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Skip CPAP for UPPP?
#1
Skip CPAP for UPPP?
I have been diagnosed with moderate OSA and I have absolutely zero interest in using a CPAP.  I am young and have a BMI of 23 so I’m not the typical person having to wear a CPAP.  I used the APAP machine for the first time last night and while it wasn’t as bad as I thought it would be, it was still uncomfortable because I am a side sleeper and I woke up several times to the hissing sound of air leaking from the side of the mask.

Do I have to be compliant or non-compliant with using the machine in order to qualify for surgery? 

Should I tell my doctor I just cannot use it for whatever reasons? The end result is still going to be the same: I will not use this machine long-term. If I have to use it for a short period of time to get surgery, then I will do so.
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#2
RE: Skip CPAP for UPPP?
none of us want to use cpap. no matter whether you're typical or not. it only matters that you suffer from apnea. search the forum for UPPP. I have no personal knowledge about this but have read on this forum a number of cautions against UPPP and other surgeries. they help some, like 50%, but only something like 50% effective even in those that do work. apparently in most cases will not relieve us of having to use cpap and apparently they may have to be redone after a period of years. side effects of some of these surgeries can be significant. this is from memory so take the numbers with a grain of salt. I should think cpap is less expensive and certainly is less traumatic. not what you want to hear but best to be as informed as possible before deciding.
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#3
RE: Skip CPAP for UPPP?
I had the operation done, It did not help, I still needed a CPAP, and now I have other issues like gagging and getting food up into my nose, since they reduce the separation between your throat and air passage. I was also out for a good 4 weeks. I do not suggest it.
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#4
RE: Skip CPAP for UPPP?
UPPP or any sleep apnea surgery for that mater will not allow you to 'skip' cpap. If you must 'skip' it, only getting a permanent tracheotomy will remove the need for a cpap.

My modified-UPPP helped me in that I don't need as high pressures as I used to need.
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#5
RE: Skip CPAP for UPPP?
I appreciate the replies, thank you.  I’ve noticed the forum allows users to state what equipment and pressure, etc they using but I wonder about BMI and weight.  It is known that apnea is more common in larger folks.  I wonder if the UPPP isn’t as effective in persons of size.
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#6
RE: Skip CPAP for UPPP?
there are plenty of people here with apnea that report not being overweight but you're right that weight and obstructive apnea are associated. besides being more likely to have oa as weight rises, apneacs tend to gain weight, particularly before treatment but even after.

the chances of staying at your ideal weight decline with age. what happens 20 or 30 years after UPPP? still, your question is a good one. I'll be curious to hear the answer.
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#7
RE: Skip CPAP for UPPP?
(05-19-2019, 03:26 PM)sheepless Wrote: none of us want to use cpap.  no matter whether you're typical or not.  it only matters that you suffer from apnea.  search the forum for UPPP.  I have no personal knowledge about this but have read on this forum a number of cautions against UPPP and other surgeries.  they help some, like 50%, but only something like 50% effective even in those that do work.  apparently in most cases will not relieve us of having to use cpap and apparently they may have to be redone after a period of years.  side effects of some of these surgeries can be significant.  this is from memory so take the numbers with a grain of salt.  I should think cpap is less expensive and certainly is less traumatic.  not what you want to hear but best to be as informed as possible before deciding.

^^^

I looked into UPPP when I first got CPAP and found similar numbers.

At the time, UPPP was considered a success if it cut AHI scores by 50%.  That might still leave you needing CPAP.  Also, the rate of returning to pre-UPPP AHI levels after 1 yr was also 50%.  So it's a painful surgery that might keep you off CPAP long term...maybe...with no guarantees.

Things might have changed since then, so be sure to ask your doc or surgeon what to expect.
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#8
RE: Skip CPAP for UPPP?
(05-19-2019, 11:05 AM)Bedsheet Wrote: ... I used the APAP machine for the first time last night and while it wasn’t as bad as I thought it would be, it was still uncomfortable because I am a side sleeper and I woke up several times to the hissing sound of air leaking from the side of the mask...

I, too, found that side sleeping was all but impossible...at first.  Now, it's second nature, and I have an AHI monthly average of about 0.5 currently.  That is to say, you have to learn how to sleep with the appliance.  First you persevere, and then you adapt.  Your apnea will only get worse left untreated because when left untreated it leads to wrecked sleep, obesity, endocrine disorders, etc.  Oh, and even worse apnea.

My advice, as much as it is worth: tackle it now, with verve and determination, and with the health you have going for you today.  You'll thank yourself in the years ahead.
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#9
RE: Skip CPAP for UPPP?
(05-19-2019, 07:25 PM)Bedsheet Wrote: I appreciate the replies, thank you.  I’ve noticed the forum allows users to state what equipment and pressure, etc they using but I wonder about BMI and weight.  It is known that apnea is more common in larger folks.  I wonder if the UPPP isn’t as effective in persons of size.

When i was diagnosed my AHI was 60+ with 55kg and 170cm.
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#10
RE: Skip CPAP for UPPP?
Bedsheet, I notice that your BMI is particularly low and you don't fit the "profile" for obstructive sleep apnea. I think it would be interesting to look at the details of your sleep test to see what kind of events are actually occurring, and then discuss some options. OSA is often diagnosed even when other problems are actually present such as central apnea, upper airway resistance, and others. We could probably tell quite a bit if your post and OSCAR therapy chart. UPPP is a very painful and is generally associated with a 50% reduction in obstructive events. For some people that provides enough treatment to take them off CPAP, at least for a while. It's important to get detailed information from an Otolaryngologist to verify that any anatomical contributors to apnea are treatable with surgery. Another option may be to resolve simple positional issues that close your airway. It is very common for people to use pillows too tall or to tuck their chin in a way that breathing resistance is greatly increased. If you have positional apnea, there may be ways to treat that with something as simple as a soft cervical collar or wedge.

Let's start with the sleep study with personal information redacted, and take a look at the type and pattern of obstruction there, and post a chart from OSCAR. The software is free to download, and it's easy to post a chart as shown in the lnks in my signature. We're not here to be cheerleaders for CPAP, and we can identify any diagnostic questions and treatment inefficiency, as well as point to less painful and more effective alternatives.

Finally, you are using a nasal interface. Try getting the Resmed Airfit P10 nasal pillows mask. It is smaller, and easier to seal, and does not make any noise compared to a nasal mask that covers your nose.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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