How much did septoplasty help CPAP therapy

[GeorgeCleveland]

Hello. I have been using my hybrid mask for about two months now. I am finally starting to fall asleep with it on, but only for about an hour. My sleep doctor had me recently see an ENT at the Cleveland Clinic because my septum looked deviated. I checked out the ET and his reputation is great and he seems like a good doctor. Long story short, aside from severe obstructive sleep apnea I also have a severe deviated septum per the ENT. I get that the deviated septum is not the direct cause of the sleep apnea. That said, my ENT surgeon is saying that having the deviated septum fixed would greatly improve use of CPAP. (I have a very high setting that ramps up between 8-20.) So, has anyone on here ever used CPAP with a severely deviated septum, gotten the deviated septum surgically fixed and then gone back on CPAP? If so, did it make CPAP more effective, easier, etc.????

I looked through some past posts on here but most of the older ones start out asking the question I ask above but then turn to arguments about about if a deviated septum itself all alone causes sleep apnea. I am not looking to start that argument but just want to know if anyone has had a septoplasty and how it affected their CPAP treatment.

Thanks in advance for anyone who offers any insight. I am leaning toward getting the surgery. This doctor usually does not leave any packing or splints in the nose after the surgery and work is okay with giving me an entire week off to recover. So, my thinking right now is why would I not get tis fixed. Also, the physician is Dr. Kominsky at the Cleveland Clinic if anyone has had any experiences with him in the past that they could share.

[LSAT]

ZERO..................viewtopic.php?f=1&t=115470&p=1120078#p1120078

[linuxman]

I'll let others speak to the efficacy of the surgery ( I have my doubts that a deviated septum would cause any substantial resistance to airflow under pressure), but I think you need to understand better why you're having trouble with CPAP generally. Going for two months and only being able to tolerate it for one hour per night is not typical. You need to figure out why you can't sleep with it on. Is it uncomfortable? Is it leaking? Solve that first. Ramping from 8-20 is also likely not optimal. Chances are good that you need a higher starting pressure, and probably a tighter range of pressures overall. The machines in Auto mode can get into a runaway condition on pressure, especially if there are substantial leaks present.

[GeorgeCleveland]

The ENT believes the lack of ability to breath well through the nose is the cause of the waking up. I went through four different masks. It does not feel uncomfortable. I do not believe it is leaking. I simply wake up between 50-65 minutes of use,sometimes gasping for air ripping the mask off. The MyAir iPhone application says I have no leaks and am not having any events.

Also, I doubt this is relevant but you never know so I will add this..... I sought out a sleep doctor because I was having night terrors. I would wake up every couple hours terrified and did not know why. The sleep doctor did a study and it turns out I was having over 50 apneas an hour. It then made sense because all of the night terrors dealt with breathing..... me being choked, drowning, etc. Now, when I use the CPAP for even an hour without falling asleep, I no longer have the night terrors. But, if I try to entirely skip CPAP, the night terrors return.

[D.H.]

You been using a hybrid mask for about two months. Does that mean you used something else before, or that you're new to CPAP?

Please note that the fact that the night terrors are gone indicates you're getting some benefit from CPAP!

I really don't know if such surgery would help, but I would see if I had the best mask first (your "best" mask might change if you do have the surgery).

Also, are you experiencing soreness or irritation from the mask?

[ChicagoGranny]

I have a very high setting that ramps up between 8-20.

If you want good help from the forum, please state the details of your settings:

Ramp pressure?
Ramp time?
Minimum CPAP pressure?
Maximum CPAP pressure?

.. and fill out your equipment profile - https://www.cpaptalk.com/ucp.php?i=prof ... pment_info

There are too many unknown details at this point to give you anything but a very general answer that may be worthless for your specific case.

