Which operation is best for really loud snoring and sleep apnoea?

[@lesptitsoiseaux]

Your channel is a public service in itself!🎩

[@VikVeerENTSurgeon]

really glad you find it helpful, makes it worthwhile.

[@shahinkondoker919]

You have no idea Doctor Veer, I have been told that CPAP is the gold standard so I have resigned myself to a life of exhaustion. These videos and the information they provide are like a ray of light at the end of the tunnel, keep up the good work.

[@gurkansefer8352]

Dr veer has done my op on 3/4/2024 iam currently recovering at home i was expecting more pain but with the meds and rest its going smooth thank you dr veer

[@VikVeerENTSurgeon]

I'm glad it's going well for you. hope to catch up soon.

[@preetimittal2123]

Which operation you did

[@Idyllll]

Been waiting for this and I thank you. Everything you share helps patients to make more informed decisions so pls dont think you're rambling. Thank you for the gem video

[@VikVeerENTSurgeon]

you are very kind, thank you for the comment.

[@erob65]

Thank you, Dr Vic Veer, for all that you do. You give me hope that one of the 42 surgeries can help me.❤

[@elaineinnz]

thanks for the video, when my daughter slept in the bedroom next to mine, she used to say she could hear me snoring and it was very loud. Here in NZ, sleep apnoea isn't particularly considered to be a serious medical condition. I had to pay for the sleep assessment, and purchased my first apap device. Much later, I discovered the health service will issue a machine for free if you have severe Apnoea (which I did) but there is no after-care, and no one ever suggested a surgical solution. I find your video's fascinating.

[@Abdul12_34]

Hi dr veer Finished the video I agree with you the DISE is crucial to diagnosing the exact cause for each persons apnea and therefore being able to use the optimal surgery. I’m glad I was a patient of yours although I can confirm that the tonsillectomy with barbed suture pharyngoplasty was unbelievably painful, I’m scared to imagine how much more painful an expansion one could be lol! As always, looking forward to the next one!!!

[@VikVeerENTSurgeon]

I need to film it so it might some time. need to allocate some time to the book. I'm thinking of doing my hypertension one next.

[@kevinwarner9012]

Hello Dr Veer I think this is what you diagnosed me with after my DIN. I was a bit tired so I couldn't take it all in. I'm happy for you to use my video you did on mine . It was on 06/12/23. We are due a catch up on the 17th April so I hope I am right or not. Please do reach out if you want me to sign anything. I'll do anything to help other people with this condition .

[@VikVeerENTSurgeon]

let's talk about it next week, thanks for watching these videos still. Vik

[@Abdul12_34]

First! Looking forward to watching this one all the way through but wanted to comment first!

[@VikVeerENTSurgeon]

Hahaha! Morning! You were a Barbed by the way... njoy

[@darrengordon8221]

Hey Vik, came to see you about 16 months ago not sure if you remember but you said I had a perfect example of pharyngial wall collapse and attempted to take a photo of it , Had my first appointment at the Royal ENT yesterday, so going through the NHS process now to eventually see you, maybe you can get a decent image of this condition then .🙂👍

[@mikekaraoke]

@@darrengordon8221 If you saw him 16 months ago-why didn't you have the operation/scans with him/follow up appointment??

[@maydayvic]

Thank you for making videos about snoring and sleep apnea ! 9:04 🙏 people think it’s “just snoring” and laugh/ joke about it, but seeing an enthusiastic and professional doctor like you make me feel a bit hopeful about fixing my snoring problem. I finally went to see my GP and asked to be referred to your hospital in London but was turned down and referred to a local one which is in Canterbury Kent.. I wish I had pushed and insisted. Now I just worry that this might be a waste of time.. if they won’t do drug induced sleep endoscopy and find out the actual cause of my snoring? Could I have insisted to be referred to London on NHS even though I’m in Kent? How much would it cost to get a drug induced sleep endoscopy on private? Many thanks

[@VikVeerENTSurgeon]

some regions will only refer you once the local area has exhausted their attempts in the local area and the patient needs treatment that is not available unless they are sent elsewhere. I'm really keen to try and get sleep surgery (and basic general sleep services) to flourish around the country (which is one of the main reasons for me to make these videos and speak at BACO etc). You might have a new department that is trying to help local patients. personally I would follow the advice of your local center and I hope you get the improvement you need.

