Sleep Apnea Surgery - any experiences with UPPP?

[Rooster71]

I was diagnosed with sleep apnea three years ago and was prescribed a CPAP. I don't like using it, comfort issues sometimes make it ineffective. To make a long story short, I am scheduled to have UPPP and tongue reduction surgeries on December 1. Does anyone here have any experience with these? I have heard it it extremely painful for several days post-surgery.

[MrTrik]

I have no experience with this surgery. I am very interested in the outcome though. Please update the thread or PM me with experiences.

Good luck.

[Jeff W]

I'd get a second opinion before undergoing radical surgery.

[BigBaitsim (milo)]

I'd try a better/different CPAP before surgery. My wife has serious apnea, and recently switched CPAPs. This one is a MUCH more comfortable one with variable pressure and a better mask.

Then get a second opinion.

If better/different CPAP fails and second opinion agrees, get the surgery. Sleep apnea can really make life more difficult.

[fyodor]

I had that surgery for snoring. It was ineffective.

[Rooster71]

[ QUOTE ]
I have no experience with this surgery. I am very interested in the outcome though. Please update the thread or PM me with experiences.

Good luck.

[/ QUOTE ]
Thanks. I will keep you posted.

[Rooster71]

[ QUOTE ]
I'd get a second opinion before undergoing radical surgery.

[/ QUOTE ]
The second opinion really depends on what type of doctor I see. Respiratory docs almost always insist on CPAP's. ENT's will want to operate in many cases. Neurologists also work with apnea and most likely recommend CPAP.

[Rooster71]

[ QUOTE ]
I'd try a better/different CPAP before surgery. My wife has serious apnea, and recently switched CPAPs. This one is a MUCH more comfortable one with variable pressure and a better mask.

Then get a second opinion.

If better/different CPAP fails and second opinion agrees, get the surgery. Sleep apnea can really make life more difficult.

[/ QUOTE ]
I've tried several masks and have decided that I don't want to use a CPAP for the rest of my life. I have alot of other medical problems and this is an attempt to make things easier for myself over the long run.

I have read some bad stories about UPPP, but I have studied it alot. The medical profession generally says that the UPPP alone is a success in roughly 70% of cases. (I don't know how they define success) I think it is important to remember that if someone has problems with a CPAP that can't be reasonably fixed (allergies, comfort, etc.), then CPAP is not 100% effective either. Also, if the surgery can reduce the level of apnea from a severe to a very mild case where the CPAP is no longer needed, then I would consider that a success.

I have a large uvula (the fatty mass at the top back part of the mouth). When I am tired I can feel this blocking my air (when I am awake). When I used to drink, it would sometimes flap excessively when talking or laying in a certain position. IMO, if this obstruction were removed, my breathing would have to become easier.

Also, most articles I have read say that this surgery is most successful when performed with a similar surgery (to further correct the blocked airway). So the tongue reduction should help also.

My doctor also said that no matter what surgical procedures were performed that sleep apnea would probably be a problem again if I were to gain alot of weight. For other health reasons I have to control my weight, so that won't be an issue.

[LSUfan1]

Since sleep apnea can be a dangerous thing if untreated and you are uncomfortable with the mask, it seems that surgery would be the only other option. I would personally get your doctors definition of success regarding the surgery however, as you don't ever want to go under the knife if it is not going to be fairly helpful.

Good luck to you brother. My dad has a horrible time with his CPAP, but he is not willing to have the surgery at this point.

[astroglide]

it seems unlikely, but are you AT ALL overweight?

[Grisgra]

[ QUOTE ]
it seems unlikely, but are you AT ALL overweight?

[/ QUOTE ]

On that note, it's been shown fairly conclusively that those suffering from sleep apnea due to morbid obesity almost always have the sleep apnea resolve after bariatric surgery. Ditto diabetes. Not many people know that (they know that the surgery generally causes weight loss . . . but it usually helps resolve sleep apnea and diabetes as well.)

[astroglide]

i bring it up because i was far from morbidly obese but i recently lost a fair amount of weight. i apparently stopped snoring completely, and i used to jump up in bed every once in a while gasping for breath.

