Do I need surgery?

I have used a CPAP for five years, and it has helped, somewhat. But my wife says I still snore like crazy all night (8 or 9 hours consistently) and I wake up very tired most mornings. My throat is very closed, even when I sleep on my side or stomach. Anyone have a similar issue that has been resolved with surgery to remove flesh from inside the throat?

I got weight-loss surgery (R-XY) in March and have lost almost 100lb, but I still snore and choke many times per night. Thanks!

Hi, first of all, can you please click on 'User Ctl Panel' under the main logo and then on Profile. Using text (not icons please) fill in the full name & model # of your machine and mask, and whatever your pressures set at (I'm assuming Apap but if Cpap, what pressure?). Those will all then appear auto. under any posts you make (including this first one) so we have something to go by when advising. Thanks.

How many hours of sleep do you get? Do you take meds? Have you seen an ENT doctor and if so what did they say? And... are you using software to track progress overnight? If so, can you post (using a Photobucket link) a pic of a recent graph?

Surgery is absolutely the last resort you'd want to think of because while there are a handful of procedures that surgeons are happy to provide (usually extensive and painful), the great majority of them do not result in either your apnea going away, but more often instead create new problems, especially with your ability later on to use Cpap, due to your altered anatomy... in other words, from the frying pan to the fire, and of course once done, it can't be undone.

Surgery is a toss up and very painful. What you really need is to optimize your therapy. If you still snore and gasp then the pressure is inadequate.

Most of us here would advise against surgery, as it often produces a different set of problems. You do need to make your own decision, however.

When I was first told I needed a CPAP machine I resisted it, and spent two days researching other options. All of the options sounded horrible to me, and I began to realize that CPAP, as the gold standard of therapy for apnea, was really the only option, and that I shouldn't dismiss it without giving it a chance.

logancircle2 wrote:I have used a CPAP for five years, and it has helped, somewhat. But my wife says I still snore like crazy all night (8 or 9 hours consistently) and I wake up very tired most mornings. My throat is very closed, even when I sleep on my side or stomach. Anyone have a similar issue that has been resolved with surgery to remove flesh from inside the throat?

I got weight-loss surgery (R-XY) in March and have lost almost 100lb, but I still snore and choke many times per night. Thanks!

Hi logancircle2,

It depends.

I would first follow the advice to make sure your pap therapy is optimized. If it isn't, i would do what you could to change that situation.

If it is, then you have some decisions to make since struggling for 5 years is a very long time. One site I found possibly helpful is needsleep.net and the discussions on the apnea forum about surgery. Not sure how current the discussions are but I did find it helpful to read the archives.

Basically, you need to make sure you are picking the right surgery for your situation. For example, it sounds like if you decided to do surgery, that radio ablation might be your best option although please keep in mind, I am not a medical professional. Then of course, picking the right surgeon is a whole other discussion.

In a nutshell, unlike many folks on this board, I am not opposed to surgery. I mean, if you have clearly given pap therapy a shot at optimal conditions which of course has not been determined, frankly, I think it is stupid to say to someone to keep trying. No surgery is not a guarantee of success but even a 50% chance of success is better than if pap therapy hasn't been working for 5 years which again, we don't know the reason for so I did want to add caution to that.

Finally, I would also look into adjustable dental appliance therapy although if you are reporting a feeling of your throat closing in spite of using the cpap machine, I am not sure if this would be appropriate or not. I have posted a study on this board that gives the chances of getting the AHI below 5 at various apnea severity levels. The chances of success are greater for mostly mild to moderate ranges as an FYI.

Best of luck.

49er

I am interested in hearing your response to the above questions. If your therapy is subpar and it's been that way for 5 years, that is so very sad. Did your doctors know you were still suffering? While the thought of anyone going 5 years like this makes me want to scream, it is encouraging to think that just some tweaking of your pressures could very well be all you need to turn this thing around. Best wishes.

Welcome to the board, Logan.

Before trying surgery, be really sure you are getting the maximum benefits CPAP can bring. Surgery is expensive, painful, has long term side effects, and can't be undone.

Look at the link in my signature and fill in the equipment you have.

If you have the right equipment, we may be able to help you learn how to read the data your CPAP machine records and let you figure out how it's working, and maybe make it work better for you.

Many of us here think that certain percentage of the doctors and surgeons are way too eager to do surgery. They have delusions of grandeur and visions of dollars dancing in their heads. Google the horror stories of UPPP or apnea surgery.