xjarhead50 wrote:Just had my post OP sleep study. I'm not very happy either. My AHI score was a 9.7 with very mild central apnea events, this to my understanding is very mild apnea. My new score is 110 with severe central apnea events. How the hell can this happen? How can I get worse after getting the surgery? This was probably my last option to keep my military flying career. Now I'm screwed!
My wife says I don't snore any more and she doesn't notice any breathing pauses and I wake up in the morning feeling much more rested than before the surgery. Could the test be screwed up? My Dr is trying to get tricare to pay for another sleep study to confirm or dispute the results.
Does anybody have any insight into this. I sure hate to think I had this surgery only to get worse.
1-A month post-op is way too soon to do a follow up sleep study. You probably still have inflamation from the surgery. I was just starting to get off the cpap after a month following my surgery.
2-Did your Dr. address any air restrictions with your nose, and even more importantly, your tongue?
FYI, there is a new proticol that is being tested that EVERYONE who is undergoing apnea surgery should insist they have. In addition to having the optical scope down the nose pre-surgery, fiberoptic examination with Muller maneuver, they are now scoping the airway as they put you under before the UPPP surgery gets started. The patient authorizes the Dr. to conduct one or more tongue base surgeries depending on what they see through the scope when you are sedated and sleeping. The surgeon can see first hand what areas of the throat are causing obstructions which is much more effective than the "awake" test with the scope. I've long thought the erratic succuss rate with surgery was due in large part to the poor diagnostic procedures carried out by the Dr. I highly recommend EVERYONE who will undergo UPPP surgery pick a surgeon who will do this test in a sleep state. Further, your surgeon should have the expertise to do a tongue advancement, hyoid advancement etc and be willing to do these extra tongue base procedures depending on the outcome of the sleep induced scope. IMO, this is a very exciting new diagnostic procedure that all folks who are considering surgery should be aware of...
"...a major goal of surgical upper airway evaluation in OSA is determining the pattern of obstruction. The authors of the largest meta-analysis of surgical treatment of OSA wrote that the failure to identify and treat all levels of airway obstruction was the principal factor in not achieving optimal surgical results.1 A Cochrane Collaboration review of surgical treatment for OSA indicated that determination of the site of obstruction should be a major focus of research efforts in sleep-disordered breathing.4 Techniques that are most commonly used to characterize the pattern of obstruction utilize specific components of physical examination,2 awake fiberoptic examination with Muller maneuver,5-7 and lateral cephalometry.6 Because they are all performed on the awake patient and because most also provide a static rather than dynamic evaluation, they may not be ideal methods to assess the behavior of the upper airway during sleep.Drug-induced sleep endoscopy (DISE) avoids these drawbacks and provide a more accurate evaluation of the upper airway."