How I think sleep apnoea should be treated

[@ImNoclue]

My experience with the American medical system is they do a sleep study, Rx a CPAP and send you on your way. Its complete rubbish.

[@VikVeerENTSurgeon]

I'm sure you'll be able to find someone there who might interested to take you on. Good luck!

[@pikubird]

Same in Canada. I’ve been struggling for 5yrs now and still can’t use cpap. No hope here ans im so desperate. I hope there will be something coming up because this thing is life threatening and I don’t know what to do

[@petercyr3508]

They do this because it has been established that insurance will pay. Another example of this is butchering the stomach to treat obesity.

[@leni_lava]

Same in the UK!

[@pm3480]

Yes. Same thing here in South Africa

[@happinessisstartrek8466]

You're not rambling. It's clearly your passion to help people. That's a great thing! More doctors like you are needed across the globe.

[@tamrakat]

Wish I could find a doctor like this in the U.S.

[@AndrewVerran]

Interestingly, I was first diagnosed by a US doctor via an email conversation in 1997. Totally on his own time, so they are out there. Not confirmed by the NHS till 2003 & not treated until 2007, so it's very variable wherever you are I guess. In 2007 that particular Drs view was I was fat and that was that. I lost 40Kg & it made no difference...SATS 71%...fixed in the main by BiPAP & a different Dr (didn't get on well with CPAP).

[@alliebarnett8020]

Wish I knew this sooner- just got the inspire surgery- not activated yet- only have mild sleep apnea. I believe snoring can also come from Stomach problems- gerd and such but that was not explored. Medical society doesn’t understand that issue well yet either

[@shellyeades8356]

Dr Zaghi at the breathe institute

[@gracechase5574]

I have chronic OSA and been on a CPAC for 8 years. All that was don't was three sleep studies and then came the machine. No follow up ,no other test,no look down the throat,no other evaluations. Just you have it here is the machine and use it for the rest of tour life. Now I have a weak esophagus, bad acid reflux, sleeping issues,headaches and my teeth are in a diffrent position everytime I wake. I've only seen the doctor once and I'm told to lose weight. I lose weight and he tells be I still need to use the machine. Phillip had a recall on there machines ,several years ago and I still haven't recieved a new one and the CPAC machine cause cancer per phillips recall reason. I feel Iike this machine is why I have spams in my esophagus but no one will confirm it or treat nor explore the possibility. I still have brain fog , headaches and fatigue. 😢

[@krisholt8390]

Ditto. It’s not a matter of finding a doctor that’ll prescribe a sleep study, it’s being as deeply knowledgeable and as thorough, not to mention being in close proximity to that individual. I also like that as a surgeon, going straight to knife is not his first thought. I know I’m over simplifying greatly, but this is a nice benefit of being in Europe, it’s akin to us yankees going from one state to the bordering state.

[@cyberphox1]

The NHS needs more great doctors like you.

[@TeresaWells-y7g]

So does the USA!!!!!!!!!

[@earleagleson5912]

Also Canada.

[@shankar0cr]

One of those rare doctors, that understands what it's like for a few patients who can't tolerate CPAP. Keep up the good work Dr Veer.

[@karimalameddine5092]

Look into the BIPAP machine, might be a lot less jarring to use... 🤲🙏🌷

[@donnalang5105]

I love your philosophy. I just turned 57 last month and have been watching your channel since late last year. Last year I was on the Keto diet for 6 months and couldn't get below 183 lbs. and that is with swimming 3-4 times a week for 40 minutes. My friend said if I lost weight I would get rid of the sleep apnea. WRONG I started a new Job 14 months ago that has great insurance. My sleep study showed I was having 72 apneas per hour and Oxygen was in the 70's. My primary care Dr. was speechless. I saw an ENT, I said yeah I know I need to lose weight. He said your weight has nothing to do with this, but since I started using a C-Pap and showed him my numbers that were between 5-10 apneas per hour he said to continue. It was very difficult in the beginning and I already wear a night guard for teeth grinding. I have to say it took about 5 months to get used to the C-Pap. It did give me terrible anxiety in the beginning to go to sleep. I had to mentally give myself permission to take it off at any time during the night. Once I did that I began to be able to leave it on longer. By April 2022 I weighed 195lbs.at my well needed foot surgery. By July I started noticing my weight was finally starting to drop. I noticed sugar and caffeine cravings going away, as well as allergies. Before the Cpap, I was using a Netti Pot daily to help me breathe better. I haven't needed to use it in a month and allergies going away. I feel my immune system is getting stronger, because obviously I sleep better. Since April, I have been weighing myself weekly and have been losing 3 -4 lbs a month without really trying. My only exercise has been walking the dog a couple times a day for 20 minutes. I am now down to 174 lbs. Woo Hoo! It's been 3 years since I weighed this. I still find myself getting better sleep all the time. Last Saturday I got 9 hours sleep. Last night was 7 hours sleep and it said the AHI was .6. My AHI is now averaging between 1 and 2 per night. It's amazing how sleep apnea really changes the body chemistry. I feel like I'm climbing out of a rabbit hole, and my health is getting better all the time. I appreciate your videos. Wishing you and your family a Merry Christmas and Haooy New year

[@donnalang5105]

Happy New year!

[@closerwinner]

@@donnalang5105 happy new year :) I started the apap therapy with 61 apneas per hour, and now it's 0-1. I weigh 300 lbs though. I'm really struggling with weight loss. I have high blood pressure and I'm prediabetic. I try to walk an hour and a half a couple times a week and watch what I eat, but I could do better with dieting. Kinda need advice on dieting.

[@VikVeerENTSurgeon]

Amazing story, so glad you managed to work this out on your own. I think this is inspirational. Merry Christmas and Happy New Year to you too.

[@bethwagner133]

Ive watched a few of your videos. Very informative. Thanks. I haven’t seen one yet where you mention jaw surgery as a possible option. Do you sometimes see a need for MMA if tonsillectomy, septoplasty, turbinate reduction or MAD or CPAP don’t work.

