Ok I have a question about deviated septum surgery but some back story first.  I am 28 and about 3 years back I was getting lousy sleep and was exhausted all day.  I had brutal headaches in the morning too.  I was waking up in the morning gasping for air at times and I also could not breath at all out of my nose.  Was recomended for a sleep study.  The experience was brutal, I tried CPAP during the study and I felt like the room was closing in.  I tried CPAP both with the mask over my nose as well as the plugs up my nose.  

The results came back that I had sleep apnea, I can't remember the severity of it.  My ENT suggested surgery, removing my tonsils and deviated septum.  As the day got closer I decided to just go the tonsils and passed on the septum.  After the surgery I felt great and while once in a while I might have woken up a little groggy, it seemed to have passed.  No more headaches or gasping.  I did not do a follow up sleep study.  

Now in the past few months I've noticed I wake up feeling a bit out of it sometimes, similar to the feeling I used to have.  Not even close to as severe but I notice I am not getting quality sleep anymore.  So I've decided to try the deviated septum surgery and if that doesn't help finally turn to CPAP.  

I have a question about the septum surgery though.  When I feel like I can't breath, I kind of freak out.  I can't breathe well through my nose but I can enough to know its working.  My doctor has told me that after the surgery my nose will be packed and it will not be functioning at all.  This is causing me a great deal of anxiety.  I have asked him if this would affect my sleep apnea at all and he said no.  Still I have concerns.  So my question is to people who have had the surgery.  Did you find breathing afterwards difficult?  Is it possible to have no packing in your nose?  What are peoples thoughts?  I was gung ho about doing this but now I am having second thoughts due to anxiety.  Thanks for listening!

The deviated deviated septum won't affect your sleep apnea; getting it fixed will probably make it much easier to use a nasal CPAP mask.  Make sure that you get a sleep study done after your septum surgery heals.

Quote:

Ok I have a question about deviated septum surgery but some back story first.  I am 28 and about 3 years back I was getting lousy sleep and was exhausted all day.  I had brutal headaches in the morning too.  I was waking up in the morning gasping for air at times and I also could not breath at all out of my nose.  Was recomended for a sleep study.  The experience was brutal, I tried CPAP during the study and I felt like the room was closing in.  I tried CPAP both with the mask over my nose as well as the plugs up my nose.  

The results came back that I had sleep apnea, I can't remember the severity of it.  My ENT suggested surgery, removing my tonsils and deviated septum.  As the day got closer I decided to just go the tonsils and passed on the septum.  After the surgery I felt great and while once in a while I might have woken up a little groggy, it seemed to have passed.  No more headaches or gasping.  I did not do a follow up sleep study.

Tonsillectomy for OSA in adults is even less effective than a UPPP, which has dismal success rates. I suspect that you got a 'bounce' effect and your apnoea has now fully returned.  

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Now in the past few months I've noticed I wake up feeling a bit out of it sometimes, similar to the feeling I used to have.  Not even close to as severe but I notice I am not getting quality sleep anymore.  So I've decided to try the deviated septum surgery and if that doesn't help finally turn to CPAP.

Correcting a deviated septum won't do anything to improve your apnoea. As Bearded One has posted it will make it easier to use cpap.

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I have a question about the septum surgery though.  When I feel like I can't breath, I kind of freak out.  I can't breathe well through my nose but I can enough to know its working.  My doctor has told me that after the surgery my nose will be packed and it will not be functioning at all.  This is causing me a great deal of anxiety.  I have asked him if this would affect my sleep apnea at all and he said no.  Still I have concerns.  So my question is to people who have had the surgery.  Did you find breathing afterwards difficult?  Is it possible to have no packing in your nose?  What are peoples thoughts?  I was gung ho about doing this but now I am having second thoughts due to anxiety.  Thanks for listening!

If your septum is badly deviated then having it corrected will allow you to breathe easier, and will help with cpap. It won't cure your apnoea.

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Beebop wrote:

Did you find breathing afterwards difficult?  Is it possible to have no packing in your nose?  What are peoples thoughts?  I was gung ho about doing this but now I am having second thoughts due to anxiety.  Thanks for listening!