[Wingnut]

I too, suffer from this affliction. I've been on a CPAP for the last 6 years.

The original ENT that I went to suggested a UPPP, but also got me started on the CPAP. I got a second opinion from another ENT (who had been mentioned in the news regarding a new kind of surgery involving sound waves - not sure whatever came of that), and he confirmed the diagnosis of apnea, but determined that it was caused not by my uvula or palette, but that my tongue was falling back into my throat as I slept. The UPPP may have been the worst thing that could've happened to me, because it would've stopped the snoring, but not done anything for the apnea.

My point being, be sure that you have been diagnosed with the right kind of apnea. The procedure that led to my diagnosis involved putting a fiberoptic tube with a camera down my nose into my throat, and then videoing what happened when I attempted to breathe through my nose with it pinched shut. The doc even let me keep a copy of the tape. /images/graemlins/grin.gif I am confident that this is the correct diagnosis (or at least much more correct) because if I sleep on my stomach or sleep in any position with my head facing downwards (like in a chair with my chin on my chest), I don't have apnic episodes (I still snore, so it drives my wife nuts).

I spoke with another doctor in his practice, and he mentioned hyoid (sp?) bone surgery - this is apparently a small bone near the lower jaw that has tongue ligaments attached to it. It can be drawn closer to the front of the jaw, pulling the tongue with it. At the time, it sounded too radical, so I didn't pursue it any further (this was about 5 years ago).

Fast forward to today, and I believe (yet to be confirmed by anyone with MD in their name) that the years of CPAP therapy pushing my tongue out of the way (and into my lower teeth) while I sleep has given me somewhat of an underbite (which my parents so lovingly paid for correcting during my teen years). My front teeth scrape together sometimes when I eat, and I often find myself with my tongue between my teeth (muscle memory??) when I am just sitting around (and noticing such things). Even right this second I can't close my teeth all the way because the fronts are interfering with each other. After I go see my dentist next, I may have to reconsider the surgical options for apnea treatment.

Anyway, good luck to you, whichever route you choose. I'd be interested in knowing the outcome.

-David

[Rooster71]

[ QUOTE ]
it seems unlikely, but are you AT ALL overweight?

[/ QUOTE ]
I am about 5-8 lbs over my ideal weight. I am 5'8" and 168 lbs. About 10 years ago I started gradually gaining weight and reached around 190 lbs. Last year I lost the excess and wound up staying around 168 lbs. This has been an important factor in my decision to have the surgery. I lost 22 lbs with no noticeable improvement in sleep apnea.

[astroglide]

fwiw i'm 5'8" and 163 pounds. i look totally average, but i have excess material on my thighs and abdomen. i'm still dieting and i expect it will be around 150 pounds when i'm actually around my ideal weight. i know bodies vary widely. you would be challenged to tell the difference between me at 185 and me at 205, i generally carry weight great and have a 'fireplug' kind of build. it could be worth considering that you're not close enough to ideal.

gf observed that i snored the worst when i ended up sleeping on my back. i would think that position could impact something like apnea as well. have you tried focusing on a specific position, using stuff like tempurpedic head/knee pillows, and that sort of thing?

[fyodor]

I thought having the uvula removed was relatively basic and risk free surgery. As risk free as getting anesthetized gets anyhow. The only "downside" for me was there is a kind of snorting noise I am no longer capable of making. I remember that coming in handy on occaison.

[plaster8]

[ QUOTE ]
I spoke with another doctor in his practice, and he mentioned hyoid (sp?) bone surgery - this is apparently a small bone near the lower jaw that has tongue ligaments attached to it. It can be drawn closer to the front of the jaw, pulling the tongue with it. At the time, it sounded too radical, so I didn't pursue it any further (this was about 5 years ago).

[/ QUOTE ]

My doctor recommended this as the surgical option most likely to work. He told me they would break my upper and lower jaws, set them forward a bit and wire me shut for a month.

The success chances were "50-50." I decided to keep my CPAP. /images/graemlins/grin.gif

Ironically, I'm guessing that by wiring my jaw shut for 30 days, I'd be on the road to losing enough weight that sleep apnea wasn't a problem anymore. But I'm going to have to go the willpower route on that.