[@VikVeerENTSurgeon]

Please have a look at my video on how successful is surgery for information about MMA

[@zzyyxxzzyyxx]

omg, a specialist who is also a scientist. not simply applying the cookie cutter approach but seeing patients as individuals, and taking great care to make an accurate diagnosis! incredible, and sadly far rarer than you should be, doctor. I will be sending this to my sleep specialist, who, frankly, is inferior to google at this point. thank you for your sensitivity and your enquiring mind, and finding the balance between following evidence based guidelines while leaving the dogma aside. thank you!!!

[@RhiannonRaven]

If more doctors looked at people "in their entirety", the world would be a much better place. What a great doctor.

[@mgmt4325]

All doctors should be like this. Thank you!

[@reihanakingi8898]

Kiaorana from New Zealand, I use a CPap machine, it does help, I just finished watching this video from Vik Veer, what a good man. I can see his genuine desire to help people resolve their issues, without harm. Keep up the good work and other practioners will follow. God bless us all in our journey to fulfill our potential and love one another as Jesus loves you

[@MrsHazel]

I became a bit teary-eyed when you said sorry to those who were let down by medical professionals. I am part of the 30% that can not use a cpap machine and feel like I'm not being heard. The headaches and pressure in my ears from the cpap are horrific and worse than the symptoms of the sleep apnea. I'm getting fitted for an oral device now. Nobody has ever looked at my throat, nose, etc. and I'm just being checked off the list of what's next. I wish more doctors were like you and truly wanted to help and not just check off a box of tried this or that.

[@kevOzilla]

im in the same boat now and i have severe sleep apnea and i cant deal with the cpap i tried for a whole month and im giving up it has givin me soo much symptoms of aerophagia it isnt even funny and anxiety so ima try the oral appliance and going to see a ent doc to see if i have a deviated septum or any other bloackage

[@ebo7310]

​@@kevOzilla how are you now?

[@sidewinder1639]

Thank you for expanding my view on sleep apnea. I use a cpap for 17 years every sleeping hour in my life, but I consider myself lucky and I learned a lot of tricks to deal with the cpap. It moved me when you started on the weight gain being a result of sleepapnea instead of the other way around.

[@lynlawley8903]

That's so sad but what to do

[@tpegyt]

My first night using CPAP last night. One hour I lasted. Will try again tonight. It's obviously doable.

[@EdwardChiswellJones]

As a former paramedic and current osa sufferer, I’d like to say thank you for your pragmatic and holistic approach to this problem. I was left feeling angry and insulted after being told by a consultant that I was ‘non compliant’ in my cpap use. They made literally no attempt to understand WHY this was the case. 18 months on I have improved but really in spite of, rather than because of, that consultant!

[@mindyourownbastardbu]

Speaking as a surgical colleague in a related field, what an excellent presentation sir! The simple logic and elegant explanation of the surgical approach. If only every surgeon took this approach, broadly speaking.

[@Wally2024]

Great caring doctor who takes many good additional steps to treat patients. On the other hand, many other doctors are robotics, they spend a quick few minutes with patients and then provide the verdict 'you got this health issue and here is your prescription'...

[@jugglingjakeuk]

Babble all you like, it's so nice to hear a Doctor who really cares & Genuine. Thank you so much 👍

[@DarkHorse-bp3xf]

My sleep study at a clinic was about 3 years ago. The bed was really hard, I had to wear full pajamas, and the room was really hot! I can't imagine it was an accurate test due to this. Having the study in your own bed makes perfect sense but nobody in my (large) city does this. I'm learning so much from this channel that no sleep professional bothered to tell me. Thank you!

[@OBE_EnterElysion]

Thank you so much for this Video. I have felt my whole life terribly tired and started to gain weight so much. At 39 finally they found after a sleep study I got very severe Obstructive Sleep Apnea with an AHI of 100 my oxygen level dropped til 68% extreme fatigue and still kept on thriving with everything in life. Docs were in shock how I did it all. I now am almost a 3/4 year using my Cpap machine, and I feel tremendous and slowly better. I even set my father to do a sleep study as well at the age of 76 and he had the same as me. AHI of 45 but had several strokes heart problems and alrzheimer now even due to never being treated. It's never too late to start using a Cpap machine. He already as my self is more alert and it really shows off. Never give up you all. Much love.

[@wildbrasil8037]

The world is such a better place with amazing people like you. I admire and am grateful for your loving contribution to helping people.

[@mclbru89]

My experience with the Canadian medical system. I've been diagnosed with sleep apnoea a couple of years ago. I'm currently using a CPAP device. In the back of my mind I've been thinking about somehow troubleshooting the sleep apnoea. I also thought the sleep apnea was caused by my obesity. I really like this youtube channel's content and you have a very comprehensive approach.

[@GarethStack]

This is incredibly useful. Stumbled across your videos looking up Myofunctional therapy, as I've had a SA diagnosis, with CPAP treatment for over a decade, as well as a septoplasty, and am still suffering from very severe insomnia and fatigue. Really great to have my intuitions about the inverse link between weight gain and SA confirmed, as well as hear some of the frustrations I've experienced as a patient (in Ireland unfortunately) be validated. You're doing an incredible service to people in severe distress here. Thank you so much for taking the time to create these and share your perspective.

[@margeryriviers3432]

Second!

