Hi all,
I am very impressed by the level of knowledge shown by the posters here. Seriously, it seems some of you know better than the doctors...
27 year old male here with mild-to-moderate obstructive sleep apnea (AHI of 15.5. worse on the back than the front). I have a thick neck (17 inches), but I maintain a healthy body fat (hovering around 14% now) and play rugby and powerlift, so weight loss is not on the table. I believe the main culprit is my craniofacial morphology. I can post some pictures later if anyone is interested. I have a high, narrow arch, was a chronic mouth-breather, never had my tonsils or adenoids removed...the usual pattern. My paternal grandfather had OSA (he used a CPAP), and two of my uncles on my maternal side also have OSA. I am not sure if they use CPAP or not.
The first surgical treatment I underwent was a septoplasty plus turbinate reduction, three months ago. It really did not help much, even for daytime breathing! I think my nasal airway needs to be expanded to allow me to respirate normally. Fortunately, I do not snore.
I currently use a dental device, and it helps, but I also suffer from jaw/tooth pain due to the re-positioning. I really can't tolerate CPAP, and feel like an old man on my death bed when I used it. Of course, the goal is not to require the use of any device when sleeping, and although it works now, sleep apnea will only worsen with age, so if I am already mild-to-moderate as a healthy 20-something, I can only imagine being 45, 50, 60...
My question would be this...
For surgical treatment of OSA, could surgically assisted rapid palatal expansion (SARPE) come before maxillomandibular advancement surgery, or after, or should they be performed in conjunction?
Also, Dr. Posnik, in Chevy Chase, MD -- very good if considering any sort of jaw surgery? He seems to really know his stuff (just reading through his website, have not done any consults with anyone)
Thanks.
