What do Surgeons think about CPAP? AND my process in treating sleep apnoea.

[@ivonnikolova503]

GOD BLESS YOU, doctor ! I am from Bulgaria and because of your teaching NOW i know how to spray correctly. God bless you again, you and your family !!!

[@TheFleetflyer]

Don't forget the very small percentage of OSA sufferers who, although they can use CPAP, don't benefit from it. I was one of those unlucky few and I had a pretty rotten time. My CPAP data proved I was using the machine and sleeping through the night, but my daytime fatigue was worse than ever. After about 11 months I gave up. My hospital sleep dept (Frimley Park) was convinced I had figured out a way to fake the data as they couldn't believe someone could still be severely fatigued and be 100% compliant. Anyway, thanks to the persistent and expert surgical efforts of Mr Veer on my soft tissues at UCLH, and a Surgically Assisted Rapid Palatal Expansion with the maxillofacial unit at Chelsea & Westminster, I'm very much improved and better and less fatigued every day as my nasal pharynx progressively becomes wider.

[@VikVeerENTSurgeon]

great to hear, keep up the good work!

[@samfarahani7772]

Thank you doctor. This video about using CPAP prior to and after any operation opened my eyes.

[@paulclarke8523]

Hi did the tongue exercises as my snoring is bad really surprised with results thanks really works

[@VikVeerENTSurgeon]

Excellent! that's great news. did you use the old video or the updated exercises?

[@jakec5618]

Great video !!! Always look forward to them. Very informative and helpful info.

[@VikVeerENTSurgeon]

Much appreciated!

[@Hope2SleepCharity]

Thank you so much Vik and especially for highlighting how important CPAP use is pre and post-surgery due to anaesthetic and surgery recovery. Also love the way you work to treat the patient rather than just the condition and work with each patient for the best solution ❤️ For the record, I have too many reasons for my severe OSA (weight not being one of them though) so will be on CPAP for life, but I have had nose surgery - septoplasty and turbinates reduction so that I can now breathe better in the masks 😊 Thanks and Happy Easter! Kath

[@VikVeerENTSurgeon]

happy Easter to you too Kath. thank you for setting up a charity that helps people with this condition. Hope2Sleep is a great place to get support and knowledge for free.

[@Hope2SleepCharity]

Thank Vik, and just like you, we love what we do as it's so rewarding helping people sleep better which has a knock-on effect for better physical and mental health ❤️🎗️

[@LaughinLoneStar]

Have you had MMA and a genio yet?

[@eddie195777]

I have never been able to sleep with my CPAP machine. It is not uncomfortable at all. The problem I have is that when I put on the cpap mask and the air starts pushing into my sinuses, I become very invigorated and feel very awake. As soon as I take the mask off, I fall asleep. The only way I've been able to sleep with the CPAP was with prescribed sleeping pills. What I've done instead of using my CPAP is 1) myofunctional therapy 2) Supplement with RNA for CNS communication improvement. 3) I sleep on my side. How do I prevent myself from sleeping on my back? I place a tennis ball on the back of my T-shirt with a rubber band. I started wearing a tennis ball 7 years ago and have not woken up gasping for air since. I have seen improvement with the Myofunctional Therapy, but I've only been doing the exercises for six weeks. The RNA around 6 weeks. It takes 6 months to see a strong positive improvement. Also, I'm changing my diets slowly to go gluten free, sugar and carb reduction. PS: I am 65 years old and have had a OSA since is was 5 years old. That's 60 years with OSA and no use of CPAP.

[@dubj1831]

Hi Dr Veer, I am one of your patients in Queens Hospital. I have been using cpap for 4 years now and still undecided from the operation procedure. Hopefully you will make a video about the pros and cons of having the procedure especially what to expect and the possible risk. Thank you and keep up the good work! What a great vlog…

[@SimiSilver]

What other procedures do you perform for OSA

[@maryhinge128]

Love my CPAP. Life changing. All for the better.

[@robertp.wainman4094]

Such well explained sensible advice - as always.

[@VikVeerENTSurgeon]

Glad you think so!

