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[Symptoms] CPAP or jaw surgery?
#1
CPAP or jaw surgery?
Hi, im almost 100% sure I have sleep apnea. My jaw bite is not perfect, my tongue slides into the back of my throat when im 100% relaxed. So what happens is, I have to conscientiously keep the tongue in a way that is not blocking the air pathway, which means, im not 100% relaxed and I remain alert during sleep (because otherwise I choke). This makes me being aware at all times, since I have to keep the tongue posture forward, I have also to not have my head looking down since the tongue presses in the upper back and blocks it even further. The fact my jaw is a bit recessed doesn't help, and perhaps upper maxilla would need counterclockwise rotation. In anycase, while I would like the aesthetic improvements of jaw surgery, the post surgery is too brutal. If I could get a good sleep with CPAP I would deal with it, however, there's the question:

What happens if my nose is stuffed?

If it wasn't enough, I typically also have one of my two nostrils stuffed at some point during the night, and worst case scenario, the nostrils become completely blocked. In the case I manage to fully fall asleep, chances are my tongue is in this relaxed positiion described above, resulting in it blocking the air pathway, this would resolve in I guess you going into the last resort: mouthbreathing. However, what happens if I was wearing a CPAP mask? Im not familiar with how they work yet, but I remember seeing some video and apparently they push air to make you keep your mouth shut so you are forced to breathe through your nose. But what if I have a night where im fully stuffed? there's no way out. Mouth is shut, nose is stuffed, what then?

Another thing that concerns me is that I remember reading some horror story about CPAP usage. The firmware was outdated, or the setup was wrong or something, point being, it resulted in some sort of injury.

This makes me wonder if I should go all in with the jaw surgery and hope it gets fixed and I could live without a CPAP.

While I wait for my appointment, I would like to test at home with some device. What could I buy specifically? I know you can use an oximeter, one of these you pinch in your finger, and you get a log of oxygen saturation % and BPM. If I get some outrageous results I may be able to show up with this data and accelerate the appointment. I could also just pay for a private clinic to go faster. My mom im almost 100% sure has sleep apnea since I remember hearing the characteristic start-and-stop struggling snores at some point. Seems like the same as me: trying to breathe while the tongue is block the pathway.

I have tried sleeping on all possible positions, and I cannot find a way for this not to happen. For some reason, when im fully relaxed the tongue just decides to rest in a way that blocks the air. Like I said before im not sure if it's due not having the jaw and maxilla properly positioned. I can post pics later.

Sorry for the long post but im trying to decide what's best and start as soon as possible, im feeling specially zombie mode today. I have heard stories of people improving a lot once they fix their sleeping quality and I can't wait to get started.
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#2
RE: CPAP or jaw surgery?
Get the CPAP machine. The humidifier will help with sinus congestion. The trick is to put the machine on auto with temp and humidity so that there's good amount of humidity to prevent nasal congestion. I've had issue with waking up in the middle of the night likely due to reduced air flow, and I come to find it it's due to sinus blockage from dry air.

I believe that CPAP isn't just for people with high AHI, but people that has issues with sinus congestion. The humidifier is what is really beneficial in such cases. The way you get humidity is through the mask, so it's much more effective than a room humidifier.

I don't know why there isn't a dedicated humidifier like CPAP for people suffering from nasal congestion during sleep.
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#3
RE: CPAP or jaw surgery?
That reminds me of an early appointment with a sleep doctor and surgeon.  I didn't fit the traditionally diagnosed patient profile.  I didn't have one core problem that was causing my severe sleep apnea.  It was a little bit of many body issues that were slightly irregular, such as a slightly larger tongue, slightly narrower breathing area, slight jaw misalignment, slight teeth misalignment, slight nasal misalignment, nose gets easily stuffed up, etc.  Altogether, they contributed to severe sleep issues later in life.

So, the list of surgical adjustments was significant, along with possible consequences to each adjustment.  For example, my voice might change, I might choke on food more often, etc. etc.  Plus, some apnea might remain even afterwards.  

