Surgical Procedures and Options for Obstructive Sleep Apnea : Review and Comparison

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Have you had any of these surgeries? What was your experience? Review of several surgical options for OSA and my opinion of them are discussed.

Hypoglossal nerve stimulation (Inspire), Septoplasty, UPPP, LAUP, Tracheotomy, Maxillomandibular Advancement, Hyoid Advancement and I'm sure something else is discussed in this video.

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[llaus]

I had a General anaesthetic done twice this year. First failed down through the throat and second try a month later was up through my nose. The anaesthetist found I have polyps up both nasal passages. Made it reasonably uncomfortable for a while before the team could get past the obstructions.
As far as my breathing goes, the ENT said that the polyps could be removed if I forced the issue but he recommended I delay that sort of operation. My sleeping using my CPAP is terrific.

[allenwaters]

I’ve always had trouble sleeping (PTSD3 didn’t help). My samoan cousin was admitted to the hospital for a stomach procedure, the night nurse gave him medication, the next morning they found him deceased from an undiagnosed apnea. My family redirected their attention to me and urged me to get tested. It was some kinda take home device that smelled of cigarettes. Nothing happened with that, 5yrs latter I tried again with a professional and a sleep study to get my family from nagging me. I was told I had a severe apnea. My pressure was so high it was like having a hovercraft on my face. Surgery was suggested, first septoplasty, then teeth straightened(underbite) which was followed by maxilllomandibular advancements. Over 7hrs of surgery and over $100k was supposed to correct my apnea. While the surgery reduced it by half, it did not cure it. They told me that there was nothing left to do and some doctors suggested that an aspect of my apnea may be from a residual neurological response. There was no physical therapy or followed examinations. I was never referred to any special evaluations before or after the procedure. I watch your channel often to be a better steward of my health. I don’t want to die in my sleep yet. Thank you for your channel

[PadACheek]

Thank you Jason for the very thoughtful work you do. The information given may prevent someone from being talked into surgery. As you said, these options not only do not work, but do more harm than good. The horror stories are out there. The support for CPAP therapy is lacking for sure. I do hope more sleep doctors, clinicians and healthcare providers will hear this and rethink their patient care. Please do not stop sharing your views and your caring of your sleep apnea patients. We need more like you.

[johnlawfourtyfyve]

I had the UPPP surgery in 1990 which only worked for a few years when everything grew back. I was finally put on CPAP in 2001 and have slept fine since. The more you need it, the better CPAP works.

[RayBrach]

In 2000 I had uppp and hyoid advancement. I was cleared by sleep study. But in 2017 I was again experiencing symptoms. Diagnosed with sever sleep apnea, I began using the DreamMachine. I have taken the foam out like you expressly told me not to do. It is working great and I also use the tape you recommended on my mouth. No more jerky tongue. Thanks for all you do!

[rayalvarez]

Lefty, I have tried 3 surgical procedures to treat my severe apnea including the deviated septum surgery, UPPP, and a more invasive technique to trim the fat around my esophagus and the only one that was successful was the septum procedure. You are spot on when you state that any surgery involving cutting around your esophagus results in increased scar tissue that worsens the problem because you now have to contend with tougher and larger skin obstructions. Looking back I should have avoided the surgery and focused on losing weight to diminish the fatty tissue in my neck which I believe would have been more beneficial for me. the septum surgery is tough as well because you have to mouth breath for a few days while the sutures heal in your nose which may require you to have gauze stuffed up both nostrils for a while, but the result is instantaneously when the gauze is removed. right now i continue to focus on maintaining a healthy weight, doing some form or regular cardio to strengthen my breathing, and do regular check-ups and making periodic adjustments to my mask according to my needs. thank you for making these videos for our community, we really count on you to remove the mystery and confusion for us so we can make informed decisions on this serious problem. we appreciate you!

[Echoz]

I love my CPAP and he is soooo right about the crappy follow up. My Neurologist doesn't care. The Sleep Clinic team doesn't care. The medical supply team doesn't care. Only if u are experiencing issues do they care. Its disheartening. The only education and support I get is online. Rhanks so much for your content.

[MrGlenspace]

I have used a specially made oral appliance for sleep apnea. It keeps my jaw forward and no problem sleeping. Used it fir years and only had new one made after some years.