[@day161]

Hi Vik, I love your channel this may sound a bit over the top but I wholeheartedly believe it’s saved my life. Your videos helped me understand that I had sleep apnea and able to talk to my dr even though she only did a epworth test and told me that my score didn’t reflect that I had sleep apnea. So much so I paid for a sleep study myself where it was confirmed I had server obstructive sleep apnoea. I also paid for an ENT consultation where I was told just I had a deviated septum and I needed to loose weight to help with the snoring. I then took my private report to my GP where she referred me to sleep clinic where I had another sleep study and I was told that my AHI was 123.7 per hour, and that I qualified for CPAP but the clinic that did the study wasn’t commissioned to provide the treatment and there is an understandable waiting list. So in the mean time I purchased my own CPAP machine and within three days of using it everyone around me said I was my normal self again it was honestly like I was seeing colour again. Even though I don’t find it comfortable to use or look forward going to sleep if that makes sense, but it works so for now I will just put up with it I guess. I’m still waiting for my appointment since the last one back in may. I am so glad that I watched todays video as I recently had an appointment with an ENT consultant where he told me that there wasn’t much treatment for sleep apnoea other than a tracheotomy or many different operations that would inevitably lead to one. However I feel as if I can go back and ask for more and not just take his word for it and not be treated unless it an extreme measure. I really wish you were my consultant. It seems like it’s taking a while for the advancement of treatment for sleep apnea to reach the clinics and doctors up in the north west. Thanks again for all your videos! (P.S sorry for the long story)

[@VikVeerENTSurgeon]

It was a great story, thank you. I hope the North West catches up. I was trained in the North East and so a lot of the practice there is transferred across to the lakes. I hope you get to the bottom of this. keep going!

[@LilysLife-ns4qs]

123 AHI per hour that’s really bad. Was that all on your back or on sides too

[@albussnape2]

@day161 Great story! Glad you’re better! We could use Vik clones here in the rural middle of New York State!! He seems brilliant, and a true physician-compassionately giving us important information, when doctors we’ve consulted haven’t been helpful.

[@nenathurman4124]

Yes we’re neglected here in New York

[@lindavid794]

Dr. Veer sounds so wonderful. I’m in rural south, USA. I don’t think there’s any doctors here who are as knowledgeable. I wish we had someone like him here.

[@InvictusEagle]

Thank you. Hearing you speak on this video makes me realize I'm not crazy! I live in the US so I can't visit you for treatmeant I'm just hoping there is a doctor in the new york city area who thinks like you. I'm so sick of doctors just having 1 approach. Its either a CPAP or an oral appliance and if it doesn't work its my fault. Keep doing what you are doing you are changing peoples lives in ways you will never know.

[@jamesdooleyhypnotherapy9920]

It's amazing that we have someone like you, offering people with sleep apnea hope.

[@avivat3010]

I have just been diagnosed as needing a CPAP machine. My experience with the technicians was very nice, but I felt like I was on a conveyor belt at a factory. Answers were mumbled, information limited and my 6th sense alarms were ringing quite loudly. I know something is wrong. I know I'm much more fatigued than I should be. Your approach makes a lot of sense and the amount of information you provide calms me. You are believable and your level of experience is palpable. I hate being treated like a person who won't understand the details. I want to exercise my right to understand what is happening. I fully appreciate your passion. The details you describe are very helpful and you seem very kind and interested in doing the best for your patients. Thank you so much for the information you provide.

[@shonnapnw]

Fabulous video thank you. Finally good to hear a doctor that cares & gets it.

[@VikVeerENTSurgeon]

You are so welcome! And thank you so much for your support. Merry Christmas

[@tinaharnack3704]

I came across this video while scrolling. As a former RT, this is the best video I have ever watched. Lately I have watched more, for lack of a better word, ignorant, videos suggesting taping your mouth shut, stooping the use of CPAP, stating there is no such thing as sleep apnea. One video was done by a wood craftsman who suggested you tape your mouth shut with painters tape, then showed how his oxygen sets improved with his apple watch! I literally screamed. I wrote a comment stating how irresponsible he was, but people believe these snake oil salesmen. Having watched patients struggle to live a good quality life with sleep apnea, then seeing the change a CPAP or surgery can do, I'm so grateful that you are doing these! Thank you!

[@VikVeerENTSurgeon]

Hahaha, it can be frustrating but I hope I am helping a bit.

[@shehzadhussain2849]

At last someone who really understands

[@Dave-901]

I'm on my second month of CPAP and to be honest its changed my life, before I was diagnosed I woke up every hour now I'm able to sleep 8 hour straight. I also have COPD Asthma overlap which has improved a little since starting therapy. Thanks so much for the video is so informative and have now subscribed.

[@mickelfritz]

This video made me feel like crying. If I had a lot of money I'd fly to England just to see you. I live in a wealthy state that has health care coverage for those who are low-income like myself, in a country that supposedly has some of the best medical schools in the world. And yet it essentially came down to giving me a CPAP and abandoning me (and acting like it was my fault) when I couldn't use it. None of the things you're talking about were addressed. I guess I need to go back in and make them address these things. I had given up, thinking nothing could be done and that I'd just become more and more sleep-deprived as I get older with the attendant health issues. I can't even tell you how angry I am. What good is it to have all this information if it doesn't inform the treatment people need to get better? The system is so very, very broken.

[@robiny.4395]

Let me guess….are you in California? That was my home state. Glad I’m gone.

[@medwayhospitalprotest]

I'm in the UK and my experience is just the same as yours. Every 6 months they change my settings but nothing improves. My stats are terrible. They've done something so I can't see the stats anymore and telling me they are fine! Now I am developing heart problems.

[@NatureScapesStudio]

@@medwayhospitalprotest when the world changed over to 5g all of the machines stopped transmitting. Mine did. Resmed doesn’t care and dr says they started asking them to fix it, but they won’t. And don’t care. They are making massive $$$ off of us. I feel like you on this. I get blown off by the pulmonary dr. I lost weight on my own. Was doing well when I took meds for sleep and back pain. I’m off most if the meds, did better for a while but the stress on my body is mounting up from the stress of our world situation. Been off the machine but that is all they want to do. This dr is ignored here.

[@Dulcimerist]

The sleep apnea surgery removing tonsils, adenoids, uvula, and excess skin in the back of the throat can permanently remove sleep apnea for patients, so that they don't have to wear a CPAP and don't have to continuously have return visits to their doctor. It worked wonderfully for me, and I wish I had gotten it done years sooner. I no longer get sinus infections or ear infections after getting this surgery, so that was a bonus benefit.

[@dandersohn]

I feel your pain dear. I’m the same.

