First Post with Questions

[Mytai11]

Hi Everyone,

First post here. I just completed my sleep study and got the results.

I first went to my ENT because of being addicted to Afrin. Back in June, I had a head cold and got hooked on breathing. Last week, I went to the ENT and he passed a scope through both nasal passages. I've got a deviated septum on both sides, as well as a bone spur occluding more than 50% of my right passage. He said in surgery, he would do "something" with the turbinates. I've had my tonsils out, and I've got an extra long uvula.

At night, I snore, and have periods of apnea as evidenced by my girlfriend witnessing them first hand. I really, really need my nose open to sleep well.

During the day, I'm drop-dead tired, have poor short term memory, and take naps often. My sleep is terrible.

I had the sleep study and got a score of zero for my AHI.

I did have some arousals of unknown etiology, so that probably is contributing to my daytime sleepiness.

My Epworth scale is 12.

Some numbers: Zero apnea's/hypopnea's. BMI 26.3. N3 was reduced, as well as REM latency. Sleep efficiency of 80.3%. Sleep R was reduced. Sleep architecture was fragmented due to arousals of unknown etiology. I also had no plm's. Since my AHI was 0.0, CPAP was not indicated.

Can anyone help with further information? I'm still looking into surgery for the uvula, nose, and possibly palate.

Thanks in advance!!!

Maitai

[mytai11]

PS - it asked for my username, which is maitai11, but it wouldn't let me us it in the "username" box. Sorry!

[Pugsy]

Nose surgery....to help open the passages...sure worth looking into.
That other stuff...I am not so sure I would jump on that without really checking into it.

Now I am not saying this is your problem .....UARS...but you might look at it while you are studying things.
Upper Airway Resistance Syndrome
This will get you started...Google Upper Airway Resistance Syndrome and start reading
http://en.wikipedia.org/wiki/Upper_airw ... e_syndrome

Tell your girlfriend the next time she sees you stop breathing while asleep to see if she can estimate the duration in seconds.
To get scored as part of an AHI the events have to last at least 10 seconds.

[Sir NoddinOff]

Wow, this is one of the toughest posts I've seen in awhile. My first thought was post traumatic stress disorder, but I'm not a doctor, I just pretend to be one on the internet <kidding>.

My heart goes out to you... you must be feeling stressed out. I'm sorry I can't really offer any solid advice but I sincerely wish you luck and encourage you to come back to let us know what you find out.

[jweeks]

Now I am not saying this is your problem .....UARS...but you might look at it while you are studying things.

Hi,

(Following up to Pugsy's comment, but directing the reply to the original poster.)

That came to my mind, too, since this was my primary issue for the past 2 years. There are 2 numbers that I didn't see the poster mention...oxygen levels and RDI. I am curious if those arousals occurred along with drops in blood oxygen levels? RDI isn't measured and reported by all sleep studies, so it is possible that the sleep study didn't give this number. But if RDI is much higher than AHI (which was zero), that could be RERA breathing.

What kind of doctor did you go to for the sleep study? Was it at a hospital, clinic, or a home study? I suspect that you might need a more experienced specialist, such as a good sleep neurologist.

On the surgery--I'd consider getting a second opinion. If that second opinion recommends the same thing, then consider having it done. I know a person that had this a few years ago, and he tells me that it really improved his quality of life.

-john-

[JohnO]

Did your SpO2 drop at all during the study? It should be in the mid-nineties, but if you stop breathing as with sleep apnea, the amount of oxygen getting into your blood drops.

John

[Jewels109]

I had deviated septum and turbinate reduction surgery almost 2 years ago..... Best thing ever I could FINALLY breathe thru my nose!!!!! I slept really well for a while until my apnea kicked in again!!!! Do it u wont regret it!!!!

[need2snooze]

I saw an ENT yesterday for the first time, mainly b/c I've been having breathing issues and am looking for anything that might help me figure out why I have such fragmented sleep every night. The dr.'s office requested that I bring in my sleep study. Although my sleep study showed that I had an AHI of 16, this dr. said that he didn't really think I needed CPAP, as their sleep dr. in that office doesn't usually prescribe CPAP for patients with an AHI under 20. He did diagnosed me with UARS. Also said that I might benefit from an oral appliance, one supposedly better than the one I bought three years ago that gave me jaw pain and was unbearable. He also suggested that I have surgery for a deviated septum, and while stating that it wouldn't necessarily help with the sleep apnea, it would help me breathe easier. I have an appt. with my sleep dr./neurologist next week and will get her take on this. I definitely would want to get a second opinion on the surgery before getting it.

[maitai11]

Thank you, everyone!!!

I'll address each post as thoroughly as I can...

Pugsy - Thanks for the info on UARS, I'll look into it

Sir Noddinoff - Thank you so much for your concern. I truly appreciate it. I don't have PTSD

Jweeks - 02 Sat was in the "Normal" range...above 90% for the whole test. No mention of RDI. Actually, they said it might be related to UARS...Micro Arousals were otherwise unknown etiology. An ENT referred me for the test, and a Pulmonologist/Sleep Medicine specialist scored my test and graded it.

Need2snooze - Thanks so much, and I'll look into that appliance...although I cringe at the thought. I'm more interested in surgery I think.

Thank you all, I really appreciate your help!

[maitai11]

Hello Everyone,

Well, I saw my ENT last week, and we are opting for surgery. Here's what we deduced, as well as my thoughts:

1. I think I had the best sleep study possible for my own individual situation. I never had apnea or decreased SP02, but I DID have several micro-arousals. My deduction? UARS, as well as being pre-apneic. The doctor concurred. As mentioned in earlier posts, my girlfriend suspected that I had periods of apnea, and for sure I snore. SO - I don't need CPAP (couldn't use it anyway due to my career (firefighter) and other factors), but I DO need surgery to correct some things. It turns out that UARS (Thank you, Jweeks) is the most plausible diagnosis...but...

2. The insurance company won't pay for UARS surgery. They're like, "What??? UA-What?" They wouldn't touch it with a ten foot pole, according to my physician. So I'm kind of screwed in that regard. My ENT said, "Well, we'll just have to keep you healthy, and yada yada yada..." Hearing that was a huge let-down. However, I remember when he scoped me, and...

3. Turns out that even though I can't have "snoring surgery", I can have surgery to correct my deviated septum(s), bone spur, collapsing nostrils, really wide septum-base (OMG my nostrils are SO SMALL because my septum-base is so wide), and really long uvula. So, it appears as though you can't say "UARS/Pre-Apneic", but if you say "Anatomical Deviations", then hey, no problem - you're pre-approved! I'm so excited and thankful because I'm going to get the end result I wanted in the first place just by saying a few correct magic words! I highly doubt that my soft palate has anything to do with my particular snoring architecture (had tonsils out, too), and my tongue was not the cause either.

4. I'm SO looking forward to walking away from Afrin after this. I'm weaning as we speak - Dr. supervised. Along with that, the increased ease of breathing is probably going to be the key to getting better - no more mouth breathing, which will lead to no more snoring (when I use the Dr's protocol to keep my nasal airways open, I don't snore), trim the uvula and that should help, etc.

5. So, thanks so much for all your input. I will further update you after my surgery on May 8th. Any and all comments, suggestions, or inputs will be welcomed with open arms. You are all very special for taking the time out of your busy day to help a working stiff like me. Thank you so much

V/r

Maitai

[-tim]

Get a supply of some cheap surgical masks and start wearing them a few days before your operation so you can get used to them. Wear them anytime you are subject to any dust or high pollen or small flying bugs for a few weeks until your nose heals. You don't want junk collecting in your healing nose.