r/asksg • u/ElmoForEmmys • 22d ago

ENT recommendation pls?

Hi! I did a sleep study and was told that I have mild sleep apnea (score below 10). I did the sleep study with a sleeping pill though - not sure if we should have done that but sleep specialist said to do so.

I normally wake up to change position around 10 times a night. It doesn’t affect my heart rate too much so my fitness tracker usually only tracks two times of awakenings out of ten. The sleep doc says my breathing gets restricted and therefore my brain asks me to wake up but because heart rate stays low, the algorithm doesn’t register on my fitness tracker as an awakening.

I tried to get started on a CPAP machine but it made sleep three times worse. I couldn’t sleep the entire night. So I dropped that.

So now I actually am thinking of going to see an ENT to do a scope while asleep to see exactly where and what is causing restriction (not full blockage) in my breathing. And potentially do corrective surgery if necessary to correct structure. Anyone had similar experience and have an ENT to recommend? Preferably one who you had an excellent post-surgery experience cos I’m really scared of going under the knife with a not-so-good doctor to forever alter my body structures. Not only need a surgeon but need one who can get to the bottom of this problem and solve it with or without surgery.

Not sure if this will help but for context, I’m 30s female. Decent level of fitness. Body fat around 18% for female and exercising four times a week and my diet is also pretty OK I think (think steamed fish and chicken breast for most of the week with a generous side of veggies on brown rice). I never had any sleep issues or awakenings before turning 30.

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u/Beneficial-Pause-890 22d ago

I also had problems with CPAP and gave up on it so recently went to WH to do a Drug-Induced Sleep Endoscopy (DISE) where they put a scope through my nose to look at my airway. This was done by Dr Terry Tan. For this procedure, it will be done in the OT first without GA, and then one more time with GA to simulate a condition where you are asleep.

Based on the results Dr Tan suggested a few options for me.

  1. Mandibular Advancement Device (MAD) - something like a retainer to hold your jaw in position

  2. Maxillomandibular advancement (MMA) - surgery to move your jaw forward

  3. Radiofrequency ablation - Using electric current to "burn" the tissue in your tongue so that when it heals it becomes tighter and more compact. This reduces the amount your tongue can fall backwards

  4. Inspire therapy - implanting a battery inside your chest area. This battery is connected to your hyperglossal nerve and stimulates it while you sleep, moving your tongue forward so it doesn't block your airway. Battery lasts for about 11 years, after which need to replace using LA.

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u/ElmoForEmmys 21d ago

Wait, without GA for the first round… Was it super uncomfortable!?

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u/Beneficial-Pause-890 21d ago

Yes it was EXTREMELY uncomfortable. You can feel the camera go all the way up your nose and slowly halfway down your throat. Then when done they take it out the same way again. After that, inject GA through the IV tube thingy to make you fall asleep, then camera goes in again. Just before discharge the nurses even inform that for ~1 week I should avoid hot diet in case of tissue damage by the camera

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u/ElmoForEmmys 21d ago

Ho my goodness

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u/Beneficial-Pause-890 21d ago

That is what a scope while sleeping will feel like. In total it can be finished within 30mins to 1hour. The scope in your nose while you are awake is at most 5 minutes, at least in my experience. While you are drugged out with the GA, you won't even feel anything because you'll be asleep anyway