[@sandmanjono1239]

I wouldn’t wish sleep apnea on my worst enemy ! I’ve tried every piece of equipment and use CPAP. Every night going to bed is a nightmare to be honest, I could write a book on the stress I have gone through over roughly 25 years. It’s ruined my life (so many physical and mental issues) and I’m adamant it will end my life early 😞

[@morpheus1586]

I feel your pain. I go through it, too. Please keep pushing and look for the surgical option. That's what I've done, and although it's not perfect and done yet, but I have to keep pushing. I wouldn't wish it on anyone. It's literally a slow death.

[@nicholastsaclas2619]

Don't give up. The Inflammation in your airway that causes swelling might be from reflux. Try a new nasal spray called SENTINAL NASAL CLEANSER. It's by Toppen Health under Wellness. By reducing Inflammation you decrease swelling which opens up the breathing passages. It's worth trying for $20 bucks.

[@VikVeerENTSurgeon]

sorry you are going through a lot. this video might help? I wish you the best. kzbin.info/www/bejne/bXWnmHyretmYrZo

[@sandmanjono1239]

@@morpheus1586 I’ve even been to two countries to discuss surgical options on snoring - truth is due to the structure of the throat and associated areas and person to person, there seems to be no one ‘cure’ at all sadly. I met a fellow sufferer who had major surgery to the back of his mouth / throat and base of tongue, it took 6months to recover and he had no snoring for a year, then due to the soft tissue etc it grew back and and the snoring returned. I just don’t know what to do and sadly yes I agree it’s a ‘slow death’ so far I have become epileptic, high BP, type II diabetes and bouts of depression, just hope the heart attack is not next …….. ironically or otherwise I am actually a patient of Vic (who I must say is a total pro and gentleman)

[@shahinkondoker919]

Same here brother, I feel your pain, here i thought i was suffering all on my lonesome. It is soul destroying, sleep deprivation has been used as a tool of torture so essentially we are being tortured everyday. I stay up late at night stressing about what sleep or there lack of I might attain that night. I watched a video about the most monitored man on earth, Bryan Johnson, not the AC/DC lead singer but a tech billionaire who sold one if companies for 800 million dollars, then spent 2 million dollars in a year of research to improve his health and reverse aging as he had run himself into the ground building his company wearing his dishevelled look like a badge of honor. Sharing his discoveries for free online called Blueprint protocol. Anyway when asked of all his research and the extreme protocols he follows like 5 hour eating window 9 hours fasted before sleep and 75 or so supplement tablets a day, ' if you had to name one thing and before that person finished his question he answered sleep is the most important, now he looks younger than his 17 year old son at 46. This quote, urged me to seek out Doctor Veer after seeing his videos whom, I must say, seems to read research reports to his children instead of bedtime stories. Although he is ENT surgeon he seems to be incredibly well versed in the nuances of sleep apnea in fact i believe tried CPAP for two weeks as an experiment, sho does that sithole sleep apnea. So I would advise you to at least arrange a consultation with a good specialist who can perform a DISE, drug induced endoscopy. I have been told that CPAP is the gold standard and to lose weight so I resigned myself to living like a zombie at best and on the periphery of insanity on most days. Ps. Previous consultants have been shocked at my smart watch app and the exsercise I do from hiking twice a week 3-4 hours, resistance training 3 times a week and cycling and i still managed gain another 10 kilos in the last year. Exercising like this without proper sleep takes all the will power i have. There is a video explaining that sleep apnea can cause weight gain so refuse to except this your lot.

[@mrichards913]

Good morning Most interesting thank you Best regards

[@VikVeerENTSurgeon]

Good morning!

[@Puggalug]

Dr Veer, within the past 24 hours, various news outlets reports that Zepbound is showing that it helps with the CAUSE of sleep apnea. This is in contrast to the CPAP machine which treats the symptoms. Can you cover Zepbound in a new video?