[@ellemelbaus1129]

Another informative video, thank you. I use a CPAP for my severe sleep apnea but have not considered surgery at this point in time, even though I dislike wearing it. There are some nights when I just can't bear to put it on but mostly I do and when I do use it, I know it's beneficial. Just having fantastical and memorable dreams (something I'd not had for many years prior to diagnosis) encourages me to use it because a) I enjoy the dreams , b) I understand that dreaming is a sign that I am in the deep REM phase and c) I wake up refreshed knowing I have had a good night's sleep.

[@VikVeerENTSurgeon]

glad you have really thought about it. makes sense to have insight and realise that enough is enough.

[@yerrrboy100]

Hi vik I messaged you on here, I’d appreciate it if you replied, thanks

[@chrisr7426]

This is an excellent video. I was just diagnosed with OSA in Feb with an AHI of 53. I suspect it’s from enlarged tonsils from a severe case of strep/mono as a kid. Waiting for my cpap machine then hopefully I’ll get referred to an ENT to explore further options.

[@mimbeim3262]

Balanced and informative as always!

[@VikVeerENTSurgeon]

Much appreciated!

[@iseeyou1312]

Despite being compliant on CPAP for 3+ years and having excellent numbers, it's really offered no discernible benefit for my severe OSA and I'm just as fatigued as I was prior to starting therapy. My maxilla and mandible are both extremely recessed, so I'm having maxillomandibular surgery soon to advance them. Patients being able to make informed decisions is hugely important. When I was diagnosed I was never provided with information regarding alternative therapies or what was causing my sleep apnoea to begin with. Instead, I was told I had to start CPAP that week or else my drivers licence would be cancelled. In hindsight, I strongly disagree with the decision for someone in their 20s, with a BMI of ~19, to be given CPAP for the rest of their life as their only recourse.

[@shankar0cr]

Strongly agree with this. Doctors need to provide all sorts of options on the table rather than just handing out a life sentence of CPAP even when it's not working. Moreover, CPAP is not a one-size fits all solution because the cause of OSA is different for each person. I will be pursuing MMA soon too because of my recessed maxilla and mandible.

[@peterc2248]

I was diagnosed with severe OSA about six years back. I would fall asleep in the office, on trains and in the park. I was knackered all the time. At night I had repeated dreamlike sensations that I was under water, suffocating and clawing to reach the surface. I would wake with an explosive intake of breath - it was awful. I had no idea what was wrong but my snoring was legendary. It was only when my partner told me how she had watched me almost choking to death one night that I had a sleep test. I had an AHI of 71. The wonderful NHS people at Mile End and then Broomfield Hospital set me up with CPAP. The first night I used it I slept for 12 straight hours and my bedclothes were hardly disturbed. I felt like a new man entirely. Now, I use a newer machine with a nasal cushions mask every night - and I mean every night. I cannot sleep at all without it. I don't think my quality of sleep is as good as when I was a kid but there again I don't move as much. Perhaps therein lies the problem? Great video's by the way :-)

[@howardgray9068]

Excellent video mate, very informative and easy to understand. Thumbs up 10/10

[@VikVeerENTSurgeon]

Much appreciated!

[@saleembeg9956]

Thanks, Dr Veer, as always. The impression I got speaking to a consultant 10 years ago is that surgery is pretty much hit-and-miss with high risks. Very few surgeons adopt a methodical approach to the issue by identifying the exact causes and determining which surgical procedures - if at all - may help. I feel if the latter approach was adopted more widely, it would be far more practical to manage, rather than putting everyone on CPAP, and then having to manage that for the rest of their lives. For many people, CPAP should only be a temporary solution where surgery can help. I was given a Philips CPAP to use a couple of years ago. About 6 months ago I received a letter from the NHS saying that the equipment has been recalled, and I would be issued a replacement within 2 years. Clearly, this is unsustainable for the NHS and the patients.

[@VikVeerENTSurgeon]

Nice to hear from you Mr Beg, the problem is that sleep is not taught at medical school so no one knows much about it. these problems therefore get poorly treated and it takes a long time for people to catch up as they remember data from their old trainers rather than looking up what is going on now. things are changing and people are looking to other sources of information rather than relying on doctors. I am trying to get the message out here but I'm sure I'll get things wrong as well.

