Class I Sleep Apnea/UARS with narrow airway & ENS

[erikavs]

Yes, I agree! I doubt our tongues have gotten bigger Our faces, jaws, upper airways are smaller!

[dantheman]

Yeah, trust me I've done it all. Everything. Still have issues with night-time nasal breathing. Was going to get a turbinate reduction via a minimally invasive technique (www.arthrocareent.com). I don't see any other options short of an osteotomy with palatal expansion to fix this. I don't think I have an especially narrow palate though so I wonder what is causing this. The daytime symptoms are tolerable and most of the time i can breathe through my nose. I rather have someone punch me in the face every morning and not have to deal with the hangovers that last up until early afternoon.

edit: i should mention I've had my nose scoped and nothing obviously structural other than diffuse swelling. They don't know what to make of it, eg: whether this is allergic or non-allergic rhinitis.

[erikavs]

Do you have Nasal Valve Collapse? Do Breathe Right Strips help? If so, that is a surgical option, and fixing deviated septum. Not everyone winds up with ENS, fortunately, so just do what you need to do and I'm glad you've researched the safest methods.

My nasal breathing was also very screwed up by turbulence from NVC and my airways being blocked by my soft palate. You could see if either of these issues are occurring. I'd just hate to see anyone wind up like me

[erikavs]

I don't have allergies, and my issue is a neurological one - nervous system impaired from bad sleep resulting in Vasomotor Rhinitis. Dr Park thinks fixing sleep reduces the nasal issues caused by Vasomotor Rhinitis. I've had that my whole life. I would do anything else but Turbinate Reduction first. I am applying for disability now...it's that bad.

[erikavs]

Here is the link to a new ENS site. Def research ENS before touching your turbinates.

http://sindromenarizvacia.wordpress.com/

[erikavs]

IF you have any questions about ENS there is an FB public group run by Dr Houser, the only dr in the country who does implants to help ENS. Turbinate tissue will need stem cell technology to regain function, though.
https://www.facebook.com/groups/44406735710/
This one is my group - it's secret
https://www.facebook.com/groups/154585118068642/

There is an ENS patient forum, too on YUKU
http://guest.fr.yuku.com/

Maybe you can email Dr Park for advice or second opinion first. He thinks most nasal surgeries are unnecessary. Def read his articles, too. And fix the sleep issues - they are NOT caused by your nose, most likely. THe nose is a symptom not a cause. VMR can be a result of bad sleep. DO anything else first and just use for now, get through...

I know you may not agree, but I have to say that because my life was ruined by ENS and there is no fix for it.

[erikavs]

Sorry to sound scary. But our medical system is run like a business. They add on unnecessary procedures and don't care about the patients who don't react well And  since there is no way to test or see the problem, drs deny the situation to avoid malpractice - this is a standard surgery, but it shouldn't be. The tissue can get swollen and stuck that way in some cases like varicose veins, but if you're young, I doubt that it's irreversible. This tissue is like erectile/clitoral tissue and reducing it is somewhat like genital mutilation. It won't work again with Viagra! We patients are trying to get stem cell regenerative therapy...

[dantheman]

So vasomotor rhinitis is a subtype of non-allergic rhinitis and from my understanding usually presents more often with a runny nose. As for something neurological, I believe this without a doubt. If i'm lying in bed anxious that i'm running late (for example), I can literally feel (and hear) my turbinates shrink, due to the sympathetic outflow. Now the question is whether this is an exaggeration of a normal physiological response or completely normal. After all, the fact that at baseline I have so much swelling does not make it a surprise that small changes to blood flow to my turbinates has such a drastic response...

At the end of the day I might try an aggressive workout routine in an attempt to increase sympathetic tone. I believe if I can achieve this I will have at least some improvement to my symptoms.

[erikavs]

From my experience into the depths of neurological problems caused by ENS, sleep is the biggest factor. Exercise helps alot too. Acupuncture. Do all you can to heal your nervous system - and I think structural/dental issues with sleep are a big problem. Dental appliances might show you if you have a crowded airway blocking airflow (that is my original issue, they should never ever have touched my nose). Soft tissue reductions don't always work but they are worth trying, except for turbs. Even meds are better than surgery for turbinates Sudafed, Adderall although those won't help you sleep. I have to take them to clear the AM brain fog....

I just worry that you're so much like me, you might have VMR, UARS and could be prone to ENS which I think should be told as a complication for patients with a more hyper nervous system.

[erikavs]

Here is a great article and he has many more on his site! Our issue is UARS

http://doctorstevenpark.com/attention-all-mouth-breathers-5-important-reasons-why-you-must-breathe-through-your-nose

Also when I google my symptoms I always get Vet sites for Brachycephalic dogs YUP! It cracks me up but it's true. I'm like a flat faced dog

[erikavs]

I don't know if you are east coast or west? Dr Guilleminault at Stanford or anyone affiliated will be good for UARS and sleep. In Cleveland - Dr Houser is the MAN. NYC - Dr Park or Dr Sclafani.  I can ask my groups for a good ENT for a second opinion.
VMR sucks but I think you will find ways to deal until you can fix the underlying issue. Turbinates are just canaries in the coal mine (symptoms)...not the cause. Drs love to just cut out the symptoms and usually it's ok, but I'm f**king disabled now!! So obviously it's not ok in this case...they same the same about sinus surgeries, too. lots of unnecessary stuff.

[erikavs]

Another good post on UARS and nervous system issues in sleep-breathing problems, AM headache

http://doctorstevenpark.com/the-connection-between-migraines-sleep-breathing-problems

[dantheman]

Yeah, it's all enough to make your head spin. Did you have lots of tissue removed? ENS is a rare complication and as far as I understand even more rare with the new ablation techniques.

I wonder if there is a  connection between turbinate hypersensitivity and chronic emotional stress. It's all tough to figure out what caused what. It all appears to be a vicious cycle.

[erikavs]

Don't give up. It's not a vicious cycle but it is a complex intersection of systems. That's why they don't understand it well - it's not clearly divided by medical departments and you need a more holistic dr like Dr Park. He has helped me so much. I hope you can read his articles and books. I just would do the least risky things first...Email him if you like! He knows those who get ENS are those with nervous system issues. Any chronic stress will make that worse.

The research is much better than ending up like me.

[dantheman]

I have anxiety and a lot of baseline stress which I'm sure contributes to the heightened sensitivity and probably inflammation levels as well. Funny you mention diet. I plan to do diet shortly that eliminates wheat, dairy, sugars etc. to see if that helps. And I will work on my stress levels. I always wondered why I sleep better and breathe better on vacation!

As for aging, I think life has taken a toll on me. Dark hollows under the eyes... May be the jaw issue or may be sinuses , congestion, UV, who really knows. I wish I knew what started the ball rolling... Stress or sleep?