[@juliaandrewjuju]

Yes please mr veer, I too will be interested in your view on this. I’ve read that about 62% improvement with the combined use of cpap and the drug, which is very very low!!??

[@trevorcullinane6420]

Is it best to just get a DISE first before actually doing any surgery's or getting devices

[@VikVeerENTSurgeon]

I don't think it's necessary for all cases. big tonsils or a blocked nose for example doesn't require DISE. MAS has good evidence without needing a DISE.

[@bhstone1]

What do you think about hyoid bone advancement to the mandible for anterior posterior collapse at that level?

[@nc5909]

Dr V! Thank you so much for doing my DISE and Septoplasty. Recovering well! How long should I stay off CPAP whilst I recover? Thanks to you and all Of your team - Nicholas C

[@VikVeerENTSurgeon]

stay on every night - and turn up the humidity a bit.

[@nc5909]

@@VikVeerENTSurgeon okay great! Thank you! Look forward to the follow up.

[@SajidKhan-kt6rz]

I had a double jaw surgery few months ago and I no longer have sleep apnea. I believe jaw surgery is the most effective than soft tissue surgeries

[@nickstraker5028]

Can you please elaborate

[@VikVeerENTSurgeon]

I have a video about the success rate of double jaw surgery. kzbin.info/www/bejne/l3vChJiipbqobLM

[@SajidKhan-kt6rz]

@nickstraker5028 After jaw surgery my AHI dropped down from 103 to 2

[@yahyaelmi8435]

Jaw surgery has a better cure rate , but it’s usually successful after performing this procedure that Dr vik veer is talking about

[@yahyaelmi8435]

@@SajidKhan-kt6rz did you do any other additional surgery

[@Onelegron]

I am due for a barbed suture in August at ULCH. How soon after this procedure could I be able to have another general anaesthetic ? I’m also booked to have a Subacromial decompression and the hospital have asked me to ask so they can book me in.

[@VikVeerENTSurgeon]

4 - 6 weeks afterwards

[@lucerne1070]

Hello. What do you mean by muscle "stops being functional" in expansion pharingo? I just got that surgery, in addition to my septoplasty and tonsil removal so i'm a bit scared that results of expansion pharyngo are not permanent.

[@VikVeerENTSurgeon]

The muscle turns into fibrous tissue, but still holds the lateral wall out. it stops acting like a muscle.

[@travv88]

What do you suggest for central apneas?

[@maxaffe3195]

The tonsil removal is a big minus. It is an organ of the immune system. Can these procedures be done without removing the tonsils?

[@VikVeerENTSurgeon]

I have a chapter in my new book about tonsillectomy and the immune system. I go through all the evidence

[@didgeridude8430]

How do you know whether to pursue Expansion Pharyngoplasty vs. Double Jaw Surgery when you have palate collapse?

[@maxaffe3195]

I only knew the UPPP...

[@mrichards913]

Presumably, the tonsils are removed with both operations?

[@VikVeerENTSurgeon]

yes, but I've seen those reduction rates without tonsillectomy. patient selection is the most important bit.

[@mrichards913]

Understood Thank you for your confirmation Best regards

[@juliaandrewjuju]

Hi mr veer, what can be done for central sleep apnea??? Any surgeries?? Or is it only a cpap/bpap machine. I was on cpap for 16 months for OSA diagnosis , i havent been tolerating it very well for various reasons including having roseca. I was contacted by clinic to ask why I wasn’t using the cpap, because it was difficult to tolerate plus I wasn’t feeling any benefit from it, then they tell me I have central sleep apnea, not OSA !!!! first I’d heard of that diagnosis !!! In my hospital letter from the sleep clinic it says I have OSA, !!! I’m confused I’ve had the cpap 17 months . So in a couple of weeks I’m been given a different machine that should help my “new” diagnosis. I don’t know how I’ve gone from having OSA to CSA. The clinic tells me that cpap wouldn’t have helped CSA and that I need a BPAP machine!!! All this time they have been treating me for the wrong apnea!! I’ve notified my clinic that I’m in touch with another surgeon(not told them who or where, but in fact it’s you!) to get another opinion and a firm diagnosis and hopefully treatment, as I’m not happy as to why I cannot be properly diagnosed by them ? and the clinic are unwilling to do more tests to figure out what’s going on with me! Thank goodness you told me you would get to the root of the problem, having heard I have been told different things, I have high score/low score of apneas, I have OSA, I have CSA, they haven’t told me I have both!! I’ve heard you talk a lot about OSA but not CSA. What are the options for treating CSA or infact both together??

