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Re: Dr NP in May!

Posted by westernjoe on April 18, 2005 at 07:57:22:

In Reply to: Re: Dr NP in May! posted by mikeinboston on April 14, 2005 at 19:32:19:


My case is different than any others I've heard of, and different than any sleep doctor I've been to has seen. In fact, I went to the main sleep docs in BigD and they basically said, can't help you.

As soon as I fall asleep, my airway closes off and awakens me resulting in a strong startle response (heart racing, deep breathing). These events are the emotional equivilent of a car wreck and after a few I'm so adrenal'd up I can't fall asleep for a few hours. So basically I can't sleep without cpap. It started 4 years ago randomly, then became constant within a year. It's getting worse. Even if I drug myself I only can lightly doze (no rem) and that only after hours and hours of trying. These events are very position dependent and the only time I have every fallen asleep without cpap or an oral appliance is while sitting straight up in a car. Apparently I'm either very sensitive to these events, or my airway is very completely closing off.

Because of what happens, I technically have NO apnea. This is because I never get to sleep through the airway closure, only hypopnea, AHI=20, w/severe sleep fragmentation, No desats. All events were obstructive, snoring minimal, no plmd, rls.

With cpap (now at 10cm - goes up about 1cm per year), and some drugs, I can actually sleep, but I still feel very sleepy most of the time. Just can't get good deep sleep. Cpap is gradually becoming ineffective, even with an autopap. I have a constant big bump on my nose from the masks (nasals and full face), pillows don't work because using a humidifier makes my nasal close off. Nasal masks must be used with a chin strap and a mouth strap, full face masks must be used with my oral appliance which is now giving me tmj problems. I'm thankful for cpap, but I'm ready to solve this, even if it means a trach.

I've already had a uvulectomy, somnoplasty, tongue suture, GA, and Laup - all with only moderate results. I'm 140# at 5'9', 43yr (BMI=21)old so I don't think weight is the issue unless then 10# I've put on in the last decade is all in my airway - possible.

Got ideas? I'm all ears!

wj

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