Recently diagnosed - Extreme OSA

[vagabond007]

Hello everyone..

I am a new member here and had not even heard about sleep apnea few weeks back. When I complained to my doctor about heavy snoring and not getting quality sleep, he asked me to get tested for sleep apnea. 
Since I am 39 yrs old, 5' 8" height and 150lb without any major health p, my insurance denied sleep study in center and asked me to do home test.
I recently got the results of the study and turn out case of extreme OSA with 61 AHI and approx 20% of the time oxygen level below 90%.
My doctor told me that this was the most extreme case he has seen with my body type
He feels my tonsils are too large and needs surgery to remove them. 

I have an appointment tomorrow with ENT surgeon for follow up but my doctor thinks surgery is must in my case. 
i am still learning about sleep apnea and trying to read about various possible surgeries. Hope to learn from more experienced members here.

My main worry is, will any kind of surgery cure my problem or make it better? Any pointers on what questions I should ask to ENT surgeon? 

Appreciate your help !!

[Walla Walla]

I'd ask to be put on a Auto CPAP machine and see if that solves the situation first. I think surgery should always be a last resort.

A lot of people have had surgery and still ended up on a CPAP machine.

[Hojo]

Can you do another home sleep study with a cervical collar to see if that helps line up your trachea, and with a flatter pillow (if you have a big pillow).

[mrkdilkington]

Two pieces of advice from someone who has had several surgeries:

1) Depending on a lot of different factors, MMA/corrective jaw surgery may be a good first-line treatment (possibly the best in some cases), so in addition to the ENT, I'd recommend seeing a jaw surgeon or two who also does telegnathic surgery.
2) When going the ENT-based surgeon route, it's best IMO to find an ENT who is heavily specialized in sleep surgery and has a lot of experience doing that. These type of ENT's can do a 'drug-induced sleep endoscopy' to pinpoint where your problems occur. You may need multi-level surgery that targets different parts of the upper airway, and a DISE is helpful for that. They will also know far more/newer procedures than a garden variety/general purpose ENT who dabbles in sleep surgery. Some sleep surgeons are ENTs and also do MMA/MME - these are great surgeons to use because you can potentially do many procedures with them, one at a time until you're cured.

This is the best resource I've found that covers almost all OSA surgeries available: http://sleep-doctor.com/surgical-treatment-overview/

[Sleeprider]

I like Walla Walla's suggestion. Severe obstructive apnea will not be cured by a tonsillectomy. You will still need CPAP. Please get the auto CPAP, preferably a Resmed Airsense 10 Autoset, and get started on your therapy right away. You can decide if the results are good enough, or if you want to pursue surgery. Your new machine will give you a sleep test every night, showing the number and types of events. You should see a significant improvement. Decline the evaluation for surgery until you have the therapy in hand, so you have a fair basis to compare the improvement.

There are more people here with your physical size and severe OSA, and some that found they had complex apnea. Doctors really need to get over the "surprise" a thin person can have sleep disordered breathing.

[Gary1of2]

I had my tonsils and anoids removed and I still have to use cpap. Tonsils removal really is pain full fir about 2 weeks.

[Kryogen]

You have a retruded lower jaw?

[trish6hundred]

Hi vagabond007,
WELCOME! to the forum.!
I would only do surgery as a last resort. At least give CPAP a try.
Good luck to you on your decision and keep us posted on how things go.
Hang in there for more responses to your post.

[KCFLY]

I've had my tonsils, adenoids, uvula, and some soft palette removed.  

After all that, my AHI at a sleep center for a study was still in the "severe" range.

Bottom line, get the APAP machine.  Save yourself some time and pain.

Good luck!

[HalfAsleep]

I’ve had the surgery that pulls the lower jaw forward. I wouldn’t recommend it to anyone that can get apnea addressed by other means; this is not a minor surgery at all, and you may be in serious pain for the rest of your life.

People seem not to appreciate that jaw surgery changes your face.

Yes, I have sleep apnea, jaw surgery notwithstanding.