Thanks Melhajj,

I dont suffer from insomnia. I was taking ambien so in hopes that it would keep me asleep throughout the night as I was waking up around 2-4am every night. The pill allowed me to stay asleep, but the next day it made me feel worse..so i stopped. I am VERY exhausted throughout the day so getting to sleep usually is not a problem. But my anxiety is pretty bad, so if i have any soda or sugar after about 5 or so, my mind tends to not want to shut off at night. I do eventually get to sleep though as my body eventually just says "OK mister, i'm done". So thanks for your concern, I definitely think Excercise should be a part of my day regardless, as it is healthy. However, at the moment i am just so tired that getting the motivation to do anything is difficult.

I do have memory issues...and I relate that solely to sleep deprivation. I also attribute all of my symptoms to sleep deprivation. Anxiety, depression, loss of appetite, loss of libido, foggy brain, heart palpitations, memory loss, weakness, shortness of breath, light sensitivity, GERD, irritability...the list goes on. I have had the gamut of tests one if not several times and all have come back reasonably "normal". This includes, MRI, EKGs, Heart Monitor, several sleep studies, TONS of bloodwork, allergy tests, CAT scan, Upper GI ....again, the list goes on. I'm not almost 100% convinced that ALL of my problems originate from my lack of sleep...which in turn is due to sleep apnea. This is the source...and it is this I fight to battle..... and I WILL win.

Right now, i'm trying to get some money together to pay for some fillings so i can have my somnomed made... but I have to send in my insurance claim to see if and what they'll pay, and then i'll have to figure out how to pay for the balance on that... I was praying that the Silent Nite would at LEAST give me SOME releif, but so far I have felt none.....just snore releif. I really would like to have a sleep study done with this device, but i'm not sure my insurance would pay for it. And I want to have one after I get my somnomed, which will hopefully be around the same time i get work done to my nose (fix deviated septum)... so I dont want to have them pay for 1 now only to find out they wont pay for one later....

Sometimes I wish that a team of doctors would come and take me away to their secret laboratory and run tests and and try out treatments on me and monitor me until they found out wtf was wrong with me and fix me..... so i could live the rest of my life.....

That wish and .50 gets me a 1/6 of a gallon of gas....

(sorry this post seems so pessimistic.... just tired and frustrated....)

melhajj wrote:

your great help, such kind of doctor should be around patients more often; i will review in detail all the information you have just answered. Also, i do have BIG questions about  this disease; for example, my doctor told me that i do have a big tongue and that might be the reason of my severe OSA, if i have a big tongue since i was born, then shall i guess that i do suffer from sleep apnea since i was born? i am not an obese person at all,

You don't have to be obese to have OSA, and yes, the large tongue can play a very big part.

 i have like 7 pounds of extraweight, which is not very much, but certainly it is around my waistline accumulated; i did not use to snore when i was a child,

Very often, snoring is not a component of childhood OSA. This is very different in children, and you could have very well had this condition early in life.

 the snoring started around twenty years ago but not as loud as continous as it was before the use of the cpap; second question: i have a long history of gerd which has caused esophagitis and i wonder which one appeared first, the GERD or the sleep apnea eventhough all the medical articles talk about a correlation between these two diseases, but, my question is, which one was there in the first place?

There has always been debate in this area, but in reality, either could have come first, and both could make the other worse. I read an article about this earlier today, and would provide the link, but I get too agitated when any link I provide is removed, so I have stopped this practice to keep my sanity.

third question: since the respiratory center is regulated by the autonomous nervous system, is that the root of the problem? that there might be something wrong with that regulatory system? are there any studies researches that system where the main cause might be rooted there?

It certainly could, Melhajj, but this would typically be central sleep apnea. Did your sleep study mention any of this?

 i wonder about all these things, because if we do not find the real cause of the problem, how can we address the problem? in my case, about my big tongue about the main cause of my problem, wouldn't it be easier to have something that pulls my tongue out while i am sleeping, like a tongue sucker or some kind of similar artifact; what i see about this tongue sucker is that it is not to be used for long periods of time since it might affect the circulation of my tongue;

I'm not a huge fan of any tongue-retaining appliances, but they do serve a purpose. I would try a mandibular advancement device first, as this also pulls the tongue forward. There is also an increase in the baseline activity of the genioglossus with a MAD, which simply means the tongue pulls forward on its own, without being pulled, when using a MAD.

 the surgeries about cutting the tongue sounds very primitive, in my opinnion; and the other kind of surgeries does not seem to have a very high success rate; it sounds that must of the surgery is still in the experimental stage, what is your opinnion about these surgeries?