[@mrichards913]

Another most interesting and well presented video. Many thanks Happy Bank Holiday

[@VikVeerENTSurgeon]

Happy holidays!

[@thomasputko1080]

Please do talk about CPAP! I received mine and initially its very nice but when I fall asleep it wakes me up as I cannot breath out due to high pressure provided. Then I feel very unwell, cannot sleep take it off. Somehow it rises my pressure and cannot fall asleep for another 2h. Now it just sits and I feel guilty for not using it, straining NHS resources...

[@VikVeerENTSurgeon]

get an ENT to look at your nose. sounds like you have congestion at night. is your nose blocked first thing in the morning and then settles after walking around a bit? might be the answer.

[@thomasputko1080]

@@VikVeerENTSurgeon yes, thats pretty often state of things. Im waiting for referal letter.

[@nardjissmaroua1480]

very pertinent vision and explanations, your way to see things helps me a lot as I start in this domain. I work as a sleep doctor but for children, I want if this could be possible to see videos on sleep pathologies in children

[@Dr.Ignacio.Alcala]

Great video as always, any tips for sharing for an starting ENT youtuber?

[@VikVeerENTSurgeon]

I'm about to do a video on how to edit. there are no good videos out there. might do a skillshare course. all the courses assume you have time and knowledge. they are all based on filmography rather than content etc.

[@mcfly2727]

Great video Vik!... although Id still embrace any next surgical option rather than stop and stick with CPAP!🙂

[@VikVeerENTSurgeon]

look forward to seeing you soon. thanks for the comment as always.

[@danieltran8922]

Hi Dr. Veer it would be cool if you could do a discussion with another sleep apnea specialist regarding myofunctional therapy for sleep apnea. There’s not so much of that on KZbin!

[@itdies2dayyo]

So basically cpap only works for me when conditions are perfect. My airways get blocked (muscles relax in my throat more) when I'm overly tired and when my room is too warm. So like I said, it only works under perfect conditions otherwise I may not fall asleep for hours and hours. It's debilitating and ruining my life and I feel that surgery is necessary at this point, I'm hoping my ENT will help me out and try to pinpoint my issue although I'm fairly certain it's my soft palate. The thought of me never being live a normal life, sleeping late, lying with my girlfriend in my arms, etc.. is something I can't come to terms with and I believe surgery is what I need. Edit: I also just got done with septoplasty, turbinate reduction, and nasal valve collapse surgery so I assume I wouldn't be able to do anything right away anyway.

[@PaulWashington..]

I so hope and pray you are doing better now one year on?

[@trevorcullinane6420]

Hi vik ,love your videos . I'm 39 years old ,72kgs and fit and healthy but still suffer from sleep apnea, was diagnosed with ahi of 17 to 20. I have managed to get it my ahi down to 5 now with a dental appliance and also got tonsils out but I still wake up some mornings with tightness in my chest. I have went back on capap machine now for a few days and ahi on that is 4.6 . I think I probably have a tongue base problem as if I sleep on my side I wake up abit more refreshed when I don't use capap. I am due to get endoscopy scan in a few weeks to just get an idea as to what is going on and hopefully get a clearer picture if it is a tongue base problem I really don't know what I'm going to do . I have tried tongue retainer and also the new zeus device but still feel abit tired in the mornings . I really don't like capap machine the thoughts of it just make me depressed . That's just my thoughts on what I have been going through and capap is a not a option for me the thoughts of wearing this for the rest of my life 😫

[@VikVeerENTSurgeon]

really excellent that you are thinking through it carefully. no reason to rush into an operation, just examine your current situation and weigh up the pros and cons.

[@TathaC]

Hi Veek, Can you please talk a little bit in a video if long term use of CPAP has any negative impact on lung / diaphragm / breathing strength? I am using auto CPAP with 4-20 pressure but I never see my machine go beyond 9-10 but I am getting concerned if it is weakening my lungs or may give me a harnia?