So, sleep studies and CPAP became the “easy solution”.
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#4
RE: CPAP or jaw surgery?
Schedule a sleep study, then you will know whether you have apnea or not. I know nothing about jaw issues, but even if you had jaw surgery done it may or may not help with your sleep.
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#5
RE: CPAP or jaw surgery?
(05-14-2022, 01:04 PM)WakeUpTime Wrote: That reminds me of an early appointment with a sleep doctor and surgeon.  I didn't fit the traditionally diagnosed patient profile.  I didn't have one core problem that was causing my severe sleep apnea.  It was a little bit of many body issues that were slightly irregular, such as a slightly larger tongue, slightly narrower breathing area, slight jaw misalignment, slight teeth misalignment, slight nasal misalignment, nose gets easily stuffed up, etc.  Altogether, they contributed to severe sleep issues later in life.

So, the list of surgical adjustments was significant, along with possible consequences to each adjustment.  For example, my voice might change, I might choke on food more often, etc. etc.  Plus, some apnea might remain even afterwards.  

So, sleep studies and CPAP became the “easy solution”.

I also have sligthy crooked teeth on the lower end, and also slight nasas misalignment, not sure how big the tongue is relative to the maxilla. I have geographical tongue since a year ago, some marks appear on the tongue and move around for some reason, drs have no idea about that, just another annoyance for the package.
I take 75mcg eutirox before sleep to improve thyroid function. So coupled with subpar sleep zombie mode is enabled during the day. Specially when I wake up. I feel better at the end of the day when I should be sleepy.

What did you results exactly show?

Did you improve with the CPAP? What do you do if you have a stuffed nose in the middle of the night while wearing the mask?

(05-14-2022, 12:40 PM)CorruptAlligator Wrote: Get the CPAP machine. The humidifier will help with sinus congestion. The trick is to put the machine on auto with temp and humidity so that there's good amount of humidity to prevent nasal congestion. I've had issue with waking up in the middle of the night likely due to reduced air flow, and I come to find it it's due to sinus blockage from dry air.

I believe that CPAP isn't just for people with high AHI, but people that has issues with sinus congestion. The humidifier is what is really beneficial in such cases. The way you get humidity is through the mask, so it's much more effective than a room humidifier.

I don't know why there isn't a dedicated humidifier like CPAP for people suffering from nasal congestion during sleep.

Can you recommend the best humidifier? also, how do I measure the actual humidity in my room to get an idea what im doing before blindly just enabling an humidifier?

Btw I have an air purifier, Levoit Core 300. I was using it all day but I read some study that HEPA filters can push endotoxins into the air... so now I don't know what to do with it. I thought it would make sense to use since my room has poor ventilation, but now im not sure, so I use it for a while when I wake up to move the air around but not all day.

Also, can you recommend a device to do a sleep test at home while I wait for an appointment? something that would help me gathering proof I have subpar sleep.
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#6
RE: CPAP or jaw surgery?
I was actually recommending getting a CPAP to use it's humidifier since it's very effective. I don't have experience with room humidifiers, but I wouldn't waste money on advertised cool mist humidifiers. Humidity should not be 'cool.' It will warm up the ambient air to get effective humidity. This is why I recommend CPAP to deliver humidity. Because warm humid air is delivered only through the hose and to the mask. Doesn't change the ambient air. This is the advantage of a CPAP.

I have a thing against air purifiers. I think the ionizer does something odd to the air that triggered panic attacks to me. I don't use them, and from what read, they are not necessary unless air is really polluted where you live (like a forest firer or something).

