Geekzone: technology news, blogs, forums
Guest
Welcome Guest.
You haven't logged in yet. If you don't have an account you can register now.


View this topic in a long page with up to 500 replies per page Create new topic
1 | 2 | 3 | 4
bendud
324 posts

Ultimate Geek
+1 received by user: 98

ID Verified
Lifetime subscriber

  #3063917 15-Apr-2023 16:10
Send private message

Just wanted to hop on and say that there's a lot of sensible advice on this thread, over what can be quite a tricky problem. Always glorious on geekzone how sensible most of the discussions are. DOI - I'm a sleep and resp physician working in the public sector.

 

Just a couple of extra notes:

 

1) Snoring and sleep apnoea are a couple of overlapping Venn diagrams. You can have sleep breathing issues with not a lot of snoring, or can have dreadful snoring without OSA. Often the key issue is the effect on the individual the following day - and this often predicts tolerability of CPAP. If people don't feel better using CPAP then it's a real challenge to keep going with it, as it is a bit of an embuggerance at the best of times - about 1 in 3 just can't do CPAP for whatever reason. 

 

2) A properly fitted and adjusted mandibular advancement splint is an excellent choice for mild and moderate OSA especially if travelling/tramping/hunting etc. It's not a great choice for severe OSA - may take it down to mild or moderate but probably won't be back to normal. Over the counter devices rarely work as they fit poorly and are not that adjustable. Privately about $2.5k would be the ballpark, some public access e.g. from Dent school in Dunedin.

 

3) The new kid on the block is pacing the base of tongue/neck muscles. There's a place in AKL doing this now privately. It's again probably better for milder OSA, costs a lot, and usually treatment success is limited by friction of tongue edges inside the mouth causing ulcers. I don't know anyone who has actually had a pacemaker implant for this and would be pretty wary until the tech matures and NZ experience has accumulated. 

 

4) Various drug combos are being used but as usual they might lessen severity but often not sort out the underlying issue. We don't as yet know what their use is in real life. 

 

5) For many people weight loss is effective unless there is another anatomical factor (such as tonsils the size of Australia or a marked underbite). "Curative" weight loss means usually about a 25% loss of body weight, so needs to be slow and deliberate. Tonsillectomy as an adult is exceptionally sore post op! Anti-snoring surgery like the UPPP procedure tends to be effective for a short time rather than a long term fix.

 

6) Severe OSA is associated with worse cardiovascular health (>30 pauses/hr) but mild and mod OSA aren't particularly, so there's no real gain to treating mild OSA without daytime symptoms i.e. sleepiness, for most people

 

7) Positionally severe OSA is quite common but really quite hard to stop falling on to your back in the night. The tennis ball technique is cheap and easy but rarely a long term training solution. There are some electronic devices (the Night Shift has USB export for position data; the Phiips Night Balance seems well liked but is hard to find in NZ). They're not cheap...

 

Hope that helps - good luck to the OP with your CPAP trial! If you are happy using it, it is still the best "tonight" treatment.

 

cheers

 





From the Antarctic Riviera



networkn
Networkn
32871 posts

Uber Geek
+1 received by user: 15465

ID Verified
Trusted
Lifetime subscriber

  #3063950 15-Apr-2023 17:54
Send private message

Thanks for your post, that was quite an interesting read. I can only imagine how sore getting tonsils out as an adult would be. I had neck surgery and they had trouble getting me intubated (narrow airways). In the end the consultant was called and he ended up (apparently) ramming it down my throat. The pain the few days afterward was horrific (not as bad as kidney stones!). 

 

I have been on the waitlist for a sleep study for quite a while now, I'd love to know how much longer that wait might be. 


bendud
324 posts

Ultimate Geek
+1 received by user: 98

ID Verified
Lifetime subscriber

  #3064069 15-Apr-2023 22:15
Send private message

Depends on your location really. There’s quite a lot of variation in access across the motu. It’s been a long slog to get our waitlist down to about a year, which is nowhere near where we want but way better than the 2-3yrs it was. Getting testing out of hospitals and in to the community is definitely the way to go given the unmet need out there. Until a couple of years ago we were funded to do fifty tents for a population of 250,000 each year (we did about 500 a year on that money)…

Hopefully not long for you. Private studies are about $200 usually so not catastrophic but definitely more than a lot of people can afford who need them…

B




From the Antarctic Riviera



Lias
5655 posts

Uber Geek
+1 received by user: 3978

ID Verified
Trusted
Lifetime subscriber

  #3064340 16-Apr-2023 15:55
Send private message

wally22:

 

Lias:

 

I've been on a CPAP about a decade now. Short of surgery (Maxillomandibular advancement) it's the best solution for OSA, but I'd get the surgery in a heart beat if I could afford it.

 

 

My sister's husband used surgery, but because he liked pies had to have repeats of the surgery.

 

 

I suspect you are talking about bariatric (weight loss) surgery. I'm talking about having your jaw unhinged and remounted an inch further forward, which is the "gold standard" treatment for OSA.





I'm a geek, a gamer, a dad, a Quic user, and an IT Professional. I have a full rack home lab, size 15 feet, an epic beard and Asperger's. I'm a bit of a Cypherpunk, who believes information wants to be free and the Net interprets censorship as damage and routes around it. If you use my Quic signup you can also use the code R570394EKGIZ8 for free setup. Opinions are my own and not the views of my employer.


Batman
Mad Scientist
30014 posts

Uber Geek
+1 received by user: 6217

Trusted
Lifetime subscriber

  #3064342 16-Apr-2023 16:13
Send private message

Lias: I'm talking about having your jaw unhinged and remounted an inch further forward, which is the "gold standard" treatment for OSA.



