Debating commiting to a septoplasty and turbinate reduction?

[kermitthefrog]

Hi all,

I've got a diagnosis of fibromyalgia, hypermobile joint syndrome, ADHD and mild obstructive sleep apnea. 
I tried out a CPAP device, however didn't see major benefits from it - sometimes I'd feel a bit better but it wasn't the holy grail some have preached it to be. I'd also sometimes take the mask off in my sleep. I have quite inconsistent insomnia, and will wake up multiple times per night some nights. I'm always waking up feeling unrested, sore and can easily sleep for 12 hours+ total, and feel better as the day goes on. I ended up returning my CPAP (rental) as I just wasn't using it.

I've recently vistied an ENT, whose identified that I have a deviated septum and large tongue; likely both contributing to my sleep apnea & snoring. He's offered me a septoplasty and turbinate reduction, in suggestion that it may help me tolerate a CPAP better and just generally help me to breathe more comfortably. We also discussed a mandibular advancement device, however I'm currently halfway through invisalign treatment (overbite, class 2 malocclusion and crooked teeth) - so this would likely need to wait until after my treatment finishes as my aligners have already been created.

I was wondering if anyone here experinced sleep improvement / cpap benefits / or could share their experince, with a septoplasty. 

Also wondering if a BiPAP may work better than a CPAP?

I've attached my sleep study results below incase they're of any benefit. I'm a bit confused as to why it states I'm having both obstructive & central apneas.
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[HalfAsleep]

So, here’s the thing….

XPAP takes a while to get used to. Your body has to adjust a lot. This may take many weeks. Often, it seems, folks throw off their masks in the night either because they aren’t adjusted yet or/and because the settings are incorrect, and they aren’t getting enough air. It’s very possible you didn’t get past this threshold when you trialled xPAP before.

I recently had septoplasty and turbinate reduction after I noticed (when I began xPAP treatment) that one nostril was blocked. I encourage it on the grounds that it changed my sense of the world because I have a better feel of breathing in fresh air. I’m not sure it made a whole lot of difference to xPAP treatment. So, I think the better question for septoplasty is: “Will it improve my quality of life?” and not so much “Will it make xPAP work better?”

At some point in my life I also had mandibular advancement surgery. It was a piece of an orthodontic plan. I would never do it again, unless my jaw was much more retracted than mine was. This was absolutely the most excruciating surgery I’ve ever had, and long-term, I believe it accomplished squat.
For the purpose of sleep breathing, there are other hacks (e.g. cervical collar) than devices and surgeries to keep the jaw from retracting in the night. I’m not sure how invisalign results would get messed up with a mandibular advancement device. You might just be inviting trouble. There’s no telling, either, I would bet, whether mandibular advancement will improve your night time breathing, and it might just make your jaw joints complain loudly. If it were me, I’m not sure I would take that on if my body was already in significant pain from other causes.

Evidently, I have a small mouth for the size of my tongue, but as I get older, I’ve learned to pick my battles. There are always opportunities for medical interventions later: no need to do anything right now unless it makes me feel better and contributes to quality of life. However, the septoplasty fit the bill, and I’m glad I had it done. Keep in mind, though, it is not a no-risk event. There are risks from anesthesia and the surgery itself. Actually, it was a long recovery for me (I was off work for a month), very painful, and this was far outside the norm. Ya never know!

Hope that helps.

[SarcasticDave94]

Note as well that your Obstructive and Central were almost equal but not quite, 10 OA to 8 CA. This indicates a current need to treat both, and it might require the specialized ASV. Probably an easier answer is the ResMed AirCurve 10 VAuto with high to very high trigger. Just be aware that no other device but ASV is specially tasked with Central Apnea treatment.

This is if you end up getting a CPAP based machine.