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Sudden Spike of OAs
#1
Question 
I am recovering from a septoplasty and turbinate trim. My OA count has spiked from nothing to huge (night before last was 1 hours, 6 minutes in apnea). I feel like I have been dragged out of a coffin!

I don't think this is directly related to (caused by) the surgery. Nor do I think it is permanent. My best guess is that the injury, clogged nose, or FFM is making me chin tuck and thus closing off the airway. I got a cervical collar today which I will try tonight. I am posting some SleepyHead images in case someone has alternate theories.

The way it was:
[Image: kBAut34.png]

The way it is:
[Image: pYdYuLZ.png]

Close up of OAs:
[Image: pkYCOWF.png]

Thanks
Chuck
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#2
Well, the cervical collar made no difference. I took the dressing off my nose to reduce mask leaks and at least some come kind of sleep for larger periods. My next guesses are that as the Anti-Frank nose breather that I am closing my mouth and trying to suck air though my blocked nose or that mouth breathing is causing something like swallowing my tongue. I don't notice any feelings like that.
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#3
Two things jump out at me. When your AHI was low your leak graph is smooth and your pressure never approaches the max of 14.

When your AHI was high the leak graph is jittery and the pressure is often approaching and reaching the max of 14.

Did you take any medications that may have caused your throat muscles to relax more or cause you to sleep on your back only on the night when your AHI was high? Any kind of a sedative, including alcohol, can do that.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
Thanks for the reply. I am not on any medications or drinking more since the surgery. I have no pain so I am not taking any sort of pain killers. I hate sleeping on my back so that is not it.

The higher leak rate is from the dressing that I had on my nose. The tape extended under the mask (F&P Simplus) and the size of the dressing affected the seal. I took it off in the middle of the night last night which resulted in a much better seal but no change in the OA.

My guess is that the higher pressure is in response to the higher numbers of OA and other events. I get the splints out next Wednesday, so hopefully that will end this if I have not resolved it before then.

I miss sleep!
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#5
Just so you know, the Amara View is a full face mask that doesn't sit on top of the nose, it goes under it. Using something like that is probably the only way you'll ever get the sore to heal. After mine healed I went back to my Simplus. It's the best fitting mask I've ever used, and I particularly like the fact that it leaves no marks on my face.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
There is no sore, the surgery was inside the nose. The dressing was just to keep the... uh, gore from leaking into the mask. Big Grin But it is mostly dry now. I am going to try a "Snore Guard" tonight to see if that makes any difference. I had a nap this afternoon. Just as I was drifting off, the machine spiked to 14 again and blew the mask around. We need an emoticon for a Mask-berry sound.
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#7
After my jaw surgery, my face was swollen up to the size of a watermelon. Although your surgery was less severe, perhaps it results in internal swelling?
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#8
There is internal swelling, but I think it is all in my nose. My throat does not feel any different.

After a night with the snore guard, I am ready to declare that I Am The Anti-Frank! Objectively my AHI is still above 9, but half of what it was before. Subjectively, I got a much better night's sleep. I don't feel well rested, but I don't feel like a freshly re-incarnated zombie either. I think my lizard brain really wants to breathe through my nose, blocked as it is. So it tries to strangle me every couple of minutes to see if it can. The snore guard keeps my teeth apart and makes it harder to close my lips. Not that my lizard brain was not struggling to close them according to Sleepy Head (and assuming the machine was scoring a clogged nosed and closed mouth as an OA). A few more nights of this and I should be able to breathe normally again. On the bright side, this suggests that the surgery might result in better sleep too if I struggle less to inhale through my nose.
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#9
Hi Chill,

Your doctors advised it was okay to keep using CPAP during recovery period?

How about after the nose pack will be removed? (There will still be a recovery time after the nose blockage is removed.)

The operation was only inside the nasal passages, not in the throat at all?

In any case, it may help to sleep during the recovery period in a comfortable reclining chair using the cervical collar. This may elevate the head enough to help prevent tongue from falling back and closing your throat. Would be better than back sleeping, but not sure if would be better than your usual position(s).





Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#10
My doctor advocated for use of CPAP in the recovery room! Big Grin I had the packing pulled out this week and the splints come out next week. The surgery was only in the nose, just a septoplasty and trim of the lower turbinates.

I have very little chance of sleeping sitting up, even in a recliner. I will doze a bit on long haul flights.
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