[@heatherh3457]

You are absolutely right about the mental trauma that the medical system put a patient through. I was told I was just too fat and wanted attention - right to my face only to be diagnosed 6 years later with pain cause by an error in surgical procedure. Undiagnosed with OSA for 10 years plus. When retested rousing 69 times / hour. You carb load to try to get some energy! But I am just a fat slug who is causing my own hell and deserve contempt. Bless you for your compassion.❤ It has done my heart good.

[@medwayhospitalprotest]

I've started protesting outside my hospital because I just can't get any help. Now I'm developing heart problems. Same as you, they tell me its my own fault, but they do nothing except tweak the settings every 6 months and send me away again. I am 100% compliant with CPAP.

[@heatherh3457]

@@medwayhospitalprotest I am so sorry. Wishing you restored health and compassionate care.❤

[@zomronshamrikas1534]

​@@medwayhospitalprotestis it possible for you to lose 10 percent of your body weight? Recent research has proven that doing this alone cured 85% of those who were diagnosed with atrial fibrillation (a major correlation exists between sleep apnea and atrial fibrillation and heart issues).

[@hollandanish5557]

Please do not stop what you are doing. It is so valuable. Thank you for your commitment and care. If all doctors showed your level of concern I suspect that patients would be better able to help themselves.

[@faevoryn6578]

This video is so helpful! This big-picture explanation helps immensely. I have felt discouraged, but this video clarifies that improvement is a process, and that there are a multitude of options that can help. I also appreciate how it is pointed out that weight loss is more difficult when a person is not sleeping. It's easier to work on the problem when one can set down the feeling of failure, and focus instead on what is possible.

[@VikVeerENTSurgeon]

Thank you for your message, I'm glad that it helped.

[@yahyaelmi8435]

@@VikVeerENTSurgeon dr from what I have learned if nasal breathing isn’t corrected everything else goes wrong ,

[@mundevaibhav7939]

Sir how do I get an online consultation with you I’m in India

[@bschratz1117]

I started doing these exercises on Thursday. Last night, Saturday, I slept for the first time in 2 years without waking every hour. I am so very hopeful! Thank you for this video.

[@psynurse]

Excellent video! Sedation to observe areas that potentially obstructing breathing etc. I'm really impressed with your thorough exam. I use CPAP and over weight. Went to clinic for sleep study but didn't have exam anything like that. I'm so tired of my CPAP but without I immediately start snoring and wake up tired, headaches.... You know the drill

[@thebelievers9292]

Thank you Vik. i was at the end of my tether with OSA and i haven’t really started my journey at all yet. watching this video has given me hope and i will be asking my GP to refer me to see you. hopefully that will happen.

[@roycarder6179]

What a credit this Gent is to his Profession

[@arseniyonline1234555]

Doctor's and surgeons are heroes and deserve so much more respect than they get.

[@phoenixrising6337]

I can’t say thanks enough to you sir! Thank you for doing this video!!

[@VikVeerENTSurgeon]

My pleasure!

[@nonamesl3f7duuude]

Hi Dr. Veer, great video. Also, thank you for reviewing the iNap which has been great for about a year and has replaced my cpap. I'm younger, physically fit, and was having issues with high pressures making cpap difficult (UARS). We need more docs like you in the US.

[@albussnape2]

@nonamdsl3f7duuude We definitely need more access to docs of Dr. Veer’s knowledge and compassion in the U.S.! I can’t find a specialist like him. Best wishes!

[@shellyeades8356]

the Breathe institute is in the U.S. Dr Zaghi

[@taniayager3361]

I woke one morning dizzy and vomiting. I've had this happen twice in 5 months. The second time I realised it was due to lack of oxygen. I am moderately overweight and developed sleep apnea some time ago. All my doctor said after examining me was I needed to lose weight! I decided 3 months ago to invest in a wedge memory foam pillow as ordinary pillows weren't helping. I was also concerned as I have poor circulation and don't want to run the risk of a heart attack or stroke! I no longer sleep on my side but at an angle on my back. I never thought for one minute I could sleep this way. However, I proved myself wrong and I wake now every morning feeling refreshed; not fatigued! I also don't feel tired during the day either! I just never ever want to have a recurrence of dizzy spells and vomiting. I'm going away on holiday and have invested in an inflateable wedge pillow. I've tested it out and it works! I don't want to run the risk of falling ill whilst I'm away because of sleep apnea!

[@monicabatt9430]

@@taniayager3361 you will have fewer wrinkles on your face sleeping like that , Bonus😊👏👏👏👏👏

[@jordisucabadia8842]

Thank you very much. I've followed your videos. My snoring was hard. In the end I got luckily diagnosed and now I use CPAP. I struggle but I'm very happy with it. You shed light during a very confusing time for me. Again thank you.

[@sallyshipwreck4315]

Thank you for caring about your patients.

[@VikVeerENTSurgeon]

it's kinda my job, but i'll take the compliment, thank you.

[@matty6247]

I wish I could visit you Doc! I test negative for Sleep Apnea, but have every single symptom. You are doing great work for humanity, and for our spouses!

[@alimccoy9132]

It is obvious that you are not a "wrap-'em-and-pack-'em" doctor! You are willing to research each person's symptoms and address each one! Rare breed!

[@joepace6457]

Finally a real doctor, we don’t have them in the US. 15 minute appointments & your prescribed a drug that causes more problems. Bravo ! Thank you

[@fondrees]

@@joepace6457 real Doctors are rare in every first world country.

[@MartaCrowe]

Thanks!

[@VikVeerENTSurgeon]

This is much appreciated, thank you very much

[@krg250163]

Your video has summarised perfectly the way I was treated before being referred to you at UCLH. I was made to feel that being slightly overweight was the main cause of my sleep apnea and snoring despite me explaining I had this problem when I was 3 stone lighter 40 years ago! I was given CPAP and then not offered another option despite me explaining that I was finding myself unable to tolerate it. I googled my issue and came across your work and I saw you privately. You very kindly suggested that I could ask my doctor to refer me to you on the NHS. They were reluctant to do so suggesting I could have something done locally. I am so glad I insisted and I was referred to you. I am due to undergo some further procedures soon and your approach to me is exactly as you described in this video. I can only offer my sincere thanks to you for not only the way you have listened and treated me. I now feel part of the process. Like others on here I am extremely grateful for the very informative content that you regularly post. Thank you😊

[@VikVeerENTSurgeon]

Glad you feel you are on the right path. Looking forward to catching up with you in the new year.

