Hi OrphanAnnie, I am a dentist working in dental sleep medicine. The diagnosis of hypertrophic inferior turbinates is very very common. This interferes significantly with air exchange through the nose and can absolutely contribute to causing OSA. Fortunately the fix by an ENT usually only takes about 10 minutes, is not traumatic and can help quite a bit. I send my patients in to have it done all the time. You should certainly discuss it with your health care professionals. a.b.luisi,d.m.d.
Did it help your osa?
YES! It helped by giving me more airflow and helped to clear my sinuses. Now my entire airway is clear. My nose is open and my sleep appliance keeps my throat open.
Dr Tony
What sort of readings were you getting before and after?
Hard to say with just turbinate reduction. After getting Micro2, turbinate reduction, treatment of TMJ muscles, treatment of adrenal fatigue to control my cortisol levels, new diet to reduce sugar, gluten and increase potassium and magnesium, and Quantum Neurology® Rehabilitation I went from an AHI 28 to .1 AHI. Hard to say which therapy contributed to what degree.
Truly impressive. Dr. Luisi
I was a mess Dr Luisi. So I committed to getting better and went at it from all directions.
Actually, I think you are on to something here. Instead of depending on the oral appliance to do all the heavy lifting, you are hitting the problem from every conceivable angle to remove some of the pressure from the appliance. Thus the appliance ends up working better in the end and more emphasis can be put on comfort. I guess nothing spurs innovation like living the problem. Good job! Dr. Luisi
Just a bit of free education for me. OK, you go in for a sleep study and you are found (among other things) to have OSA at a rate of 10 times per hour. Instead of PAP therapy, you have what appears to a non-pro as a minor medical procedure and your AHI is now reduced greatly. Without PAP gizmo hooked up providing this info, did you have another sleep study to verify efficacy of the procedure relative to lowered AHI?
Kinda but not exactly. Let me give you a better timeline. I felt I had sleep apnea or knew I had problems sleeping. I lecture around the country a lot and own a hunting lodge so my job and hobbies tend to interfere with my sleep. So I blamed my sleep problems on my lifestyle. I was giving a lecture a few years ago on sleep apnea and invited Braebon. They showed me their new product that was a home sleep testing unit. Very intrigued so I took the test that night in my hotel room. Showed I had an AHI of mid 20s. Took it home and tested myself in my own bed. Same result but a little better. So I made myself a dental sleep appliance. This got me down to about 1o AHI. Slept much better but still some fatigue and snoring. So one Friday I am reading charts with my sleep specialist ENT and he said let me fix your nose. I said HUH! ANd he told me about turbinate reduction. Takes 10 minutes. Just charge my insurance. Said good deal lets do it. Changed my world! I drove home sucking in all the wonderful air through my nose that I never realized I wasn't getting. All good then I started to snore again. Did a home sleep test and apnea good but some hypopneas. Spring time pollen was kicking my but. So went to my ENT and yep my throat was bright red. So I got on a steroid and it helped clean up the snoring. Met with a functional internist and sports medicine doc and told him what I doing for sleep. I treat a lot of his patients. He did a thermal imaging scan to see where I had inflammation in my body. Turns out I had a lot. So I did some allergy testing and decided to change my diet cause I was getting a little wide in the gut. I am 49, 6' and 205. Not fat but not like I used to be. The new diet reduced my inflammation. Snoring gone and feel much better. New sleep study had me just under 5 AHI. I ahve been a dentist for 20+ years now. Posture not great and right arm gets tired. So I went to chiropractor that specializes in nerve conduction. He along with my in house massage therapist has me sitting on ball chairs while I see patients and focuses on the health of my cranial nerves. One of my my crainial nerves is the glossopharyngial nerve. Ok I wont get to complicated on this I promise. This nerve controls your tongue and swallowing among other things.. My was not healthy along with some other nerves. So he started therapy to fix them. Feel AWESOME again. Latest home sleep study has me at .1 AHI. It was my massage therapist that works in my office that convinced me that the best way to treat the human body is to put it back like its supposed to be, not just compensate with pills and surgeries. If the damage has been done that do what it takes to get back like the body is supposed to function. So I have spent the last five years treating myself along with my patients with that focus. Never wore a CPAP. Still wear my dental appliance to protect my veneers. Hate the diet but like how it makes me feel. I am in south Louisiana. Our food does not fit in the new diet!!!
Hello Dr. Tony, Thank you for sharing all that detail, I'm impressed that you conquered OSA without CPAP. I believe I might be in a similar situation - I was diagnosed with OSA with an AHI of 27. Originally was setup to use CPAP, didn't enjoy it much but ended up tolerating it until my sleep doctor suggested I get a mouth guard due to my anatomy. I have a small jaw and a big tongue since my tongue was probably the problem. Slightly overweight.
So I got fitted with a SomnoMed oral appliance from my dentist. Did some sleep studies - my AHI is now around 4. My dentist thinks that is good but I'm still feeling tired. It was suggested that I lose more weight and do tongue exercises to bring the AHI down further. I've been platueaing on my weight lose a bit lately and not sure if the tongue exercises have made any difference yet - just started that though. Do you get any of your patients to do those tongue exercises: i.e.: https://www.braebon.com/docs/Daily%20Mouth%20Excercises.pdf
In reading everything else that you did, the turbinate reduction is the one that I'm wondering if that could make a difference for me. I do have some spring time allergies and I am prone to sinus infections when I get a bad cold. I'm wondering if this is the missing link to me feeling better. After you had this done, do you recall feeling anymore refreshed after your sleeps?
I also noticed you used the Braebon home sleep study - I used that too. My flow limitation breaths was 34% so that was on the higher side. I guess that needs to be 20% or lower. Was your FL% on the high side like mine? Did you notice your FL% go down after any particular procedure?
You also mentioned you felt great after therapy for your cranial nerves, guess that's another area to explore. I like the whole body approach.
My diet is pretty good now but considering a paleo style diet to help reduce inflammation further.
So I will be going to see my sleep doctor soon. BTW, I tried CPAP again recently and did not feel any better. I just wanted to do that to tell myself that I should keep going with the oral appliance and other alternative approaches. I just want to be confident in my appointment with my sleep doctor.
Mark
Have I recommended tongue exercises to all my patients, yes. Do they do them....... about as much as they follow my hygienist instructions to floss!:) If you need to do tongue exercises then the tongue has lost its muscle "tone". This is one of the areas I am exploring with cranial never stimulation. Another way to look at it is why did the tongue lose tone in the first place????
Turbinate reduction made a HUGE difference for me. Mine were just about all the way shut. I could barely get air through my nose. Just didn't realize it until it was opened up. 10 minute procedure that made a huge difference.
A little on the high side. Not quite to te level of yours. Need to go get my study to see what the actual number was.
For cranial nerves find one of these doctors. http://quantumneurology.com/
Good luck with your sleep doc.
Dr Tony
OrphanAnnie hit it on the nose. I had never heard of sleep apnea when my wife got sick of me not breathing for minutes on end and then starting up with a huge gasp. First time she told me about it, I thought she was nuts. She did a short video and I was kind of knocked off my feet! Anyway, my journey to therapy was the machine route. Nothing else considered or discussed. I have a thin nose and never breathe all that well through my nose and now am thinking about a visit to a sleep ENT in the future.
I really enjoy putting my mask on as it is about the only time I can easily breathe through my nose. Dr. T., try the TexMex diet! Helps me maintain my sumo fighting weight with no problems hehe I would starve to death in South Loosiana eating that stuff scraped off the bottom of a bayou!