how you were before your surgery.

[SleepyT]

I echo what has been said thus far. When you find yourself feeling down about the cpap machine...just repeat my mantra.

It's just air....it's just air....

[jromano]

ProblemSleeper,

I'm sorry to hear you're having problems sleeping.

IMO (and I'm a Project Manager for a medical device company, NOT a doctor), surgeries are often portrayed as a "quick fix" to countless issues. (Not at all meant to undermine the many extremely useful and effective surgeries in any way...)
Let's look at Obstructive Sleep Apnea specifically. Individual risk factors may include one, all, or none of the following (I know, how specific ):
Facial/cranial structure
Genetics
Swollen or excess tissue in the upper airway
Being male
Smoking
Large neck circumference
Being older
Obesity
Use of alcohol or other depressants
(Main resource: Mayo Clinic http://www.mayoclinic.com/health/sleep- ... sk-factors)

Surgeries like Uvulopalatopharyngoplasty (UPPP) (say that a couple times fast...) and Laser Assisted Uvula Palatoplasty (LAUP) in particular tend to address the symptom of snoring, often at the expense of neglecting to uncover the underlying cause. The documented success rate of treating snoring and sleep apnea are really two unique numbers. I've pulled a sampling of articles exploring one or both, and as you can see, the numbers are somewhat across the board.
http://onlinelibrary.wiley.com/doi/10.1 ... 3/abstract
http://www.ncbi.nlm.nih.gov/pubmed/19643261
http://informahealthcare.com/doi/abs/10 ... 0802654380
http://www.springerlink.com/content/93j1756172581461/

I think SleepyT said it best:

It's just air....it's just air...

Cheers,
Jess

[DoriC]

I echo what has been said thus far. When you find yourself feeling down about the cpap machine...just repeat my mantra.

It's just air....it's just air....

I have family members and friends who were convinced that Mike is using oxygen, so my mantra was the same as yours at first, "It's just air". After awhile I just gave up!

[SleepyT]

I echo what has been said thus far. When you find yourself feeling down about the cpap machine...just repeat my mantra.

It's just air....it's just air....

I have family members and friends who were convinced that Mike is using oxygen, so my mantra was the same as yours at first, "It's just air". After awhile I just gave up!

Dori....you know, I don't think people outside the world of CPAP understand much about it at all! I try to remember what I knew before I knew I had sleep apnea...and really...my knowledge was minimal! I believe there are worse things to have. If this is the only thing I have to manage (and so far it is)...then I'm doing ok.

[ProblemSleeper]

Isn't there some kind of surgery where thy do not break your jaw but they somehow cut something (sorry) in your mouth and pull your tongue forward? I know that sounds funny but that's what I remember the doctor mentioning.

[NanceK]

One of my doctors mentioned surgery but the success rate was more like no more than 50% with the possibility of scar tissue causing more problems down the road. The surgery consisted of stiffening the pallet and back of the throat.

[jromano]

ProblemSleeper,

Yes, there are a few forms of surgery that fit your description.

Genioglossus advancement is an operation in which a small piece of chin bone is cut, moved forward a few millimeters, and secured in place. This pulls the tongue forward by way of the genioglossus muscle which connects the back of the tongue to a place on the back of the chin. This surgery is performed under general anesthesia and does not include breaking the jaw.

Hyoid Advancement is a surgery that repositions the hyoid bone which is attached via muscle to the back of the tongue and the sides of the throat. This bone sits just above the Adams apple and is attached directly to the Adams apple or the jawbone upon completion. This does not include breaking or cutting any bones and is performed under general or local anesthesia.

There are also a number of surgeries that can be performed on the tongue to the effect of shrinking or removing excess tissue. However, these do not included repositioning of the muscle itself.

Hope this helps,

Cheers,
Jess

*The information above is an opinion and is not to be used as medical advice. Please talk to you doctor (again) if you are considering surgery.

[Hawthorne]

Having had 3 major surgeries for other conditons I have (or have had), I will AVOID surgery for anything at all costs!

If that means using a cpap machine for the rest of my life, so be it! I have used cpap for 8+ years now and it is second nature to me. I cannot imagine my life without it. To me, it is a minir inconvenience. Surgery ALWAYS has risks and, in the case of sleep apnea surgery, is rarely sucessful. Cpap - 100% effective - if you use it all the time.

[packitin]

Here is a quote from Dr. Mack Jones in his book "Deadly Sleep"

In many publications on OSA, tracheostomy is often mentioned in the last paragraph as a treatment of last resort and only in the most extreme or life-threatening circumstances. Well, I’ve got news for you. PAP machine-resistant OSA is an extreme or life-threatening circumstance. When all the machines and weight loss fail to keep the airway open while asleep, you are in an extreme or life-threatening condition.

When the grizzly chases you to the edge of a cliff , you have no choice: you have to go for it. But for me, the tracheostomy was a blessing, a life saving procedure. I looked forward to getting my life back. It was my best chance to completely overcome OSA.