Are you sure about that?

bendud
324 posts

Ultimate Geek
+1 received by user: 98

ID Verified
Lifetime subscriber

  #3064343 16-Apr-2023 16:15
Send private message

If your lower jaw is too far back, then yes. There are however a lot of people who would not benefit from a replating of their jaw. Similarly weight loss isn’t always the answer (but often is!).

I have an old mate who had severe OSA. He’s about 6ft 2 and weighs 60kg, and used to be an adventure racer in the World Series. Cured by tonsillectomy and Mandibular advancement, any weight loss and we would have been really worried!

B




From the Antarctic Riviera

 
 
 

Stream your favourite shows now on Apple TV (affiliate link).
Batman
Mad Scientist
30014 posts

Uber Geek
+1 received by user: 6217

Trusted
Lifetime subscriber

  #3064353 16-Apr-2023 18:09
Send private message

bendud: If your lower jaw is too far back, then yes. There are however a lot of people who would not benefit from a replating of their jaw. Similarly weight loss isn’t always the answer (but often is!).

I have an old mate who had severe OSA. He’s about 6ft 2 and weighs 60kg, and used to be an adventure racer in the World Series. Cured by tonsillectomy and Mandibular advancement, any weight loss and we would have been really worried!

B

 

his jaw was really unmatched presumably? or just mild overbite?


Lias
5655 posts

Uber Geek
+1 received by user: 3978

ID Verified
Trusted
Lifetime subscriber

  #3064358 16-Apr-2023 19:06
Send private message

No... It's now widely used even for those with normal facial structures, as it's been shown to be effective. It's the gold standard because it eliminates OSA in more than half of patients and has measurable impact in the vast majority of others.





I'm a geek, a gamer, a dad, a Quic user, and an IT Professional. I have a full rack home lab, size 15 feet, an epic beard and Asperger's. I'm a bit of a Cypherpunk, who believes information wants to be free and the Net interprets censorship as damage and routes around it. If you use my Quic signup you can also use the code R570394EKGIZ8 for free setup. Opinions are my own and not the views of my employer.


bendud
324 posts

Ultimate Geek
+1 received by user: 98

ID Verified
Lifetime subscriber

  #3064373 16-Apr-2023 20:09
Send private message

That’s interesting. I’m only familiar with surgery in people with specific anatomical factors amenable to correction. I haven’t seen anything new in the literature about more widespread surgery - do you have anything you can point me towards for evidence? It’s not in the ASA guidance.
Cheers
B




From the Antarctic Riviera

Batman
Mad Scientist
30014 posts

Uber Geek
+1 received by user: 6217

Trusted
Lifetime subscriber

  #3064377 16-Apr-2023 20:19
Send private message

bendud: That’s interesting. I’m only familiar with surgery in people with specific anatomical factors amenable to correction. I haven’t seen anything new in the literature about more widespread surgery - do you have anything you can point me towards for evidence? It’s not in the ASA guidance.
Cheers
B

 

FYI i plugged the words into google and came back with one hit, website ->

 

https://www.welloral.co.nz/procedures/sleep-apnea/

 

 


bendud
324 posts

Ultimate Geek
+1 received by user: 98

ID Verified
Lifetime subscriber

  #3064382 16-Apr-2023 20:55
Send private message

Yep, as stated on that site it’s the gold standard *for surgical treatment*. But that’s not the same as gold standard for overall OSA management (otherwise the site wouldn’t be offering mandibular splints etc). It’s definitely not a one size fits all area.
Surgery can be absolutely fantastic and entirely curative in some people - it’s the picking who they are that’s the tricky bit!
Cheers
B




From the Antarctic Riviera

 
 
 

Move to New Zealand's best fibre broadband service (affiliate link). Free setup code: R587125ERQ6VE. Note that to use Quic Broadband you must be comfortable with configuring your own router.
lxsw20

3689 posts

Uber Geek
+1 received by user: 2175

Subscriber

  #3064391 16-Apr-2023 22:27
Send private message

I've had 2 nights with my CPAP now, first night events went down to 1.6 per hour (from 80), last night 0.2 an hour. I must say I've found the mask easy to get used to (nose pillows). It's a bit weird opening your mouth and having an airflow coming out, but other than that no real issues. Will be interesting to see how I go for energy at work tomorrow.


wally22
504 posts

Ultimate Geek
+1 received by user: 128

Trusted
Lifetime subscriber

  #3064392 16-Apr-2023 22:33
Send private message

lxsw20:

 

Will be interesting to see how I go for energy at work tomorrow.

 

 

 

 

All the best. It seems like you are taking to it well.


linw
2893 posts

Uber Geek
+1 received by user: 1205


  #3064472 17-Apr-2023 11:02
Send private message

All the best for your trial on the cpap.

 

My wife has been on a cpap machine for over 10 years. Probably saving her life. 

 

It was me being alarmed hearing her stop breathing and restarting with a gasp that started her getting help.

 

The macine is supplied free, as well as replacement bits, so thanks to the govt also!


lxsw20

3689 posts

Uber Geek
+1 received by user: 2175

Subscriber

  #3064502 17-Apr-2023 13:52
Send private message

Out of interest, what CPAP machine has the public system provided for your wife?


1 | 2 | 3 | 4
View this topic in a long page with up to 500 replies per page Create new topic








Geekzone Live »

Try automatic live updates from Geekzone directly in your browser, without refreshing the page, with Geekzone Live now.



Are you subscribed to our RSS feed? You can download the latest headlines and summaries from our stories directly to your computer or smartphone by using a feed reader.