[@davidcureton1765]

How do I get an appointment with Dr Veer thanks

[@VikVeerENTSurgeon]

just ask your GP to refer you for free on the NHS to the Royal National ENT Hospital. everything I do is available free on the NHS.

[@maxaffe3195]

Are these operations new? Do people do these in Germany? Never heard of it...

[@VikVeerENTSurgeon]

I'm sure they are available there. Lots of sleep centres there.

[@lesptitsoiseaux]

What is the reduction rate, if I may ask, for complete concentric collapse L2?

[@VikVeerENTSurgeon]

it fixes CCC, so I guess 100% if done correctly. the reason why it isn't 100% successful at stopping sleep apnoea is because most people have multiple problems that cause OSA.

[@lesptitsoiseaux]

@@VikVeerENTSurgeon You give me so much hope! :) I look forward to my DISE that I have coming up!!! Cheers from Vancouver, Dr. Veer.

[@yahyaelmi8435]

What about suspension bridge barbell suture Phargoplasty

[@VikVeerENTSurgeon]

suspension operations are a separate entity. I like them a lot but not many people do them so the evidence is lacking.

[@yahyaelmi8435]

@@VikVeerENTSurgeondo you do multi level surgery . ? BSP/EP+Tongue base reduction etc

[@toscar22link10]

UK resident here...any of these free through the NHS?

[@sirwilliamkarl5591]

any advice for an American getting DISE? My insurance doesn't believe my type problem even exists.

[@VikVeerENTSurgeon]

sorry, the American system baffles me. I have no idea. sorry.

[@maxaffe3195]

Do you think tongue base reduction has any right to be a operation?

[@VikVeerENTSurgeon]

I'm not sure I understand what you mean?

[@maxaffe3195]

@@VikVeerENTSurgeon I mean: Should it even be performed? Or never performed like you said with the UPPP

[@stevechandler5006]

I need to move to London........just to see you.

[@VikVeerENTSurgeon]

I'm sure you'll find someone just as good wherever you are. ask your ENT surgeon who is the local sleep surgeon.

[@Ali-ih4ts]

Sleep apnea is a craniofacial deformity caused by recessed and narrow jaws due to our modern diet and life style. The only cure is expansion of the upper palate via ease or marpe and advancment of the mandible and maxilla. The procedures you are advocating for do not treat the root cause and are only short term solutions. There is a very deep ethical and morale issue within the health care system, seems like you want returning customers rather than actually curing people.

[@VikVeerENTSurgeon]

although bimax surgery is an excellent operation it doesn't fix the lateral wall problem hence the fact it doesn't have the success rate people thinks it has. the other operations sadly yet haven't been proven to work and certainly don't work on lateral wall issues (tonsils and laryngeal issues for that matter either) have a look at this video about bimax and success rates as I wanted to combat some of the misinformation out there that a lot of people have fallen for. kzbin.info/www/bejne/l3vChJiipbqobLM I have literally 100's of patients who have had bimax etc and spent thousands of pounds in Switzerland and America with little or no improvement. so although I do send people to our maxfax team to have these operations, I want to try and impress on you that it isn't the 'cure' for everyone. I appreciate that I'm unlikely to convince you but hopefully you might see it less as a black and white situation. I do wish you well.

[@maxaffe3195]

@@VikVeerENTSurgeon but that is because the advancements are not foward enough and there often is no counterclockwise rotation, which is important. correctly done, double jaw helps a lot e.g. kasey li results