[@robiny.4395]

Kevin, I’m jealous you got to see this amazing well informed Doc. I know here in the states we still have some good doctors, yet sadly most are under the thumb of the hospital and or Medicare. Our government has stepped in between a doctor and their patient causing depression on all sides. I’ve been in the medical field for 40 years and have watched doctors who love their jobs and patients become depressed and angry, many have retired or are doing something else.

[@kiwikathy]

What a wonderful doctor & empath. I almost burst into 😭 tears. You totally 💯% understand. My sleep OA is dominating my life. On the waiting list in NZ for post nasal drip. Thank you for explaining sleep apnea so succinctly. I don’t know what a full night sleep is I’m so tired due to lack of sleep 💤 my grandchildren said I don’t snore….

[@user-wv5gv3dw5u]

I wish you were my ENT. The ones I've seen here in America have been atrocious. And honestly your rant at the end is one of the most refreshing and important things I've heard a western med doctor say in a very long time.

[@VikVeerENTSurgeon]

I'm glad you liked the video. I hope you find someone who can get to the bottom of your problem.

[@momc1134]

Thank you so much for being an excellent thoughtful intelligent and sympathetic Doctor...the world needs more like you... I thoroughly realize how hard it is to become a doctor and to stay in the profession in these trying times..you all need to support each other and to be the excellent human beings that you are for wanting to help people by becoming doctors!

[@sharlesb7735]

I used the same cpap mask for 9 yrs, without a problem, the model was discontinued. Got a new mask about two months ago and I can’t believe how bad it is. This new model is a common style and I don’t think there is any others that would be better, plus they are expensive to try options. I can’t sleep without one, my throat closes as I fall asleep and jogs me awake even when sitting. I wish the mask manufacturers would design better options. Good to hear a surgeon looking at other treatments besides ops.

[@samanthapierce9466]

I got my CPAP from my neurologist. At my follow up appointment, I asked to go see an ENT to see if anything more could be done to help further along with using the CPAP. The CPAP does help. The neurologist then referred me to an ENT. Turns out, I have a collapsed nasal valve, deviated septum, mass that has shifted my nasal bones, sinus polyps, etc. soooo hopefully I will be able to breathe even better with and without my CPAP soon! Thank you for your videos. I think they are so helpful!! I feel like if I still have issues after my upcoming surgery, your videos will be helpful for me to learn and advocate for myself. Thank you again!!

[@richardcranium5839]

you hit the nail squarely on the head. - national guidance-. too many doctors just follow the flow chart and off to the next patient. medicine needs to be personalized to the needs and circumstances of the individual

[@azizadily1595]

I live in the U.S. I have been using cpap since 2018. It is a struggle every night and anxious to go in my bed. It is the first time someone explain very clearly sleep apnea. I wish I can be treated by this wonderful doctor

[@JenksAnro]

I absolutely love your attitude you really seem to have a good heart

[@VikVeerENTSurgeon]

Thank you. Really kind.

[@travisogden2121]

Love your approach to find the root cause and least invasive treatment. Thank you.

[@gilliansharples5126]

My sleep study showed only mild apnea although I felt that it was disrupting my sleep to a high degree. Based on reviews and information that you have provided and also other tips, I have arrived at the nightly routine of a combination of a nasal decongestant, a nasal strip and a small piece of micropore tape in the centre of my mouth(leaving a small gap so that I can still breathe a little through my mouth). I sleep much better and only get up once during the night instead of three times. Thank you for all your help.

[@VikVeerENTSurgeon]

Great to hear, thank you

[@elizabethsprinz9683]

Thank you doctor for being along side your patient and really have this actual difficult process understood and recognized. You inspire trust and respect.

[@robertp.wainman4094]

Yours are some of the most helpful and encouraging videos on KZbin - If only all doctors were trained to explain so well....you seem to really understand the patients experience and offer wonderful medical advice....with humanity. I'm counting down the days to my appointment at the Royal National!

[@user-du1gd4gq4n]

OMG thank you Dr Veer, You have nurse blood in you, your approach is the nursing model combined with the medical model, wholistic view, RN here, now FNP. I don’t have the honestly time to go over all my apnea hx but pls know you are spot on in your approach. More to follow soon 🙏

[@martinmatte7597]

I got diagnosed with severe sleep apnea AHI of 32.4 and the lowest oxygen level of 82%. With the CPAP my AHI went to 61.7 and my oxygen level dropped to as low as 62%. Not everyone can tolerate CPAP. Thanks, doctor for putting all this information for free online. So manydoctor don't know what to do when CPAP fail.

[@closerwinner]

my ahi was 61 and now it's 0-1 thanks to apap.

[@VikVeerENTSurgeon]

Glad that it helped. out of interest did they diagnose trapdoor epiglottis? it often gets worse with CPAP.

[@martinmatte7597]

@@VikVeerENTSurgeon The epiglottis was fine. The DISE revealed that it is a combination of the soft palate, tongue base and lateral wall collapse in the context of a narrow airway. The CPAP ahi were all detected as central (all my ahi were obstructive during the initial test that diagnosed my sleep apnea). Due to a deviated septum, my nose airway is really narrow and blocked most of the time by allergies. My specialist has suggested the MMA surgery as the only realistic option. For now, I sleep in a recliner which helps enormously. Thanks again for all the work you do.

[@sakuragi_hanamichi3263]

@@martinmatte7597 how do you sleep in a recliner? Does sleeping semi setting help?

