Nasal Surgery and Other Fun Stuff

[Sleepless in New Mexico]

I introduced myself in this forum this morning as the new guy. I had a couple of friendly replies and encouragement to share my OSA experiences and story. So you asked for it! I've had symptoms of sleep apnea as long as I can remember. Sharing a room with my brother as a kid, he would complain about my noisy sleeping habits. My wife of 25 years has always said she thinks I have some kind of sleeping disorder. It wasn't until I got into my mid forties and put on some weight that the lack of sleep began to bother me. I finally consented to have a sleep study done last May. I was diagnosed with severe sleep apnea. The best night of sleep I've had in years was the 5 hours of sleep the night of my study after they woke me and put on the cpap mask. I thought everything was gonna be great and couldn't wait to take delivery of my own equipment. I have been using a cpap (or maybe it's a bipap. Can't remember the difference) for about 10 months now. But, I have yet to sleep as good as I did in the sleep center. I started out using the mask that goes just over the nose but that wasn't working because I had difficulty breathing through my nose and my mouth would open and all the air rushed out. After trying a chin strap and hating it, I switched to the mask over the nose and mouth. That solved the problem with my mouth opening but I still wake up with headaches and the foggy brain feeling. Anyway, to make a long story even longer, I saw an ENT who wants to do nasal surgery in about 3 weeks. I'm getting a septoplasty and turbinate reduction done. I sure hope that helps. Has anyone had these procedures done and what was the result? Sorry for being so long winded. This will be the first and only time I will tell the whole story. It will be questions and comments and support for all the great people on this forum.

[rested gal]

Hi Sleepless in NM,

I've not had any surgeries done, but from reading apnea message boards the two you mentioned (septoplasty and turbinate reduction) seem to get "good reviews" for making it easier to use cpap by making it easier to breathe through the nose.

I'm not a doctor, but perhaps others would have some suggestions for you if you could find out the brand/model of your machine. Also, if you could tell us what pressure you were prescribed, that would help.

As for still having headaches and a foggy brain feeling... my guess would be that possibly the pressure is not enough. A sleep study, as thorough as it is, is just a one night snapshot of a person's sleep. I'm a big fan of using an autopap instead of a straight cpap machine, since the autopap (also called an "auto-titrating cpap") can be set for a range of pressure instead of just one straight pressure that may or may not be right for you all the time. The autopap will sense from your breathing what you need and will vary the pressure accordingly throughout the night. No guessing or wondering, "Is the pressure I was prescribed right for me?"

The machine I have is the Respironics REMstar Auto with C-Flex. C-Flex is a nice comfort feature that makes the pressure drop lower each time you exhale. It's also a good idea to have a heated humidifier, especially if you have a problem breathing through the nose.

The Puritan Bennett 420E autopap is another that I used and liked very, very well. It doesn't have a relief on exhalation feature, but is a great machine too.

Good luck, and let us know what your set up is, if you can.

[PamelaDV]

Sleepless ...

I just had the sinus roto-rooter done in December. I had it done because of chronic sinusitis and the sickness that results from that, but also in the hopes that it would help with my snoring and such. It didn't help much with my snoring, but I have seen definite benefits from being able to breathe better through my nose! I don't get sick near as often. And when I blow my nose because I'm a little stuffy - snot comes out! I know - sounds silly, but when blowing your nose wouldn't do much for you in the past - this is a wonderful thing!

I wish you luck in your surgery. Let me know if you have any questions about the actual procedure.

[hockeydad]

I had the roto-rooter done last November, and so far it hasn't been much of a success. I was told that if I had it, I wouldn't need to use the CPAP anymore, which has proven to be false. I still am using the CPAP (or should I say, have begun using it again).

However, there have been benefits. Like Pamela said, I can actually blow my nose and clear it now, small thing, but after years of not being able to, it is nice. I do find myself breathing easier through my nose during the day, and I have noticed an improvement in my breathing when playing sports.

But if you're getting it to "cure" OSA, don't get your hopes up. Hopefully it will make your CPAP more effective, but it won't make the whole problem go away.

Be warned, it hurts like hell. I had a section of my septum removed, the turbinate reduction, my tonsils removed, and my uvula reduced. When they say a 2 week recovery, it means a full 2 weeks. I barely moved off my recliner for the first week.

I was told, after my surgery, that its only effective 60% of the time. Its up to you to decide if those odds are worth it.

[Sleepless in New Mexico]

Thanks for the reviews/advice on the nasal surgery. I'm not looking forward to it but am looking forward to the results and hope that I too will be able to breathe better at night. Hockeyday, I had really never hoped that it would allow me to sleep without my cpap. I would consider that a miracle! If I can just start to sleep well with it, my life would be much improved. You're a brave man hockydad. My doctor says he doesn't usually like to do the nose and throat together in one surgery because of the pain involved. I will do the nose, give it time to heal then if still not breathing well, try the tonsils, uvula etc...
If I get get out of it is the "daytime" benefits of being able to breath through my nose it would be worth it to me.
Rested Gal, to answer some of your questions: After my first sleep study, I was prescribed a pressure of 12. I slept with that until a 6 month followup visit where my doctor prescribed 14 because I still wasn't sleeping. I didn't notice any change in my sleep. The mask seems to leak more at the higher pressure. I'm at 15 now and still not sleeping well.
I've read a lot of good things about the autopap machines. I should try to get my insurance company to get me one. I am currently using the Respironics Remstar Plus with the ResMed Ultra Mirage mask.
Thanks again for your responses and I'm looking forward to getting more great answers from this forum.

[hockeydad]

I don't know if I'd call myself brave for getting the surgury. Dumb is a better word. My doctor had mentioned the possibility of doing it in 2 seperate surguries, but he thought I was clogged up enough to warrant doing it all at once.

However, another contributing factor in his decision to do it all at once was my desire to not miss any more work than I had to. I thought, "Why recover from 2 surguries when you can get by recovering from just 1"? Dumb, dumb, dumb.

Turns out I was lucky though, my surgeon died unexpectedly about 8 weeks after my surgury, so I probably would have had a huge delay getting part 2 done while waiting for a new doctor to get up to speed.