I was reviewing my sleep study and I have an AHI of 80.  The part I find interesting is that I had a total of 26 apneas and 140 hypopneas.

I wonder, since the vast majority of my events were hypopneas and I need a pressure of 19 to clear it, is it possible that it's my tonsils, adenoids and soft pallet causing this?  

My tonsils are huge.  Have any studies been done to correlate hypopneas to oversized tonsils?  If some air is getting through (hypopnea), would it be reasonable to assume my tonsils are causing a lot of the blockage and by removing them, open a lot more room for air to travel through?

My pressure setting is 19 which is really high and I can't help but wonder if a UPPP + Tonsilectomy would help in reducing, if not eliminating the OSA altogether.  Even if I could reduce it I feel that I would be able to tolerate it a lot better.  I really don't have a problem with wearing the headgear but the pressure is so high that I have bad problems with leaking.  I use the ramp feature which starts at 11 and my mask feels very secure.  If I turn the machine on to 19 it really doesn't take a lot of movement before it will start leaking.

I understand the surgery doesn't always fix the problem but if I could significatnly reduce it I would highly consider it.

Thoughts?

Given your situation if your tonsils are huge as you say then by all means have those tonsils removed!!! HOWEVER, the UPPP surgery is an entirely different ball game and I would caution you to explore this surgery, the risks and possible consequences before committing yourself to it AND I sure as the devil would be darn careful in selecting the surgeon PLUS I would want to know what measures he uses to define "success" and his success rate. Stanford U in CA is supposed to have one of the highest success rates in the country for UPPP surgery and I've read of those who've had UPPP done there and even so regretted it. Plus I've read that having UPPP surgery done in stages is often the most successful long term - but the thought of that painful of a surgery not just more than once but several times is enough to cool my interest!!! But then, thank goodness, altho it has taken some doing and quite some time, bi-level therapy is finally working for me.

That many hypopneas could indicate that you need one of the more sophisticated xPAPs than "just" a CPAP.


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.

Would you mind explaining why UPPP is risky compared to a regular tonsilectomy?

Why would many hypopneas indicate I would need something more sophisticated then a regular cpap machine?

Thanks for your response!

As I understand excessive hypopneas can be an indication of UARS (upper airway resistance syndrome).

Read up on UPPP. Just do a search on it in this forum and other apnea support forums. It is a DRASTIC surgery with a LONG recovery period AND can leave you still needing CPAP but unable to get as good a therapeutic response. You can be left w/swallowing problems, you can also be left w/problems of food and liquids going into your nasal passages.

AND you will find more surgeons who have done more tonsillectomies than you ever will find have done as many UPPP surgeries! I takes a VERY special surgeon to do a successful UPPP and as I said earlier, make sure you know what the surgeon considers success. I doubt it will be the same definition of success as what you are looking for.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.

I see.  I'm reading about MMA surgery too and that sounds like it has a much higher success rate although the recovery sounds long.

Good luck, whatever you decide!!


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity mask, ResScan 3.7, S8 ResLink, Embla oximeter.