[@gibbus91]

So I have severe OSA and my sleep study showed I had on average 80 apneas an hour, I battled with CPAP for a while and now I cannot sleep with out it, it has brought my ahi down to about 14-20 times an hour. Two weeks ago I had my tonsils removed because of repetitive tonsillitis, sine the opp my sleep apnoea has improved my CPAP isn't using as much air pressure and my ahi had dropped to 4 times an hour, I'm hoping that in the next few months as the swelling calms down and settles that my osa improves even more or disappears completely :)

[@VikVeerENTSurgeon]

fantastic news! I talk about this a bit in my new video out today. really glad things are improving for you.

[@gibbus91]

@@VikVeerENTSurgeon thank you, my surgeon told me I had the worst tonsils he had removed being that they overlapped eachother, he also mentioned that my tonsils were no doubt a contributing factor to my sleep apnoea. So fingers crossed things keep improving. Thank you for all your videos the content is great and very informative :)

[@dotnetdeveloper8158]

@@gibbus91 Hi Sir How are u feeling now??

[@preetimittal2123]

How are you now please replyyy

[@usaman7358]

Going on TWENTY THREE YEARS with severe sleep apnea. NON-TREATED! Fatigued EVERY day, naps everyday, pretty bad quality of life issues because of it all. CPAP hasn't helped a single day/night! I try it, doesn't work after a week or two of torture, back in the closet it goes for a few more years until I try again. Supposedly I have MIXED apneas with central apneas. SO NOW WHAT? I never see any answers to those who don't benefit from CPAP (not that they dont TOLERATE IT, but that it doesnt help!). If no doctor can tell me WHY I have sleep apnea in the first place, nor WHY cpap hasn't helped THEN WHAT??!!! By the way, I'm at my perfect weight and have been most of my life. NO snoring, NO gasping for air, NO large neck, NO dry throat in the morning. Just very shallow mouth breathing all night with periods of no breathing. AHI around 35. Also, while I'm ranting, why would it take 3-6 months to have to see results? If one has a baby and is up 200 times a night (similar to sleep apnea) THEN the baby is taken away and the next night one is up only 8 times (i.e..AHI down to 2) you'd think that person would notice a hell of a difference IN ONE NIGHT. Certainly after one week. The whole thing has been a 2 decade misery for me with no doctor getting beyond the "Here, try this mask and cpap and good luck to you...by the way, it will take months anyway to feel better". REALLY? THIS is the best that can be done for someone of perfect weight who was fully functionable, shows none of the normal signs of sleep apnea (except severe fatigue), was quite active through his 20's and 30's, and now can't get through a single day?

[@VikVeerENTSurgeon]

if you have mixed apnoeas I always say you need to get that checked out. I would see a sleep neurologist to find out what the CSA stuff is about. why do you have it etc. make sure you have all your bloods sorted (multiple cortisol readings, testosterone, b12 etc), make sure you don't have PLMD etc. depression also mixed in will mess this all up, see a sleep pyschiatrist as well. I would check the diagnosis as well, sometimes mixed apnoeas is not the right diagnosis I think the LankyLefty does a service for this as well. sometimes the CPAP causes the CSA. too much to say here sorry. good luck mate, but you will need to see a bunch of people and work it out. respiratory doctors won't be able to do it alone.

[@usaman7358]

@@VikVeerENTSurgeon Thanks so much for your reply. Much appreciated!

[@shankar0cr]

Sorry to hear about your ordeal. Im in the same boat as you :(

[@exxr]

With mixed apnea and CAs you might need an ASV machine, have you looked into that?

[@danbance5799]

I certainly don't want to use CPAP for the next 40 years if the underlying problem is fixable. I think it's a mistake to look at CPAP and surgery as a one or the other proposition. Even if surgery doesn't entirely cure the problem, if you can run your CPAP at a max pressure of 9 instead of 13, that's far more tolerable and you're more likely to use it.

[@helenhucker346]

Perhaps ask a carpenter about the problem mentioned at 4.48 lol!

[@boxhbbb3530]

What department do I need to be referred to from my GP to be considered with cpap solution. (Recently had septoplasty but I heard its far from a cure of snoring and sleep apnoea)

[@arthurgutierrez2729]

Is watchpat accurate test? Or is it too sensitive compare to the gold standard in lab sleep test?