In case you missed it there's a long thread on this subject where many people have shared their experiences and had their questions and concerns addressed.  If you're going to go through it, might be worth checking out just to better prepare yourself.  Reading through it is what convinced me to have this surgery early last May - and despite all trouble, I am so very, very glad I did.  For the first time in over 20 years, I have finally stopped tearing up my bed sheets during the night.

To answer your questions, though, it is impossible to breath through your nose on the first day because of the packing.  In fact, the first day, for me at least, sucked.  I'm not sure if it's possible to do without the packing, but I'm pretty sure you want it because I was told that there are numbing agents in there which help with the pain relief, which you'll definetly want.  But each successive day gets better.

After having the packing out on the second day, I could breath through my nose - just a tiny little bit, though.  Doing sinus irrigation two or three times a day definetly helped, though, and by the time I had the splints out I could breath through my nose almost as well as I could before the surgery.  If you don't know about sinus irrigation, make sure they explain that to you, because it really helped a lot even the first time I did it, after having the packing out.  But even though the first day sucked and several days afterwards weren't all that great, it was 100% worth it.  

If you really think this procedure would help you, I wouldn't let fears about anxiety stand in your way.  Not being able to breath through your nose is at the very least uncomfortable for anyone, but you can get sufficient air just by breathing through your mouth.  

You might want to raise your anxiety concerns with your doctor, though, and see how he would feel about giving you something to help with that, like xanax or valium, just in case you do need it.  The pain killers will probably help with that, anyway, but it couldn't hurt to ask.  Aside from that, all I can say is to make sure you've got some of your favorite DVD's handy, keep a good stock of ice chips handy for the first day especially, and just be a patient patient.

Hello, I am a UK citizen and over here we are years behind the US in sleep related problems and in particular OSA and CSA. I had the same problem as you with a deviated septum which restricted my air intake and caused me night after night to dispense with my CPAP nasal mask and either switch to the full face mask or attempt to manage without it. This caused a lot of stress and additional symptoms so I searched the internet for a solution, the obvious one being surgery, I found a clinic in Harley Street (this is the Mecca of English medical practitioners and very expensive). This clinic offered laser treatment called the LAUP which is targeted at snorers (not OSA patients) you can find it here http://www.theprivateclinic.co.uk/microsites/snoring/index.php my conclusion was that if I could breathe through my nose then CPAP would control my OSA more efficiently. I had the operation last November under local anaesthetic (it took 20 minutes and cost $3,500) the surgeon burnt away in 4 places, some flesh and some bone to make parallel passages. It wasn’t pleasant but the anaesthetic worked and it was quick. There was no nasal packing and although my nose was swollen I wore my mask that night. I would imagine that this type of laser surgery is widely available in America. Everything went fine and I was recommending it to everyone I know and still do because I can see the advantages for normal people. Unfortunately for me I am not normal. I am the exception who produces so much scar tissue that now months down the line the passages have narrowed again. Good Luck on whatever you decide to do ….English Eric

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Hello, I am a UK citizen and over here we are years behind the US in sleep related problems and in particular OSA and CSA. I had the same problem as you with a deviated septum which restricted my air intake and caused me night after night to dispense with my CPAP nasal mask and either switch to the full face mask or attempt to manage without it

.

I disagree with you on the level of expertise available in the UK. While I am not a UK resident, I have attended quite a few conferences (on Sleep Apnoea) in Oxford/London and Edinburgh and would argue that the expertise is certainly there, however the NHS has failed to resource it properly. From a research point of view the sleep laboratories in Cambridge and Edinburgh are second to none, while the work carried out in Loftbourough University is at the cutting edge of sleep medicine.

The lack of proper funding/resources by the NHS has allowed private medicine to fill the void. Unfortunately these private practitioners are not controlled/governed at anything like the level of guidelines applied to 'public' medicine practitioners. The actual level of success/failure is not reported, by private practitioners, at anything like the level demanded from 'public' medicine. In Ireland, a similar situation is developing with a large influx of private sleep medicine practitioners. Thankfully a professional group has been formed to 'attempt' to police this industry.

