CPAP vs. UPPP for a young person

I would not touch UPPP with a ten foot pole. It has a bad name for successfully treating obstructive sleep apnea. CPAP is the gold standard, with massive weight loss (bariatric weight loss) also helping. If CPAP is not tolerated, custom made oral appliances like the Somnodent oral appliances are currently second thing to try for mild to moderate OSA.

The issue with UPPP are many. First its been proven to be only partially effective most of the time. Oftentimes its not effective at all. Next, it eliminates the tissues in the back of your throat that the auto-titrating CPAP devices rely upon to bounce signals off of, such as little puffs of air while you sleep. If there is nothing there to bounce signals off of, all you can fall back on is lab titrated straight CPAP and straight Bipap and personally, I would NOT want to be in THAT boat!!! Thats a bad place to be potentially.

CPAP, weight loss, elimination of sedating drugs and elimination of booze after 4 PM and custom made oral appliances are the current modalities for obstructive sleep apnea.

What were your sleep study results? AHI?

Something you should know about success rates. Their definition of success for surgeons is a 50% reduction of events. That means that if you have a current ahi of 20, they will consider the surgery success if your new ahi is 10. If you have an untreated ahi of 80 like me, they would consider the surgery a success if my ahi went down to 40, which is still considered severe. So, while they make it sound like you can expect good results, it doesn't mean they expect that you will be cured or even reduced to mild.

So, a good question is to consider whether their definition of success would actually be successful for you. Doctors normally consider anything under 5 to be good. Most people here prefer to be under 2 to feel good. Is your ahi above 10? Even successful surgery will leave you with sleep apnea. And you said you are young. Most people get worse as they get older. Having surgery will not stop you from getting worse with age. I am 44, and I did not have sleep apnea as a teenager. I really don't know when it started. but I did not instantly become severe. it worked its way up over the years. It may even by higher than 80 as I never reached REM sleep in my sleep study. A full night study could result in higher numbers. So, while you are young now, it is likely that your untreated ahi will creep up over the years, even if you have surgery.

Research that 70% success rate. Last I heard, only 50% of surgeries results in "success" (reduction of ahi by 50%). Maybe they have gotten better. Maybe that number is inflated.



Let us help you make cpap a success. We define success as ahi below 5, preferred below 2, AND feeling better. Not just a reduction of 50%. We can help you find the right mask. There are some hybrid masks that might work better for you. And we can help you with getting used to it, finding the right settings, etc. And there is no risk of permanent damage.

ewoods wrote:The tissue they remove could also grow back. This is fairly common, actually.

Which tissue are you referring to? Did you have radiofrequency tongue base reduction? That tissue can grow back, but I have the understanding that tissue surgically removed from the soft palate will not grow back.

I am happy for your good results! Thanks for taking the time to compose that post!

I think that's true of the soft palate, but my understanding is that the tissue from the tonsils and adenoids (and especially the tongue, in my case) can regrow, depending on how much was removed in the first place.

I had a UPPP almost 7 years ago (when I was 30). Before that I had 3 sleep studies done. the first 2 tests we inconclusive. The 3rd test showed that I had some apneas, but was told then that I didn't have enough to be put in a CPAP. (which I was glad - because I was single and didn't want to be attached to a machine). I did have to be put on oxygen during the night. My ENT suggested that I have a UPPP to fix the few apneas that I had. During my UPPP they fixed my deviated septum, opened up my sinus', and removed my uvula. It was painful. Not having a uvula helped at first. Felt like I had more energy and slept somewhat better. That was short lived. Not having a uvula comes with its own challenges. Sometimes liquids come out my nose a lot easier. I really have to be careful when I eat, as there is nothing there to help keep it from going down the wrong tube. Food will get stuck in the back of my throat. I did stop snoring for a while, then it went to heavy breathing type snoring. There are some speech changes as well, but they aren't too noticeable. Fast forward 6 years. I had sleep study #4 and 5 late last year. Was diagnosed with Severe Obstructed Sleep Apnea and now have a CPAP. took a little bit to get used to. I sleep better. No more headaches in the morning. yes, the mask sucks. but so does choking. I also just found out last week from my new respiratory therapist that sleep study #3 (when I got UPPP) I should have been diagnosed with MODERATE obstructive sleep apnea.

Just make sure you do all the research.

I bump into a former colleague every couple of years at the grocery store.
I'm in my early 50's and I guess he has 10 years on me.
He was always a big guy and got bigger, puffier over the years.
I second last time I saw him he was ~300 pounds.
The last time I saw him he was ~200 and looked like really fit 40 year old.
He explained that he just hated CPAP so he got a personal trainer.
Now he doesn't need CPAP.

Jack Burton wrote:I bump into a former colleague every couple of years at the grocery store.
I'm in my early 50's and I guess he has 10 years on me.
He was always a big guy and got bigger, puffier over the years.
I second last time I saw him he was ~300 pounds.
The last time I saw him he was ~200 and looked like really fit 40 year old.
He explained that he just hated CPAP so he got a personal trainer.
Now he doesn't need CPAP.

He was one of the 49% for which that worked. Other end up with no change because the apnea caused it or with more pressure.

I did the UPPP, turbinate reduction & had my deviated septum fixed. AHI post surgery was no better. I still need CPAP. An interesting aside: the level of effort to breath nasally prior to surgery left me whistling though my nose post surgery. I literally had to re-learn how to breath without making noise. You may be better able to tolerate a nasal interface after surgery. Don't bank on it doing anything more for you. Some do get lucky.

This is how I think of surgery for sleep apnea.

BasementDwellingGeek wrote:I did the UPPP, turbinate reduction & had my deviated septum fixed. AHI post surgery was no better. I still need CPAP. .