Cheers,

[linuxman]

The ENT believes the lack of ability to breath well through the nose is the cause of the waking up. I went through four different masks. It does not feel uncomfortable. I do not believe it is leaking. I simply wake up between 50-65 minutes of use,sometimes gasping for air ripping the mask off. The MyAir iPhone application says I have no leaks and am not having any events.

Also, I doubt this is relevant but you never know so I will add this..... I sought out a sleep doctor because I was having night terrors. I would wake up every couple hours terrified and did not know why. The sleep doctor did a study and it turns out I was having over 50 apneas an hour. It then made sense because all of the night terrors dealt with breathing..... me being choked, drowning, etc. Now, when I use the CPAP for even an hour without falling asleep, I no longer have the night terrors. But, if I try to entirely skip CPAP, the night terrors return.

As Granny mentioned, fill out your machine details and settings. Depending on your equipment you may be able to use some software to analyze your results, and that may lead to better suggestions for machine settings.

So presumably you don't have trouble breathing through the combination of your nose and mouth during the day, so not sure why that would be any different on CPAP. Of course, assuming you're on a full face mask, or a hybrid as you mention. Your ramp starting at 4cmH20 may be part of the problem. That's a very low level, and feels like you can't get enough air for many people. Heck, at that setting, I can easily start pulling air back through the mask exhaust vent with a fast, deep breath. I'd ditch the ramp and just start at a moderate pressure. You need to get adjusted to the feeling of the mask at pressure. One way to do this is to put the mask on in the evening while watching TV, or whatever. That may help you acclimate to the feeling of higher pressure.

[Okie bipap]

I don't know if the surgery helped my apnea or not, but it really helped my breathing all day long. Prior to surgery, I could never breath through both sides of my nose at the same time. I had several sinus infections every year. Now, I very seldom have a sinus infection (maybe once a year or so).

[msla]

I started CPAP after my septoplasty so I cannot answer your question but I will agree with the others that it made my breathing much easier while awake.

[Biguugly]

The ENT believes the lack of ability to breath well through the nose is the cause of the waking up. I went through four different masks. It does not feel uncomfortable. I do not believe it is leaking. I simply wake up between 50-65 minutes of use,sometimes gasping for air ripping the mask off. The MyAir iPhone application says I have no leaks and am not having any events.

Also, I doubt this is relevant but you never know so I will add this..... I sought out a sleep doctor because I was having night terrors. I would wake up every couple hours terrified and did not know why. The sleep doctor did a study and it turns out I was having over 50 apneas an hour. It then made sense because all of the night terrors dealt with breathing..... me being choked, drowning, etc. Now, when I use the CPAP for even an hour without falling asleep, I no longer have the night terrors. But, if I try to entirely skip CPAP, the night terrors return.

Been having night terrors AND deviated septum for 40 years. Declined septoplasty due to the intense recovery period, had sleep study, went on Resmed 9 , with pressure of 12, and after 2 years am still having unpleasant dreams, but not terrors. After trial and error, I am using full face mask with cloth cushions and getting 7-9 hours sleep a night with ahi of around 5. Hope this helps.

[Sheffey]

Declined septoplasty due to the intense recovery period

Or maybe you declined it out of ignorance?

I had a badly deviated septum corrected and turbinate reduction surgery about ten years ago. The recovery was very easy. The splints came out after three days. The doc cautioned me not to bend over to lift heavy objects for 30 days.

Easy for me. YMMV.

[Okie bipap]

My recovery was much the same, except the splints were in for seven days.

[Redonthehead]

I struggled with a FFM early in CPAP use, mainly due to leaks at bridge at nose blowing in my eye. I bought a P10 out of pocket and found if I put it on while reading before trying to go to sleep, it would eventually open up my nasal passages where I could breathe OK. After my septoplasty and turnbinate reduction surgery, CPAP and breathing during the day is MUCH MUCH better. I would do it again.

Prior to the surgery, if someone had duct taped my mouth shut, I would have been dead in 5 minutes since I could not breathe through my nose.