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This caused a lot of stress and additional symptoms so I searched the internet for a solution, the obvious one being surgery, I found a clinic in Harley Street (this is the Mecca of English medical practitioners and very expensive). This clinic offered laser treatment called the LAUP which is targeted at snorers (not OSA patients) you can find it here http://www.theprivateclinic.co.uk/microsites/snoring/index.php my conclusion was that if I could breathe through my nose then CPAP would control my OSA more efficiently.

I am glad that it was pointed out to you that the LAUP is targeted at snoring and not OSA. Unfortunately some of (what I class as cosmetic type clinics) sleep specialists sell this procedure as a cure for OSA.
Unfortunately it has a poorer result than UPPP in 'curing' OSA, and medical events points towards unsuccessful 'curing' of snoring........whether months or years post operatively.

Quote:

I had the operation last November under local anaesthetic (it took 20 minutes and cost $3,500) the surgeon burnt away in 4 places, some flesh and some bone to make parallel passages. It wasn’t pleasant but the anaesthetic worked and it was quick. There was no nasal packing and although my nose was swollen I wore my mask that night. I would imagine that this type of laser surgery is widely available in America. Everything went fine and I was recommending it to everyone I know and still do because I can see the advantages for normal people. Unfortunately for me I am not normal. I am the exception who produces so much scar tissue that now months down the line the passages have narrowed again. Good Luck on whatever you decide to do ….English Eric

Unfortunately the LAUP is available pretty much everywhere. Your experience is fairly typical of results.........it can be months or even a year or two. There is no real 'cure' for snoring (not long term anyway)..........except of course CPAP.

I am sorry that you were hit for $3,500 for an 'in house' procedure. One thing about Harley Street is they do know how to charge.

Best of luck.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Daniel, I see that you have posted almost 3,000 entries and probably consider yourself an expert, you come across like a medical man and your mission is to tell the world that the British NHS is the greatest and it IS NOT!. Like you I have attended conferences in Leicester, London and Oxford with the self proclaimed top experts who I could name and you would know. In addition I have had sleep studies in all of these cities under the guidance of the very same experts and I have paid huge sums to hear their wise words. I am not a believer or supporter of the NHS (like you) and my piece was an attempt to give an alternative for consideration and did not expect to be cut off at the knees. English Eric

EnglishEric wrote:

Daniel, I see that you have posted almost 3,000 entries and probably consider yourself an expert, you come across like a medical man and your mission is to tell the world that the British NHS is the greatest and it IS NOT!. Like you I have attended conferences in Leicester, London and Oxford with the self proclaimed top experts who I could name and you would know. In addition I have had sleep studies in all of these cities under the guidance of the very same experts and I have paid huge sums to hear their wise words. I am not a believer or supporter of the NHS (like you) and my piece was an attempt to give an alternative for consideration and did not expect to be cut off at the knees. English Eric

Eric,

I think you misunderstand the purpose of a public forum.............it is to give opinions, and if one is in disagreement one should post their feelings.

The NHS is certainly not the greatest, but within every !@#! organisation there is good also. I certainly do not support the NHS, never have.........but I believe that the good should also be aired. Your comments concerning the NHS are quite broad and in areas of sleep disorders and their management the NHS is completely under resourced............but, as I have posted in the past, there are some of the world's top sleep specialists working within that system.

I also recently posted details of new clinical guidelines and costings to bring sleep medicine (in the NHS) up to and beyond standards in any other country. This paper from NICE even attacks waiting lists and offers a schedule for clearing them over a 5 year period...........no other country has gone this far.

I note that you have had numerous sleep studies in various centres...........if they were unsatisfactory, have you complained ?

You did indeed give an alternative, at a cost of $3,500 in a private clinic. The particular procedure has been around since about 1997 or so. The cost would be prohibitive for most.

I did not intend to cut you off at the knees, but you offered and recommended an alternative, that has a dismal success rate (long term) for snoring, that didn't work for you.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)