INTUS Sleep results, mild sleep apnea or UARS?

[Chimken]

Hi guys 

I recently saw an ENT for a badly deviated septum, he requested that I do a home sleep study and follow up with the respiratory consultant. See attached. 

I'm honestly confused what the next steps should be. The ENT has advised a septorhinoplasty and removal of my left tonsil (it's pretty big to be fair!)

The respiratory consultant mentioned MAD and possibly CPAP as well as the usual lifestyle changes. I could do with losing 20lbs. 

I do also have a mild class III skeletal malocclusion as well as bite issues, but after seeing a couple of OMFS consultants neither advised anything like a MMA - I don't think it's commonly done in the UK. 

Thanks!

[BoxcarPete]

Next steps are to go back to ENT for the nasal correction and tonsillectomy, and not to get an MAD if you already have jaw alignment issues because those can cause jaw alignment issues even if all is well. CPAP is another option, but if that was me (and it's not terribly different from my own results) I would (and did) get the nose and tonsils taken care of and follow up with another sleep test down the line (I'm currently awaiting results for my follow-up study).

[Deborah K.]

You do have mild sleep apnea at 6.1 and would no doubt benefit from using a pap machine.  I would be inclined to do that first and see if your breathing and sleep are better before proceeding with painful surgery.  It's up to you of course, and I hope you can find a course of action that will solve your problems.  Good luck!

[ButtonNoseBarbie]

Here is link to educational on nasal and jaw surgery for sleep apnea. It can help you decide. 

https://youtu.be/FMtom39GbnQ?feature=shared

[PeaceLoveAndPizza]

I agree with Deb that unless surgery is required looking for a kinder, simpler way to deal with things is a good suggestion. With AHI of 6.1 you are on the mild side of the spectrum, but with an RDI of 26.4, there is more going on there. A trial of CPAP may provide some answers as to whether it can effectively manage things.

Many of us have significant deviated septum and other nasal conditions. I chose not to undergo surgical options as the ENTs said there is only a 50% chance it will make any difference.

Whether surgery will help you or not is unknown. One thing I do know is that when you go to a surgeon for advice, do not be surprised when the answer involves surgery.

[BoxcarPete]

The results of my home sleep study are in, and according to the test my AHI went down to 3, from 5.4 in 2020. However, I am going to take this data with a large pinch of salt because we are comparing a PSG to a home study. I have requested additional data from the sleep test and the gal at the sleep center said she'd see what she could do for me. I don't believe arousals were scored at all, and if we go back to my 2020 PSG and score hypopnea according to ODI only, we would probably see a similar result.

That said, I can sleep without the CPAP machine or any other apnea device for weeks at a time without getting to the point where I crave a nap in the mid-afternoon, which I was not able to do before the surgery, so maybe I should believe the test that things are better. I'm still planning to follow up with a PSG now that the insurance company has wasted my and the doctors' time, as I had always wanted to do that no matter what.