Mild Sleep Apnea

[Dr. Erik]

Dear Doctor and/or staff:

Thank you in advance for answering my questions. I was recently diagnosed with Mild Obstructive Sleep Apnea. I am a 35 year old male who is otherwise healthy with the exception of Reflux Disease that is controlled with Medication. I also have a recurrent Paraesophageal Hernia that has been repaired three times. I've been on CPAP for one week and I cannot tolerate it. My reflux has acted up while using the CPAP. Also I have felt some nausea. 1)Do you think the CPAP can cause enough abdominal pressure to worsen my hernia?

My OSA is mild in that only 39 apneas occurred during the night of my study. My oxygen saturation got as low as 83%. But it stated that for 97% of the time my oxygen sat was 90% or greater. My other questions are 2) Do you think my OSA is significant enough to treat and if so should I use the CPAP despite my sympotms? 3) should I pursue surgery for a possible cure? I also have sinus problems and nasal polyps if that has any bearing on it. Tonsils and adenoids were removed years ago.Any comments would be greatly appreciated!!! Thank you so much for your time!

Erik

[National Jewish]

Based on the information provided, especially your low oxygen saturation, your obstructive sleep apnea (OSA) is definitely significant enough to treat.  The continuous positive airway pressure (CPAP) could result in an increase in swallowed air, with or without increased abdominal pressure, and thus could aggravate your reflux.

Having said that, I strongly urge you to work with a sleep specialist and his/her staff, to find ways to make the CPAP tolerable.  You may have to go to the bi-level positive airway pressure (BiPAP) machine.  And, it may take a long time for you to find settings that will be both tolerable and effective.  Positive pressure is far and away the treatment of choice.  You should give it a long trial, but not on your own.  Finally, do not consider surgery at this time.  The benefit is unpredictable and unpredictable side effects can be both dreadful and irreversible.

You should get optimum therapy for the nasal polyps to eliminate them.  Make sure, even though it is unlikely, that none of the tonsil or adenoid tissue has returned.

[ozark]

check sleepnet.com.........its a great forum..good luck