[nardjissmaroua]

Thank you very much for sharing all your valuable experience

[thinkingimpaired]

its always good to be informed of possible options to remedy sleep apnea. thanks for the video.

[brod]

Was diagnosed as a possible Sleep Apnea patient while doing a pre-surgery question session. The person taking the answer wanted to make a referral. I guess my falling asleep while driving was the clincher. Been on CPAP for a long time now. About ready to get my 3rd CPAP machine. I like the F&P Simplus ? mask. I think that's the name. Although I think I'm going to get the new Resmed Full face mask. That looks like a winner to me. Anyway, I always find your videos both educational and entertaining. Keep up the good work. ;o)

[budandtender]

What an incredibly informative and engaging video! 😄👏 Your approach to demystifying surgical options for sleep apnea with a touch of humor is fantastic! It's great to see content creators like you provide valuable insights while keeping things light-hearted. 🙌 Laughter can be the best medicine, especially when tackling serious topics like this. 😂

It's clear you recommend a thorough evaluation before considering surgery and that CPAP therapy is often underutilized due to poor follow-up. This is such an important message! 👍🩺

For those curious about how all this ties into the body’s overall well-being, interestingly, the endocannabinoid system plays a role in various physiological processes, including sleep regulation. 🌙✨ While this may not directly relate to the surgical treatments you’ve discussed, it’s part of the fascinating landscape of our health.

Keep up the excellent work, and thanks for contributing your knowledge and firsthand experience to the community! 🌟📚 Looking forward to more videos. Don’t forget to take care of your own sleep too! 😉💤

[johnpopp]

I had nasal turbinate surgery and they also replaced the bottom third of my septum using rib cartilage. Tom the better part of a year to completely heal, but I breath much better and my CPAP therapy greatly improved. I definitely still have some issues, but I was really close and then #foamgate struck.

Just a note, that the surgery wasn’t aimed at providing relief from sleep apnea, just repairing all the damage I did to my nose from playing sports, and finally just building a new septum as it was obliterated by a previous surgery.

[cybco]

Luv you you state the truth straight up. No BS.

[fwright]

You have help me a lot thanks for the advice

[michaelpeek]

Looked up the before and afters of the MMA surgeries. Wow you weren’t lying. Totally different look.

[davesuddreth]

I had the surgery for a deviated septum. They removed my tonsils and then I made them stop. CPAP has been a God send to me

[cebruthius]

Fun fact: the horrors of tracheotomy prompted Dr. Colin Sullivan to invent CPAP back in the 80s

[MrJS]

Hey TLL..I AM a man who has been treated for anxiety/insomnia.. so bad i thought i forgot how to get to sleep..40 years of paying psychaitrist for meds. Then 2 years ago.. i started napping.. 15 20 min.. my fam immmediately noticed. I never have napped unless very ill with flu type chit..and i never woke up felling better.. the same or worse usually.. but these short naps i felt good for 20 min.. then crash tired again.. it progressed to sleeping 22 hours.. eat sleep 8 more.. wake up exhausted..memory gone.. pain throughout my body. Bad Headaches everyday sometimes for 2 weeks. Mem was worst for work and sleeping thru meeting.. appointments.. ect. Fell asleep 2x driving.. with many micro naps until i understood the feeling.. the urge...i chatted with another guy. He said the same .. it felt like andre the giant grabbed the back of my neck and was pusging head to floor... in car.. my chair whereever.. i recognized i need to pull over now.. been woke up by i waa drunk...
Ok. Been on search for right treatment.. very hard to get all thr info i need.. like why inspire doesnt fix all apnea events.. did it not pulse tonge.. not enough power? I cant choose this option due to 30-40k for a 50 50 shot... my conclusion.. there is no best fix.. i hate hate medical anything... i have disigned my own products and have shown sig snoring and apnea activity.. i might stay on this path cause i feel i got 70% improvement with my techniques...

[jirisimek]

Mandible is conected to scull base using muscles and ligaments. It can move in every direction except backwards. There is bony wall creating ear canal. Nobody can move jaw back (everybody can test it on his own). This is the reason BSSO works. Problem of other methods creating connection of soft tissue to mandible is muscles and/or ligamnts can strech. It can cause partial or total relaps of aupper airway obstruction.