surgery vs. cpap machine

I agree with all on this topic. My doctor suggested looking into the surgery but what does a family practice doc know about OSA? I talked the nice folks that did my sleep study last year that they said even if the surgery was "successful" I would still need to remain on CPAP but a lower pressure. FORGET IT!

Everybody repeat after me, "I love my CPAP mask and thank God for the difference it is making in my life!"

A red mark on my nose every once in awhile is much easier and less painful than a 'snip, snip, cut, cut'.

Jeff in TN

I can tell you from experience, I had the surgery & it only helped for about 6 mon & frankly the old saying " no pain no gain" does not apply in this case, had it to do over again I wouldn't.

I am so confused right now -- not for lack of information on UPPP surgery, but rather because I am so desperate for a good night's sleep that I am willing to try the UPPP surgery. I know it's very painful -- I've read everything on it I can find and I've talked to someone who had it. But after 5+ months using the CPAP and trying four different masks (finally found one that works), I'm still not sleeping through the night with the mask on. I'm waking up with the mask in the bed with me, on the floor, on the nightstand, but not on my face. Sometimes the machine is still running, sometimes it's been turned off and the mask is hanging where I usually put it. I almost never remember taking it off. The longest I've slept with the thing on me is 5 hours and that's with taking an Ambien.

All of this said -- I'm not one for severe pain. I've had my share of surgeries, so I know what real pain is. But I am so tired of being tired! When I did my sleep study I was told I'm getting .1% out of 25% for stages 3 and 4 sleep (restful sleep). It's no wonder I feel like I've been dragged through the yard, is it?

My doc says 50-65% "success" rate for the UPPP. Right now I'm thinking that's more than I'm getting right now with the CPAP. Yes, the CPAP has been adjusted about 4 times. I don't know what else to do!

Thanks for listening.

My Experience with apnea surgery.

I have had sleep apnea as long as I can remember. They figured it out about 27 +/- years ago and I got my first c-pap. I then had the sp? uvup surgery and it did not help much. Some time later the doctor said they did not cut enough and that there was scar tissue. They did it again. It did not help much if at all.
Some time later they said there was another surgery that would help so I had spelling? mandular advancement and hyoid suspension. That is the one that advances the tongue. It did not cure my sleep apnea. I still use a bipap machine. Right now I am operating at 20 /18. I do not know what my settings would be if I did not have any surgeries. It could be higher and possibly lower. The first two surgeries took some time to recuperate but I remember I went back to work after 3 weeks the first time(quicker than most). The second was a few weeks longer. The third was rougher. The procedure is to slit the skin across between the mouth and chin then saw a square thru the jawbone the bone in the center connects to the bone that the tongue is hooked to. That bone is then shaped so that it can slide forward thru the square opening in the jaw sliding the tongue forward with it. A pin is then inserted thru the jaw and the bone protruding thru. The protruding bone is then trimmed flush with the front of the jaw bone. I think they slid it forward between 1/4 and 3/8 inch but I am not sure anymore. I do not know how they did the hyoid suspension. I was always concerned that the bones would not fuse properly but I have never had a problem. They may do the surgery differently now.

The advancement surgery makes sense in theory to me but for some reason it did not cure my apnea. I still use a nasal mask but have always had trouble controlling mouth breathing. I wear a snorban dental device along with a chin strap. Since I found this forum I an now experimenting with taping and it seems to help. Since I am at 20 I will need to upgrade to a machine with higher pressures in case I may need it. I have no problem breathing at 20.

Would I recommend surgery. Not for me again. If they have improved the GA surgery and possibly move the tongue further forward I think it might work but I would only do it if normal cpap treatment does not work correctly and I thought that I was going to lose quality of life for a number of years if I did not have surgery.

I am lucky because I am doing fine when my treatment is working properly and I am not mouth breathing etc.

My wife said she read about another surgery. If my treatment was not working I would at least read about it and study results from surgery patients.

GeneS

[quote="genevaraye"]I am so confused right now -- not for lack of information on UPPP surgery, but rather because I am so desperate for a good night's sleep that I am willing to try the UPPP surgery. I know it's very painful -- I've read everything on it I can find and I've talked to someone who had it. But after 5+ months using the CPAP and trying four different masks (finally found one that works), I'm still not sleeping through the night with the mask on. I'm waking up with the mask in the bed with me, on the floor, on the nightstand, but not on my face. Sometimes the machine is still running, sometimes it's been turned off and the mask is hanging where I usually put it. I almost never remember taking it off. The longest I've slept with the thing on me is 5 hours and that's with taking an Ambien.

All of this said -- I'm not one for severe pain. I've had my share of surgeries, so I know what real pain is. But I am so tired of being tired! When I did my sleep study I was told I'm getting .1% out of 25% for stages 3 and 4 sleep (restful sleep). It's no wonder I feel like I've been dragged through the yard, is it?

My doc says 50-65% "success" rate for the UPPP. Right now I'm thinking that's more than I'm getting right now with the CPAP. Yes, the CPAP has been adjusted about 4 times. I don't know what else to do!

Thanks for listening.

Cutting and pasting (from a previous thread) my standard reply to "I take the mask off in my sleep!", here goes:

-------------- BEGIN QUOTE -----------------

Simple solution: before going to sleep, touch your mask and look at your clock radio. Say 3 times, "I will not take off this mask before (intended wake time)". Then say to yourself, "If I want to take off the mask, I have to look at the clock. If it's before (intended wake time), I WILL NOT take off the mask." Then do the first phrase 3 more times. Be looking at the clock the whole time.

This reprograms your subconscious, in a sense anyway. When you wake up at night to take off the mask, you'll look at the clock, see it's not time yet, and leave it on. You will usually remember NONE of this process, but it does occur. Weird but interesting, no?

Works on the same principle as looking at your clock radio and saying to yourself 3 times: "I will wake up at (intended wake time)", which many people have tried, and which works a surprisingly high percentage of the time, plus or minus 5 minutes or so.

It sounds silly, but it works, it really works (for most folks). Try it!

----------------- END QUOTE -----------------

GeneS, I'm sorry the surgeries you've had didn't work out well for you.

One clarification about something you said here:

GeneS wrote:Some time later they said there was another surgery that would help so I had spelling? mandular advancement and hyoid suspension. That is the one that advances the tongue. It did not cure my sleep apnea.

From what you described about the surgery to pull your tongue forward, that sounds like the genioglossus surgery...not moving the jaw itself forward.

Doesn't sound like you had maxillomandibular advancement (MMA) surgery, which is considerably more drastic than advancing just the tongue (as drastic as that is, too.) The entire jaw (not just the tongue) being surgically moved forward is the surgery with the most success rate..about 95% or better for the MMA, as I understand it.

MMA, as well as the lesser surgeries (UPPP, GA, etc.) is described very thoroughly by a poster on TAS nicknamed Billinseattle. Discussions with many of his posts are in the bottom third of the page at this link:

Clickable LINKS to surgery, turbinates, Pillar, TAP experiences
viewtopic.php?t=2836

Also of interest at that link are the two articles at the top, pro and con about "surgery" for sleep apnea. The article by Dr. Barbara Phillips is the side I'd land on... except regarding MMA surgery.

Thankfully, I do great on "cpap" and found the mask that suits me very comfortably, so I'm not looking at any kind of surgery myself. If I were, one that I'd absolutely NOT have done would be UPPP...which is the operation most doctors and others probably think of when they think "apnea surgery."

Hope things get much better for you, Gene, and for everyone else struggling to make cpap work.