I had one and had it very near me, and I would get panic attacks. When I got rid of it, panic attacks stopped. It didn't seem like placebo.
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#7
RE: CPAP or jaw surgery?
I agree you need a sleep study. I used to think I had terrible congestion and nasal obstruction, but it turned out my nose and sinuses are functionally fine. My nose was being blocked from behind in the pharynx. Put me on CPAP to pressurize the airway or use a mandibular advancement device (MAD) and my nose "congestion" went away. Humidifier is built in for my APAP. I like the Wellue ring for monitoring. Yeah, a dedicated humidifier like a CPAP one would be great.
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#8
RE: CPAP or jaw surgery?
(05-14-2022, 08:00 PM)CorruptAlligator Wrote: I was actually recommending getting a CPAP to use it's humidifier since it's very effective.  I don't have experience with room humidifiers, but I wouldn't waste money on advertised cool mist humidifiers.  Humidity should not be 'cool.'  It will warm up the ambient air to get effective humidity.  This is why I recommend CPAP to deliver humidity.  Because warm humid air is delivered only through the hose and to the mask.  Doesn't change the ambient air.  This is the advantage of a CPAP.  

I have a thing against air purifiers.  I think the ionizer does something odd to the air that triggered panic attacks to me.  I don't use them, and from what read, they are not necessary unless air is really polluted where you live (like a forest firer or something).

I had one and had it very near me, and I would get panic attacks.  When I got rid of it, panic attacks stopped. It didn't seem like placebo.

Right so what you guys say when talking about humidifier is something that is built in the CPAP machine. Do all CPAPs have this? How do I know the one im getting has it? If I go the social healthcare route, I guess I will not be able to pick a particular model, they will supply me whatever they have availible. In this case I may be interested to fund this myself to pick the best device possible. I've found a shop were you can rent one to test it out. You can pick one of these for 14 days:

[DME Link Removed]

About the purifier, the one I have has no ionizer or UV light which I discarded due posible ozone generation, it is simply an HEPA filter basically. Since my room has poor ventilation I thought it would be a good idea.

Btw, about the humidity part of the CPAP, what worries me is that humidity will make stuff grow on it if not constantly disinfected. This is why I stopped using a Waterpik, the tubes would remain wet inside, which would grow mold. I know you can rinse it with some product but still, I didn't feel like using it, so with the CPAP it would be the same or worse since the air goes directly into lungs so yeah, how do you guarantee it's clean before use? And even if I didn't use the humidity function, I would want the tubes to be clean before using.


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#9
RE: CPAP or jaw surgery?
I saw the link to the website was removed so I will list the options I have to rent a CPAP:

- APAP Air Mini - Resmed: 50€
- CPAP Airsense 10 Elite - Resmed: 50€
- APAP AirSense 10 FH - ResMed: 75€
- APAP Airsense 10 Autoset - Resmed: 50€
- BiPAP AirCurve 10 - Resmed: 50€

I still have to learn what APAP, CPAP, BiPAP diferences are. No idea about the diferences between models, im just listing what they have. That's 14 days of testing. Should be enough?
I can also get the Phillips DreamWisp for an extra 100€. I've read this mask is the most comfortable one.

(05-14-2022, 08:19 PM)RainbowFish Wrote: I agree you need a sleep study. I used to think I had terrible congestion and nasal obstruction, but it turned out my nose and sinuses are functionally fine. My nose was being blocked from behind in the pharynx. Put me on CPAP to pressurize the airway or use a mandibular advancement device (MAD) and my nose "congestion" went away. Humidifier is built in for my APAP. I like the Wellue ring for monitoring. Yeah, a dedicated humidifier like a CPAP one would be great.



How did suck blockage occur? In my case, what I notice is that the tongue can block the airway. Not sure what generates this white sticky mucus. The feel is similar to what is described as "post nasal drip". This mucus thing builds up on the back of my nose and eventually drops into the back of my throat and I have to wake up to spit it or just have kleenex next to me. Just another thing disturbing my sleep.

I will look into the Wellue device. So it has built in memory and I can plug it into the PC and get a csv. Does it tell you a number of apneas? It has some marker that says: "drops over 4%". What does that indicate exactly?
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#10
RE: CPAP or jaw surgery?
Since you are in Spain, the Wellue oximeter may be marketed under the name, Viatom. It seems they use different names depending on your geographical location (day-of-the-week or what side of the street you are on - sarcasm Big Grin). They do not record apneas. They record SpO2, pulse, and movement.
Crimson Nape
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