Well, they've been doing the same keyhole tongue resection for about 50 years, so I'd hardly say it's experimental, but I would still place this well down on my list of options.

the other options that seems realistic but also very difficult to decide to carry on, is a tracheostomy, which would be my last choice, when i think about it, i do think about intubation; what ideas come into your mind about procedures that might help in this disease?

Tracheostomies are indeed 100% effective, but as you say, the last choice.

best regards Dr. Kent and i know that in the back of your mind you are also searching for answers, sometimes the most creative things come when we are just alone and focusing on the problem, when there is not disturbance, then we let our minds be free and create.

Sorry for my delay in getting back to you. It's been a bit hectic.


_________________
Kent Smith DDS

phorts wrote:

Melhajj,

Thanks again for your reply. To answer your question, yes, the device was prescribed by my Sleep Doctor (His background is in neurology but is now practicing sleep medicine exclusively). I have what is considered mild sleep apnea based on a commonly accepted formula that <30 AHI is considered mild. My AHI is 29.

Actually, that's "moderate", Keith.

been using the 21mm straps. No change in feeling better. Doc says (now he says this) that the silent nite's job was to reduce snoring, not apnea, and that i'll need the Somnomed. I pretty much knew this already, but i feel i was being misled. Regardless, I now have a backup should the somnomed break, need repair, etc, and it DOES reduce snoring siginificantly.

I hesitate to say this, but just because one is approved and the other isn't does not mean there is a world of difference in the capability to get your AHI under 5. I'm afraid we will be talking about other therapies for you after a few months of the SomnoMed, but I still feel it is the next step for you, regardless. Obviously, your energy level has many factors affecting it. My recommendations? Stay away from the white russians and keep using Breathe Rite strips.

BEFORE i can get my somnomed my dentist wants to do my fillings first. If i get the somnomed made first, then the fillings, the device might not fit properly. Thing is, i need 6 fillings and at $170 a pop, that sucks. But, i gotta do what i gotta do.

You might be surprised. I think just about any filling could be made to fit under the SomnoMed, unless you are currently missing a portion of a tooth or filling.

I tried a sleeping pill (ambien) and was able to get through the night, but felt weird the next day. That's the whole thing i'm trying to fix...so i'm all set w/ that.

Been off and on as far as sleeping through the night or waking up at 2-4am....

will update more later.....

As I have mentioned, stay tuned for the orexin receptor antagonists coming out. They will be much easier on your system, and you won't feel weird the next day.


_________________
Kent Smith DDS

phorts wrote:

Right now, i'm trying to get some money together to pay for some fillings so i can have my somnomed made... but I have to send in my insurance claim to see if and what they'll pay, and then i'll have to figure out how to pay for the balance on that... I was praying that the Silent Nite would at LEAST give me SOME releif, but so far I have felt none.....just snore releif. I really would like to have a sleep study done with this device, but i'm not sure my insurance would pay for it.

Does your dentist not have a home monitor he or she can use to test the effectiveness of your appliance? I think every dentist working in sleep should have at least one.

And I want to have one after I get my somnomed, which will hopefully be around the same time i get work done to my nose (fix deviated septum)... so I dont want to have them pay for 1 now only to find out they wont pay for one later....

I talked to a patient last week who said his sleep apnea was completely fixed with repair of his deviated septum. I can't give you any numbers, and as you know, everyone is different, but this might give you hope after I dashed it a while ago.  

Sometimes I wish that a team of doctors would come and take me away to their secret laboratory and run tests and and try out treatments on me and monitor me until they found out wtf was wrong with me and fix me..... so i could live the rest of my life.....

That wish and .50 gets me a 1/6 of a gallon of gas....

(sorry this post seems so pessimistic.... just tired and frustrated....)

Hang in there! One thing at a time, and hopefully the end of this thread will be a happy one. Maybe you can get a prescription for some provigil to get you through all this.


_________________
Kent Smith DDS

thank you Dr. Ken Smith for your reply; i do not have central sleep apnea, but severe obstructive sleep one;  trying to adjust to nasal pillows for the time being and waiting for results of new sleep test; i am in a hurry now, but let me tell you that i am very thankful for being so kind to answer my questions; you don't know how much confort your words and advices give us. blessings.