I'm A New Person After Sinus Surgery!

Georgio · Post by **Georgio** » Mon Jan 13, 2025 5:27 pm

I successfully managed my Apnea with APAP for 15 years. Recently I developed a bad sinus infection and after antibiotics failed to clear it up, endoscopic Septoplasty & Bilateral Turbinate Reduction surgery was performed 10 days ago. No useful cpap attempts until last night when my nose cleared up enough from surgery to somewhat breathe. After major reconfigurations on my septum and sinus cavities I feel like my old sleep study and my therapy settings are out the window. On my former settings this morning I woke with a headache in a fog with loud ringing in my ears. They plan to do an at home sleep study on me in a couple months. I need to figure somethings out quick so I return to work and function. I think I should approach this as if I were not the same person. I want to change these settings, any input will be really appreciated.

ChicagoGranny · Post by **ChicagoGranny** » Mon Jan 13, 2025 6:04 pm

Your machine is being limited to an inspiration pressure of 10.0 because that is the max setting. Hitting the max is an indication of trouble in the airway and the machine wants to pump more pressure to prevent the trouble. Why have you limited the pressure?

Have you ever had the max at 20? I would like to get you in that direction by first changing it to 12.0 and having another look at the pressure graph. If 12.0 causes any problems, let us know what they are.

Note: Many of us set the max pressure at 20.0. The machine will not raise the pressure any higher than it needs to. It sometimes comes in handy like when you have a cold, allergies, or activities during the day that impact airway patency while sleeping.

Georgio · Post by **Georgio** » Tue Jan 14, 2025 10:00 am

Good Morning and thank you so much for taking the time and caring to provide your assistance. I was titrated to 8 over 15 years ago which is why I was set to a range of 6 - 10 and my data stayed well within those limits consistently. But this is like starting over and I don't know what to expect. I found a study where 85% required reduced cpap pressure after my type surgery but 10% required higher pressure. Last night I upped to maximum 12 but did not approach it. I also slept with my head up on a wedge cushion I have been using after surgery. The previous night when I was pushing 10 i was on my regular pillow. It's uncomfortable sleeping on the wedge and I would wake up and take breaks during the night until I got sleepy.

I'm in my second week off work from surgery, my goal this week is to get my sleep hygiene and cpap settings adjusted where I can return to work next MondaY.

I'm thinking stay this same course for 1 or 2 more nights?
At some point will want to try sleeping without the wedge cushion again.
Thank you again for caring and your input!

Study:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4288609/

ChicagoGranny · Post by **ChicagoGranny** » Tue Jan 14, 2025 6:26 pm

Looking at the pressure line, the wedge makes a bigger difference than I expected. How tall is the wedge? Which brand? Internet link?

Georgio wrote: ↑
Tue Jan 14, 2025 10:00 am
I'm thinking stay this same course for 1 or 2 more nights?

Most board experts recommend this. Personally, I make changes more quickly.

Your plan to eventually sleep without the wedge is a good plan.

Georgio · Post by **Georgio** » Wed Jan 15, 2025 9:06 am

Thanks so much Granny!

This wedge has been a life saver for me right now and I was required to keep my head up a few days. My "sleep" is terrible after surgery but it appears better on the wedge than normal pillow, only about 3 hours last night. I do recommend this wedge to those who want or need one, I am 6-4 and 270 lbs and it accommodates me.

Given my airway alterations I'm like a new patient without a sleep study in this condition and see this as starting over. I did open up my range last night (on the wedge) to try and self titrate.

A study states 85% of patients that underwent surgery like mine resulted in needing lower pressure cpap by 2 cwp, I may be in that group.

Last night is interesting I may be looking at lower pressures than I have used for years, or no cpap at all on the wedge? Last night no events for the last hour and a half!

I really appreciate you caring and taking the time.

ChicagoGranny · Post by **ChicagoGranny** » Wed Jan 15, 2025 12:09 pm

I was concerned about the type of wedge you were using. You got the right one!

Georgio · Post by **Georgio** » Fri Jan 17, 2025 8:14 am

Good Morning,

Yes, that cushion is the right one I am still using it every night while recovering from sinus surgery and retitrating my CPAP requirement. While keeping an open mind about possibilities for new cpap direction, I decided to try the Airsense 11. It looked like it worked pretty well and I may be feeling a little more rested today. I should be able to address the leak with the ayer gel and snugging the mask a little. Time will tell. I thank you all so much for helping provide support!

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