Maxillofacial surgery (jaw advancement)

[keeptrying]

During the years of having sleep apnea, I would always first wake up after 2 hours in my REM sleep, even with the CPAP machine. I just had a surgery about 2 weeks ago called Maxillofacial surgery (jaw advancement), however I'm still waking up after the 1st 2 hours in my REM sleep from something, I can't figure it out. Also waking up several times later. I thought the surgery would cure this. I noticed that last night again, I woke up after 2 hours during my REM sleep. I'm concerned the surgery didn't work. I've had other surgeries in the past, removing the uvula, a septoplasty, (those helped, didn't get rid of the apnea to an acceptable level), but I was sure that advancing the jaw from this surgery would get rid of the apnea. Does anyone have some insight?

[Julie]

Download Sleepyhead software so we can look at what is going on overnight from many features (pressures, leaks, flow rate, etc.).

[keeptrying]

Is anyone familiar with this surgery? Have they had it? Did it work? when did you notice improvement?, etc. Just 2 weeks and still waking up at same times.

[chunkyfrog]

Thanks to this forum, I have learned more about things I hope to never need, for example, insomnia.
If one is able to quit cpap due to surgery, they are not too likely to return.
This is, after all, Cpaptalk, not apnea-surgery-talk.

[Sir NoddinOff]

search.php?keywords=Maxillofacial+surgery

Check out the above link... there's been some discussion here before, but not a lot that I can recall.

[Pugsy]

Maybe it isn't the apnea waking you up...maybe it's something else.
Did you know that it's normal to wake up after REM stage sleep has ended? Most of us don't remember it but it's fairly common.
Do you take any meds of any kind? If so, what?
Are you still using your cpap machine?
2 weeks post surgery...not a lot of time for things to heal and swelling to go down...maybe need more time??? What did the doctor say in regards to healing time?

[keeptrying]

I never knew that. I fall into REM sleep immediately, so maybe that is why I wake up 2 hours later because i'm done with the REM sleep. I typically fall back asleep a few seconds after that. But I've always wondered why do I wake up at the same time after I fall asleep which is about 2 hours. I have no problems sleeping, I actually fall asleep right away, but can't understand what wakes me up and why it was during REM sleep.

[Pugsy]

Are you waking up and remembering dreams and assuming that you were in REM because of the dream?
Did you know that we can (and do) dream in other sleep stages besides REM?
Normal sleep stages progress through various cycles throughout the night with first REM occurring about 90 minutes after sleep onset and as the night goes along then REM will come on more often and last a little longer with the most REM usually happening in the wee hours of the morning.
Google "sleep stages" and pay special attention to the hypnograms showing normal sleep cycles.

If you really are going into REM pretty much immediately (has this been verified by an in lab sleep study) then that's usually indicative of another type of sleep disorder unrelated to sleep apnea.

Are you taking any meds of any kind?....this is kinda important question as meds often impact sleep/sleep stages/and just in general mess with our sleep.

Now it's possible that you go to sleep...have REM onset at around 90 minute mark for about 30 minutes...give or take a little either way ...and that you simply have a normal post REM sleep stage arousal and it's totally unrelated to sleep apnea.
It's rare that I don't wake up for something despite my OSA being very well treated...sometimes all our problems can't be put in the sleep apnea basket no matter how much we want them to be there so the machine can fix it. My problems are more on the lines of pain....but sometimes I just wake up and I don't know why...what's important is that I don't worry about it and I roll over and go right back to sleep.

If you are thinking that once you get OSA treated (by whatever means) that you go to sleep and don't wake up until 8 hours later....that's not usually how things go. Sleep apnea is just one type of sleep disorder...it's not the only one.

Have you had a follow up sleep study to see if you are getting the normal sleep stages?

[chunkyfrog]

Insomnia may have many causes--not always the mask or machine.
Maybe it's time to be a pest to your doctor.
(Or not)

[keeptrying]

I don't take any meds. All along, with CPAP, without CPAP, and now after surgery with no CPAP, I wake up about 2 hours after I fall asleep during REM. So the CPAP machine, surgery, etc., doesn't seem to make a difference. I consistently wake up at the same time, 2 hours later. So maybe it's something different like you said. I just could never understand why? It isn't like it's a bad dream, I just wake up, but I do know why I'm waking up exactly around the same time after I fall asleep about 2 hours later and could never figure out why. It's really strange. But if it's another type of sleep disorder, what could it actually be if not sleep apnea. I have a difficult time understanding how it's a sleep disorder, because I actually fall asleep right away, and dream right away. So falling asleep and going to REM is not an issue. It's staying asleep that's an issue. Something is causing the body to wake up, and I could never get an answer. It's so complicated and I wish there was a way to fix it.

[Pugsy]

There's a gazillion sleep disorders (well maybe not that many but there's a whole bunch out there) and sleep apnea is only one of the possible sleep disorders.

Sleep maintenance insomnia..that's where we fall sleep fine but wake up often for no apparent reason.
Not so easy to fix without a known reason unfortunately...there's a fine line between "normal" wake ups and "not so normal" wake ups. It's one of those gazillion sleep disorders I mentioned.
Google it and start reading.....sleep apnea is just one of many causes for sleep maintenance insomnia...it sure not the only cause.

I would start with a follow up in lab sleep study about 6 weeks post surgery (give yourself more time to heal up) and see if they spot anything on the sleep study out of the ordinary. There's a lot more to sleep studies than just checking for sleep apnea....plus you need to make sure that the MMA surgery fixed the sleep apnea anyway. Right now you don't know that it was fixed.

Finally...it could very well be that you are just one of those people who wake up and remember it after the end of REM stage sleep...a sleep study could tell what sleep stage you were for sure in right before any wake ups. It may just be something you have to learn to accept...but without a follow up in lab sleep study we are all just guessing here.

[The Choker]

... I typically fall back asleep a few seconds after that. ....

I have no problems sleeping, I actually fall asleep right away

Making something out of nothing?

[ChicagoGranny]

Something is causing the body to wake up, and I could never get an answer. It's so complicated and I wish there was a way to fix it.

It's not necessarily complicated. It could be something very basic. Check this standard advice --->

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps
- Practice total abstinence of caffeine including sources like chocolate (sigh)
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Use the bedroom for sleeping (and sex) only, and make sure the bedroom and bed are comfortable.
- Learn to appropriately handle emotional stress in your life
- If you still don't feel or sleep well, make sure you have regular medical checkups to confirm there are no other medical problems

CG

[ChicagoGranny]

BTW, after that surgery heals, it is common to have a sleep study to see if the surgery was effective.

[chunkyfrog]

There is NO WAY I'm abstaining from chocolate!