[@VikVeerENTSurgeon]

too sensitive? I don't like that it makes so many assumptions and has nothing to compare to. but it is pretty good as a screening test.

[@LaughinLoneStar]

CPAP, yeah, I try and I try, can't sleep.

[@darthex0]

2:35 side effects of untreated obstructive sleep apnea.

[@chrisucl]

As my original comment was deleted, I just wanted to ask a question. I wish I could have surgery to resolve or at least significantly improve my snoring having used cpap and not tolerating it but I was told the effect is temporary lasting about five years. Is this true?

[@VikVeerENTSurgeon]

I don't remember deleting your comment, sorry. 5 years benefit would suggest that either something had changed (gained a lot of weight or something) or the wrong operation was done in the first place. a good example is doing a palatal operation when really the patient has mild sleep apnoea. palate surgery won't ever cure sleep apnoea and so the snoring will always come back.

[@chrisucl]

Thank you for your answer, it makes sense.

[@arthurgutierrez2729]

My ahi is 49 and my oxygen level drops to below 80% for less than 2% of time of study. I was told it is a concern when it around 10 % of the time. What do you think should I trust my AHI and be diagnosed of sleep apnea?

[@mehmetozsoy]

❤️

[@combomad]

I hate having sleep apnea I have to sleep on the head board to sleep as I can't get use to the CPAP I have a complex mental health conditions and I'm at the end not having a good sleep my headaches are severe and just want it to be over and have my eternal sleep as I can't function at all it is taking over my day to day activities the sleep clinic was no help at all they threw me off

[@arthurgutierrez2729]

I have long covid and my pulmonologist think my fatigue may also because of sleep apnea. We did a home study and it shows I have severe apnea the issue I have with it is i dont have fatigue before covid . I think my long covid is causing my AHI to result a lot higher because it is common for long covid patient to have shortness of breath, also before I feel alright and active but after covid I have fatigue and now doctor wants for me to be diagnosed with sleep apnea and also hypothyroidism due to fatigue symptoms. I wonder if my doctor are trying to find something instead of focusing of long covid. I hate to be diagnose of sleep apnea and hypothyroidism if the real issue is long covid. Do you have advice doctor?

[@dasherasher4176]

Are there any negative side effects from removing large tonsils and what is the best after care?

[@VikVeerENTSurgeon]

Have a look at this. You don't need tonsils after the age of 2. that's why they disappear at puberty in normal people. kzbin.info/www/bejne/g2LJlqGLl712nLM

[@mayadanooraldeen2277]

Pls doctor i have a sad quastion regarding my sisters case who did a beautifying surgery to her nose befor 10 days ..after that her tongue becomes heavy just with cetain letters like r and l..doctors say it is the tissue of the throat becomes week in addition to the nose surgery she lost about 40 kilos of weigh making strict diet..wld u pls tell me about her case if any treatment..best regards

[@preetimittal2123]

Now,how are your sister?

[@petekadenz9465]

It might be better to help people use CPAP properly and solve the problems they have with this therapy.

[@VikVeerENTSurgeon]

I don't often give a thumbs down, but to write a comment when you haven't watched the video is rather upsetting for me. This is exactly what I do and the video is all about this.

[@Hope2SleepCharity]

Pete I would definitely take time to watch the video before commenting. Firstly, it is not normally an ENT surgeon's job or professionalism to teach patients to use CPAP correctly (even though Dr Vik Veer does do this due to his passion in helping all patients). There are charities like ours that help with CPAP, and the job of sleep clinicans who prescribe the CPAP machines. CPAP is certainly still the gold standard 'treatment' for sleep apnoea, but there are occasions when surgery can help or 'cure' (not treat) sleep apnoea. Dr Vik Veer is rare than he does both - prescribes CPAP and/or performs surgery. Your previous comment too is incorrect as nowhere in the video does Dr Veer suggest surgery is more effective - he treats every patient as an individual and together they decide the best approach to treat, improve the root cause and sometimes cure the problem.

[@petekadenz9465]

You seem to have decided already an operation would be better/more effective than an operation before you’ve even used a CPAP machine.

[@VikVeerENTSurgeon]

please watch the video. you'll see that I haven't said this. in fact I said almost the opposite.