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Constant Wheezing, Sleep Apnea
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Constant Wheezing, Sleep Apnea

Dear Doctor,
if I have constant wheezing for 4 months now when I exhale what kind of treatment do I need?  I never had this and had it the same time as a throat infection.  It's when I force the air out I get a whistling noise and prednisone and singulair and dulera or combivent don't cure it.  My peak flow seems ok  
prednisone and klonopin does help my sleep apnea it seems but I don't know what else I could take?

Thanks very much!
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The first step should be for your doctor to determine the anatomical source of your wheezes.  It may be necessary to seek consultation with a lung or ENT specialist to make this determination.   It is sometimes not easy for a person (or even a physician) to distinguish between wheezing that originates in the upper airways (for example nose and throat) and wheezing that has its origin in the larynx or lungs.  In addition, wheezes that originate in the larynx or adjacent structures can closely mimic those that originate in the lungs (as do those of asthma).  If your wheezes are originating in the upper airway, that could account for the fact there was no apparent benefit from the asthmatic meds you mention.  

My conclusion from the preceding is that you will need further, perhaps specialist, evaluation to clarify the site and cause of your wheeze.  This will definitely require a thorough examination of your nose, throat and larynx and may require examination of your lungs by a lung specialist, with the use of an instrument called a fiberoptic bronchoscope.

You mentioned that the wheezes are associated with a throat infection and that you have sleep apnea.  That suggests that you might have a smaller than normal upper airway and that it may have become further compromised with the infection.  

Prednisone and klonopin are not ordinarily used for the treatment of sleep apnea.  You might want to speak with your doctor about this; specifically why these drugs were chosen.

Good  luck
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