[@LilysLife-ns4qs]

Martin have you tried a boil snd bite. It worked wonders for me for a week then stopped working as not gripping teeth as much

[@jonelbenosa3154]

Thanks

[@teresahiler5866]

Wow! I agree with everything you are saying. I have been fighting sleep apnea/snoring for 20 years. I have gone through 3 sleep studies and been fitted with 2 different CPAP machines. I have also lost 70 lbs. (current weight is 115 lbs. and 5' 2" tall). I gave up trying to use the CPAP. I would wake up gasping for air and constantly fought with the mask leaking air. I no longer snore every night, but sometimes it is still very loud and keeps my husband awake. Your approach makes SO much sense to me. It is too bad that I live in the USA.

[@VikVeerENTSurgeon]

Sounds like you are making good progress, keep going!

[@lisamccall8310]

Just be aware that not all of the UK doctors are like him. As he said, people are generally being told that they must use their CPAP and lose weight, and that their weight is causing their SA, and not the other way around. It is difficult to find good doctors and treatment in countries with socialized medicine. I lost confidence in the medical profession completely during COVID, and I'm unhappy that our freedoms in the US are being usurped, but I think it's sad that you think it's unfortunate you live in the US. (Here's to hoping freedom is restored and protected here.) And yes, wish there were more doctors as intelligent, compassionate, and understanding, and as good at teaching as this gentleman.

[@AmariLynn8]

Thank you for this information. My local ENT told me to see a dentist. The dentist said to go see an ENT 😢 I have been on an endless loop for the past 2 years. After seeing a sleep Dr. I have been diagnosed with sleep apnea and got my CPAP today. I will give the cpap a serious try because this condition is ruining my life. Thank you Dr. for your honesty. ❤

[@katelemon2750]

You’re obviously a caring doctor. The music is annoying. ThankYou for everything.

[@margeryriviers3432]

Same. Why the background repeating sounds is it supposed to help the viewer listener or is some other reason? The wonderful talk by this doctor is superb, best I’ve come across (and I’m a relentless digger in these parts) the background chimes were intrusive/distracting.

[@thecornishwildcamper]

I've just found your channel and what you explained makes 100% sense to me and I'd be grateful to be a patient of yours

[@harishardaway2981]

I’m in the US and in Boston with our best hospitals in our nation. This doctor has just given me confidence and I feel less depressed about my sleep apnea. No one has described my condition so well and his compassion is uplifting. I now know how to go back and talk to my doctor and ask the right questions. I’ve had sleep apnea for 3 yrs now and I finally understand. Thank you I don’t feel so hopeless after watching this video

[@robiny.4395]

Exactly, we can use some of his language to get through to him. I think I’d ask to send the doc this video.

[@TLCREW9]

If you find a good doctor in Boston will you post? I am looking for my adult son with Aspergers who has just been diagnosed with Severe Sleep Apnea (83 AHI/hr). I don’t think he is going to be able to tolerate the cpap, and that is all that was presented as an option.

[@nancymcgrath6283]

I live in the Boston area. If I find a good doctor, I will post it here.

[@lauraann4523]

Wow, a doctor who actually has compassion. How rare you are!

[@michaelkane7021]

Excellent video! Most people even physicians don't understand sleep apnea, "how can you be more tired when you wake up than you were before you went to sleep?" I've been using a CPAP for 12 years now, a nasal prong mask. Not only did the quality of my sleep slowly improve my allergies (dust mites) were immediately so much better and my reflux improved too.

[@VikVeerENTSurgeon]

Thanks for sharing!

[@ocwronski]

Wow, very systematic and a great approach. You are exactly the type of Doctor I have been looking for. Please keep up the education videos and sharing of all your knowledge. Unfortunately, I’m in USA and most Doctors are in for the money. You have a desire and compassion with patients in what you do. Thank you👍🏻

[@marco1983]

Hi Vik, thank you so much for posting this video. I am currently being referred to carry out a sleep study (I went to the GP today). I believe I've had sleep apnea for a few years now but have always put off getting it looked at. This is partly because I never want to go to the doctor and a general lack of understanding of how detrimental it is to your health. As you were talking it was like pieces of a puzzle coming together and it's made me realise I need to take charge of getting it dealt with. I have a young son and I want to live to see him grow into a man, not lose his dad at a young age. I will ask my GP to refer me to you and really hope you can take me on.

[@andy11362]

Thank you, Dr. Veer, for creating this video. I appreciate your approach to identifying the root cause, determining the patient's blockages, and trying the least intrusive options before the surgical options. I can only wish more doctors treat patients with empathy and care like you in the US. My Pulmonologist simply followed the sleep study protocol and he won't consider any other options than prescribing CPAP/BiBAP.

[@janeb1430]

So wonderful to hear a doctor who understands causes, and non-compliance, the sense of failure, the opprobrium . . . so sad you're in England and not here. If by any slight chance you know of someone in Melbourne who is open-minded and will Listen, it wd be wonderful. We do have a two-tier system here, where you can wait for a long time and be seen az a public patient (with variable outcomes), or as a private patient, which costs a lot. As an old age pensioner, i havee no choice. So i live with sleep apnoea, have AF, and had a minor stroke, and cannot use the machine.

[@SmallSpoonBrigade]

Same here, I would have used the machine if it worked for me, but the masks that were available couldn't accommodate me falling asleep on my side and the doctor probably should have just recommended that I buy a massage table to sleep face down on. It would have been less expensive than that stupid machine that I couldn't ever use for long enough periods of the night to offset the extra times that I would be awake at night. It absolutely sucks to have both chronic insomnia and sleep apnea as it can be difficult to get much traction treating either on its own.

[@N17C1]

Thank you for such a clear and intelligent explanation of all of the issues surrounding sleep apnea.

[@JBoy340a]

Thanks for creating this video. I am very new (2.5 months) to CPAP. Without CPAP I had an AHI approaching 60. With CPAP my AHI is under 0.3 most nights. Also, my O2 saturation drops into the mid 80s without CPAP and in the mid 90s with. So, CPAP works for me. However, I would prefer to not have CPAP, and I was going to ask my doctor about alternatives. You have provided a great layperson introduction to these options and made me a more informed patient.

