Going for a surgical consult

[David1447]

And I'm pretty sure I'm going to request a UPPP.

Mallampati-classification-class-I-fully-visible-uvula-and-soft-palate-class-II-hard-455x621.png (291.77 KiB) Viewed 892 times

I've never noticed it before, but in using CPAP and checking my breathing I've found that when I relax my throat muscles, I find it very hard to breathe.

I took a video of this with flash, and I could clearly see the blockage. It looks like class IV in the photo, and feels like the harder I try breathing, the bigger the vacuum in my throat inward, the harder to breathe up to an almost full blockage... It's really alarming for me to find.

I'd post the video here but I don't want to scar anyone emotionally. (Can PM if anybody wants to see.)

Did anybody have a UPPP successfully or unsuccessfully here? What do you think about my predicament?

Edit:

Replies so far have not been positive towards UPPP. I'll go to the consult anyway, but with this negative response in mind. I'll ask about other procedures as well.

[WindFlyer]

I had a laser-assisted UPPP back in 04. The surgery itself was painless, but the week after was horrible. It was difficult to eat anything and I was living on throat spray and cold green jello. Did it help with my sleep apnea? No. None whatsoever. I had another polysomnograph done after the procedure and not much had changed. That was my experience.

PT

[Mark Sadler]

In 2000 I had a UPPP. It stopped my snoring and I thought my apnea was fixed. I don’t remember too much pain as they had me drugged for the first week. I had a great Dr. and don’t have problems swallowing. (Some do).
Fast forward. It didn’t stop my apnea. A sleep study in
2017 showed 56 AHI.

[Julie]

Most here will tell you that whether or not they personally had the surgery, it's a waste of time as things usually revert to needing Cpap all over again within a few months, only then you're stuck with the anatomy you 'paid for' and may have more trouble than if you'd just tried (with the help of this forum, and not a hungry ENT surgeon) to optimize Cpap use.

You're correct that your muscles collapse but the whole point of Cpap is to keep them from doing so... and no surgery's necessary. You can always reschedule surgery in future, but not replace the anatomy it cuts.

[Pugsy]

What is your diagnostic AHI?
Without cpap....just how much was the AHI?

[Goofproof]

XPAP works for Sleep Apnea, you might use it..... Jim

Instead of going to the Butcher Shop!

[Wulfman...]

And I'm pretty sure I'm going to request a UPPP.

I've never noticed it before, but in using CPAP and checking my breathing I've found that when I relax my throat muscles, I find it very hard to breathe.

I took a video of this with flash, and I could clearly see the blockage. It looks like class IV in the photo, and feels like the harder I try breathing, the bigger the vacuum in my throat inward, the harder to breathe up to an almost full blockage... It's really alarming for me to find.

I'd post the video here but I don't want to scar anyone emotionally. (Can PM if anybody wants to see.)

Did anybody have a UPPP successfully or unsuccessfully here? What do you think about my predicament?

You would be making a HUGE mistake!!!

Here's some reading for you. It's been a frequent subject here for about 14 years.

search.php?keywords=UPPP

Summarizing what others have posted:
It's surgery that can't be undone once it's been performed. Within about a year, you'll be back on CPAP or even Bi-level at (more-than-likely) higher levels of pressure.

Work harder at fixing your existing problems and you'll find you won't need surgery.


Den

.

[Goofproof]

The usual rule is if you go to a carpenter and his main tool is a hammer, expect him to only use nails in what he makes for you. Jim

[David1447]

What is your diagnostic AHI?
Without cpap....just how much was the AHI?

10.8, it was worst when in REM or on my back.

[Pugsy]

10.8, it was worst when in REM or on my back.

Kinda important to know how much worse in REM or supine when evaluating potential results that you may or may not achieve.

First of all....not many people here on this forum who had the surgery and got off cpap forever....after all this is a cpap help forum.
People wouldn't be here if they weren't using cpap for some reason or other. I know I sure wouldn't be.
So consider your informational pool here.
Either the airway tissues eventually started to sag again and the OSA returned...or it never went away in the first place.

There are people who have had the procedure with varying degrees of success but if they are here to answer your question...guess what..they are on cpap. Something went wrong or they wouldn't be here...would they?

Evaluate what is considered a success rate....is it a 25 % reduction in AHI or 50% reduction or 75%???
My AHI in non REM is 12...but in REM over 50 per hour...a 50% reduction during REM wouldn't be much of a "success" in my book.
Maybe your book is different...and maybe your doctor's "book" is even more different.

UPPP doesn't come without some rather ugly and permanent side effects. Research those carefully because it can't ever be undone.
Your speech will likely be affected and stuff you eat or drink might end up coming out your nose at the most embarrassing of moments.

The ONLY part of the UPPP procedure that I would ever even maybe consider is the tonsil removal...and that's only if the tonsils were huge.

Surgery is a permanent thing..and not without risks. A good friend of mine had her grandson die just from getting his tonsils removed.
Always...always evaluate potential risks vs rewards thing.

[David1447]

10.8, it was worst when in REM or on my back.

Kinda important to know how much worse in REM or supine when evaluating potential results that you may or may not achieve.

First of all....not many people here on this forum who had the surgery and got off cpap forever....after all this is a cpap help forum.
People wouldn't be here if they weren't using cpap for some reason or other. I know I sure wouldn't be.
So consider your informational pool here.
Either the airway tissues eventually started to sag again and the OSA returned...or it never went away in the first place.

There are people who have had the procedure with varying degrees of success but if they are here to answer your question...guess what..they are on cpap. Something went wrong or they wouldn't be here...would they?

Evaluate what is considered a success rate....is it a 25 % reduction in AHI or 50% reduction or 75%???
My AHI in non REM is 12...but in REM over 50 per hour...a 50% reduction during REM wouldn't be much of a "success" in my book.
Maybe your book is different...and maybe your doctor's "book" is even more different.

UPPP doesn't come without some rather ugly and permanent side effects. Research those carefully because it can't ever be undone.
Your speech will likely be affected and stuff you eat or drink might end up coming out your nose at the most embarrassing of moments.

The ONLY part of the UPPP procedure that I would ever even maybe consider is the tonsil removal...and that's only if the tonsils were huge.

Surgery is a permanent thing..and not without risks. A good friend of mine had her grandson die just from getting his tonsils removed.
Always...always evaluate potential risks vs rewards thing.

I don't know. They haven't told me. I suspect I haven't slept very deeply during the study so the result might be skewed. I'm a bit lost right now, and do appreciate your balanced opinion. I'll keep it in mind during the consult.

[ChicagoGranny]

in using CPAP and checking my breathing I've found that when I relax my throat muscles, I find it very hard to breathe.

That's called obstructive sleep apnea. It's why most of us use CPAP.