[@VikVeerENTSurgeon]

Kind of you to say, thank you and well done on using CPAP. getting alternatives is just a quality of life thing for you now which is a good place to be.

[@LastTrump7]

@@VikVeerENTSurgeon​​⁠ Do you see blood work of high hemoglobin and Hematocrit because of low oxygen during sleep apnea?

[@AngieFromCanada]

I subscribed to you because you speak what I wish others would have in my last 50 years. I was snoring even as an underweight kid. It is crazy how quick doctors in the NA jump to the quickest assumptions and not investigate. I don't know if it is because they are so overworked but it is frustrated for patients. Here in Canada they have us stay over night from 10pm to 4am in a special building just for these tests in really nice beds in perfectly clean rooms and it is easy to fall asleep. But they never look at your nose. Just the readings from the sleep study. Even the mask they used and switched to another they said there might be a better mask for me but they didn't have one there so I got set up with a mask that I get air leaks where my nose is the lowest (between my eyes) as it doesn't quite fit snug and the only way to get it snug is to move it downward toward my mouth more (full mask) but then I noticed it is blocking partially my nostrils and they never noticed this and ADP and Disability won't cover a new one until 5 years past. For me I also still have my tonsils which they would not remove when I was a kid because I had such high blood pressure due to kidney failure. Ya I have had a very eventful life. I already take Calcitriol (Vitamin D3) because I had to have my parathyroids removed (not to be confused with the thyroid which I still DO have) removed due to issues with Calcium and Phosphorus issues related to Kidney Disease. I used to be underweight for the first 35 years of my life until I had abdominal abscesses and was out of action for a year not able to be as active. Then I was diagnosed with PCOS and have gained a LOT of weight. My family (all skinny) are very judgmental on my weight blaming it for why my sleep apnea is so bad and saying if I would only lose weight I could get off the machine. For me at this age it would be difficult to take out my tonsils as adults don't heal as well as kids and I am immunosuppressed as I got a kidney transplant 3 years ago. Could also possibly be that I have throat scar tissue from either years of chronic tonsillitis or when I had the parathyroidectomy or when they had to intubate me one time during respiratory distress back in 2018 and had a hard time and had to try a 2nd time before they were successful and my voice was gone for a week after that because they had trouble.

[@rayrock601]

I knew I wasn’t crazy!! Thank you!!!

[@lindseyplatt9091]

Thankyou for your videos I'm newly diagnosed and I have learnt so much, still struggling with the cpap but sticking with it.

[@mediaprof6328]

I am so grateful to you for offering such clarity and compassion. I am female, 77 years old from the US and I have used a bipap for decades. Within the last year, I have developed a very difficult sleep pattern, waking up frequently and getting just under 5 hours sleep every night. I was recently diagnosed with COPD and I am part of the Alpha 1 study (I have one active gene in the pair and one that seems to be on vacation.) I have been frustrated by the inattention to my concerns about lack of sleep because it is affecting my ability to function and live my life and I think it contributed to a recent bout of really severe depression. I have been told that the BiPap cannot be the problem because my AHI is low,even though the masks I try make a great deal of noise. I have been told that either I learn to tolerate the bipap or I will be untreated and have all kinds of heart problems and diabetes. I have been told I am not eligible for alternative treatments because of my weight (oh, the irony!). I had to push the point that perhaps I should have another sleep study since the last one was in 2012. Then I had to sign of waiver saying I understood the sleep study would use the recalled Phillips respironics but that the sleep center had done a bit of this and a bit of that to minimize the risk. And besides, I would have to wait until October. When I asked about he iNap, the PA told me it was not approved by the FDA, but it has been since 2020. As you noted, I am one of those getting rather fed up, but have no intention of ignoring the problem. I am off to the medical suppliers to try yet another mask, and looking around for another doctor. I am doing research on the iNap. I have tried taping my mouth without the bipap--I don't get any more sleep but oddly I feel more alert during the day. Your intelligence, obvious diagnostic sagacity, and compassion are very helpful to me at the moment. I am sending the link to this video the pulmonary specialist, whom I very rarely see. I usually am seen by a PA who is very nice but who is usually reciting a script/protocol he successfully memorized while in training.

[@doctork1708]

Stay away from PAs and NPs. They are poorly trained, but think their doctors.

[@NatureScapesStudio]

It is just atrocious that we are supposed to be the most advanced ed in medical care. HAHAHA! All lies. The only way we get we’ll is to figure it out for ourselves and DEMAND the Right care!

[@beerich2117]

Thank you for explaining the options so well and caring for people who can't tolerate a Cpap. I wish I could find a Dr like you who cares in the US. In my sleep study, the kids who screwed off all nite, about choked me. They never came when I needed them. Where were they? I wonder?!

[@thecrettin]

I absolutely love your philosophy and how you stick your head above the proverbial NHS parapet. You actually give a damn about your patients and you stick up for them and that’s a rarity. Good for you! My husband is on the waiting list for surgery with you and I know he’s in the best hands. Thanks so much for sticking to your ethics and throwing the proverbial middle finger to the iNsTiTuTiOn and doing what you’re so good at.

[@fondrees]

How long is the waiting list

[@richardemerson8075]

This is an amazing video -- life-affirming and energising. I have fairly severe OSA which has been partially addressed by previous interventions but is still a problem. Mr Veer's channel has made me realise that I should -- and *can* -- do more to address the issue and hopefully improve it! Awesome!

[@lauracremente4798]

There should be more doctors like you. My original pulmonologist made me feel like somehow it was my fault that I had severe anxiety with CPAP. The mandibular device wasn't an option because of other issues related to TMJ and the severity of my OSA. Not once did that doctor review if my nose was blocked or what was really causing the issue. She basically said I have OSA because my neck is short. Which is not medically accurate. I have an obstruction caused by my tongue and have been very successful with Inspire. Thank God I didn't stop with her. I wanted to feel better and kept pursuing more information. I now am very rested and no longer require hypertension medication and my glucose levels are now very normal. This is a silent killer if left untreated.

[@cathysilva5011]

I read if inspire can trigger incorrectly it can make your tongue dart out uncontrollably

[@alancornes8916]

What a fantastic approach to diagnosis. You are inspirational. ❤️

[@jimbaker4942]

Hi Vik, great video. Thanks for putting this together. I’ve been fortunate (unfortunate depending on how you view things) to have been receiving NHS treatment on several lifelong health problems since I was little. However, as an adult it is sad to recognise that very few doctors take the clear, considered and logical approach to diagnosing problems (that often impact on other areas of the body/ other specialists’ areas of expertise) that you do. The answer from many doctors is that the test results are in the ’normal’ range and therefore there is no problem, even though you still feel terrible. It is only when you push for the ‘we don’t normally test this’ blood test, or go private, that the answer comes back with something that shows a reason why you’re feeling unwell. There is definitely too much silo thinking and a lack of a thorough diagnostic approach with doctors in the NHS today. I would hazard a guess that better diagnosis and different specialists working together would produce a better outcome for patients and would be cheaper for the NHS too. Have a great 2023 and keep up the good work. Regards Jim

[@VikVeerENTSurgeon]

Thank you for commenting, and happy new year

[@stormwalker321]

Thank you so much Dr Vik, its most appreciated...Excellent presentation!

[@bpatters7]

Brilliant commentary and not only offers medical insights but speaks to the critical issues with doctor-provided care, especially in the USA. I did a sleep study, and it showed my sleep was pretty terrible getting about 5 hours but at the time I didn't have sleep apnea. The "MD sleep specialist" said I didn't have sleep apnea so there was nothing to be done. Unfortunately, I've found very few doctors that seem to be motivated the genuinely help a patient, probably 15%. I wish more had this philosophy and indeed something critical is missing in medical school. Doctors in the USA seem more concerned with insurance company guidance than providing care as well. Alas!

[@VikVeerENTSurgeon]

I don't know the American system, but it sounds difficult to negotiate

[@CaroleLaRochelle]

This is such a great video to see. Almost no one is treating sleep apnea the way you suggest. In my case my sleep study showed 72 events per hour, very severe apnea. I never even saw the Sleep Medicine doctor, and had to request to see an ENT. The ENT told me CPAP is the gold standard treatment. I told him it may be that, but it was only treating the result of my apnea not the cause. No one has investigated what part of my airway is collapsing and why. I want to heal this problem, not just treat it. I have lost 35 pounds and more to go. Learned to play the didgeridoo, voice lessons, laser treatment of my soft palate and tongue to tighten and tone tissues. None of this was suggested or recommended by any medical professional I saw. You are the only one who even has mentioned oromyofunctional exercises. Thank you so much for your channel. I wish more medical people approached OSA like you do. Thank you for providing such valuable information.

[@woodsmaneh952]

I’m one of those people going down “that” route, and it is a real challenge. My CPAP trial felt tortuous to me, much to the disappointment of my doctor (he was polite, but you could hear the annoyance in his voice). This is a very humanistic approach to this all, and it helps just having you walk through your professional approach as I can then gauge my experience as someone who is new to all of this. Thank you.

[@tammarabandy8022]

Thank you for being so up front! I tried c-pap for 2 years and gave up. Now, I’m losing weight to try to help.

[@currentfaves65]

I had sleep apnoea LONG before I gained any weight !!! Thank you for the information doc !

[@sarahmoon1768]

We definitely need more doctors like you in the world. And cool Gizmo pin!

[@phoenixrising6337]

I’d love to find a doctor with this approach in Jacksonville FL! I feel CPAP was pushed onto me with barely enough understanding of my specific issue.

[@tangojuli209]

THANK YOU for this incredibly informative and enlightening video. It also illustrates how the profit motive in american medicine inhibits effective treatment in favor of one that emphasizes revenue diversion to predatory "entrepreneurs". Two friends of mine had sleep apnea & snoring, one had obstructive SA. Both went to their GP doctors in Rancho Mirage, California. Both were referred to a sleep study. After, both NEXT got a call from the medical device representative in Palm Springs to fit them with a CPAP and a bill for $2500. THEN they were called in for a follow up to their docs to see how the CPAP was working. One doctor admitted he didn't know much about the process or remedies other than CPAP. This was 2008 and 2011 and I knew for a fact there were other therapies. I called foul. I suggested to the 2nd doctor that this was a racket and asked if he got a commission from the sleep center or the medical device rep. He denied it, but I have to wonder. I hope this has improved, because I stopped telling friends to get a sleep study, and instead primed them with questions to ask their doctor first.

[@HappyCupsInc]

I’ve struggled a lot with cpap. Finally got to a point where I’ve been able to use it for about a month with my AHI around 3-4. Still feel like absolute garbage. I think I probably have UARS, but even without it I think the “it’s all good if it’s less than 5” mentality is BS. Watching the LankyLefty on KZbin has helped confirm for me that I should be shooting for as minimal arousals as possible. I will be slowly increasing the pressure on my cpap while analyzing my data through OSCAR so I can really dial it in. Most respiratory therapists can’t be bothered or don’t know how to do that, that’s ok I’ll do it myself. Hoping for an end to my 8+ years of suffering finally.

[@jlg3315]

Dr Veer, you are wonderful! compassion should be a universal trait in doctors and everyone else involved in healthcare. if your provider does not exhibit compassion, find another provider.

[@usaman7358]

I freaking love this guy!!! He gets it! I'm one of those that have given up after trying, on and off, for over 20 years with severe sleep apnea. UNTREATED, yet well known to a few Doctors I've seen. Must I come to London to see you or are you ever in the USA? Do you do video consults? Any recommendations for someone living in the USA? I've found nobody even close to your level here and unfortunately mine is not one of those "simple" fixes that throwing a cpap prescription at solves. It's been a 20 year severe daily and nightly struggle with no end in sight and at this rate will cause my death. Any suggestions? Thank you!

[@SimiSilver]

Wow. Thank you again. As a dentist, I always look for these signs!!

[@VikVeerENTSurgeon]

Brilliant - I'm glad that it was helpful.