Apnea-hypopnea

[davidthai]

Does anyone have experience of the sleep clinic in Bumrungrad, Hospital, Bangkok? did you buy a CPAP (Portable oxygen}, i would like to hear peoples experience before i buy this expensive equipment

[Neeranam]

They're cowboys - stay away!

[FBN]

Does anyone have experience of the sleep clinic in Bumrungrad, Hospital, Bangkok? did you buy a CPAP (Portable oxygen}, i would like to hear peoples experience before i buy this expensive equipment

First get an examination done by a good ENT. There is a Prof from Chula doing part time work at Bumrungrad; he is an expert on sleep apnoea. Don't have his card with me now but an enquiry at the ENT dept should get you his name. His has written several international papers on the Uvulectomy procedure.

Sleep clinics may work for some. For most people it is such a strange environment that normal sleep is out of the question anyway, making this, as a diagnostic test, very unreliable. The sleep clinic room is in the cardiac critical care unit in Bumrungrad. This is not the place where you would go if you were looking forward to a good night's rest in the first instance. Taking medication to get you to sleep actually defeats the purpose; many normal people may be prone to sleep apnoea on medication anyway...

The CPAP machine definitely works for some individuals but, those who are light sleepers anyway, will never be able to tolerate this.

[Tammi]

There was a recent topic on sleep clinics - you should search for it and read. I have been in the sleep clinic at Bumrungrad (which is on the 9th floor unless they have moved it) and was not impressed. I suffered from sleep apnea and snoring and sleep paralysis.

I don't think I could have tolerated CPAP.

Then I heard about the Pillar procedure and had it done at Bumrungrad by (sorry, can't give you his name at the moment because that part of B'grad site not working but he is a prof) and have had no problems since. You should read about it on the internet and decide if it is for you. Only problem I had was a dreadful throat infection after it that the prof doctor refused to treat! I got antibiotics from another doctor and it cleared within a few days.

Cost was 44,000 baht.

[RPSGT]

I'm a Registered Polysomnographic (Sleep) Technologist in the United States. I have been practicing Sleep Medicine for nearly 15 years. I am curious as to how effectively sleep apnea and other related disorders are being treated in Thailand. Are there few sleep clinics in your country?

RPSGT

[davidthai]

I'm a Registered Polysomnographic (Sleep) Technologist in the United States. I have been practicing Sleep Medicine for nearly 15 years. I am curious as to how effectively sleep apnea and other related disorders are being treated in Thailand. Are there few sleep clinics in your country?

RPSGT

Hi

As far as i know there are only 2 sleep clinics , and they are in Bangkok private hospitals , Bumrungrad and the Bangkok hospital , i live in a province in the North East, our province does not have a sleep clinic as such but there are doctors who will treat Apnea , there is a Teaching Doctor from Khon Kaen University who visits the private hospital once a week , but most people dont know they have Apnea , the only ones who are diagnosed seems to be the people who have been on sleeping pills and have problems , then thay seek further investigation , that is my experience as one who has the problem , i only came across the sleep clinic by browsing the Bumrungrad hospital web site , then i investigated it further.

[davidthai]

There was a recent topic on sleep clinics - you should search for it and read. I have been in the sleep clinic at Bumrungrad (which is on the 9th floor unless they have moved it) and was not impressed. I suffered from sleep apnea and snoring and sleep paralysis.

I don't think I could have tolerated CPAP.

Then I heard about the Pillar procedure and had it done at Bumrungrad by (sorry, can't give you his name at the moment because that part of B'grad site not working but he is a prof) and have had no problems since. You should read about it on the internet and decide if it is for you. Only problem I had was a dreadful throat infection after it that the prof doctor refused to treat! I got antibiotics from another doctor and it cleared within a few days.

Cost was 44,000 baht.

Was his name Dr Chairat Neruntarat?

[RPSGT]

There was a recent topic on sleep clinics - you should search for it and read. I have been in the sleep clinic at Bumrungrad (which is on the 9th floor unless they have moved it) and was not impressed. I suffered from sleep apnea and snoring and sleep paralysis.

I don't think I could have tolerated CPAP.

Then I heard about the Pillar procedure and had it done at Bumrungrad by (sorry, can't give you his name at the moment because that part of B'grad site not working but he is a prof) and have had no problems since. You should read about it on the internet and decide if it is for you. Only problem I had was a dreadful throat infection after it that the prof doctor refused to treat! I got antibiotics from another doctor and it cleared within a few days.

Cost was 44,000 baht.

Was his name Dr Chairat Neruntarat?

In the USA patinets who have obstructive sleep apnea are required to at least try CPAP before attempting surgery. The reason is because after surgery, scar tissue grows in the airway eventually causing apnea to come back in many patients. With CPAP there is no scar tissue, no painful operation and is completely effective when used. Most people are highly successful with it.

I hope everyone does not perceive my reference "in the USA" as being superior to Thailand in any fashion. I only use that as a reference to what I know is standard in the USA because that is where I live and work. I've known many patients who underwent the surgery to prevent obstructive sleep apnea only to return to the sleep lab a year or two later to be titrated with CPAP. Quite often the surgery will work for two or three years until scar tissue grows back.

RPSGT

[Neeranam]

Don't buy the thing from Bamrungrad - buy it outside and save yourself $2000.

[Tammi]

There was an article in the Business section of Bangkok Post about Manarom Hospital which has a Sleep Lab and charges 9,000 baht. Manarom Hospital is Thailand's first private mental health facility and was founded in late 2006 by a group of local psychiatric professionals. It has 59 beds and is on Sukhumvit Soi 70/3. It provides a full range of mental health services for inpatients and outpatients.

[Tammi]

There was a recent topic on sleep clinics - you should search for it and read. I have been in the sleep clinic at Bumrungrad (which is on the 9th floor unless they have moved it) and was not impressed. I suffered from sleep apnea and snoring and sleep paralysis.

I don't think I could have tolerated CPAP.

Then I heard about the Pillar procedure and had it done at Bumrungrad by (sorry, can't give you his name at the moment because that part of B'grad site not working but he is a prof) and have had no problems since. You should read about it on the internet and decide if it is for you. Only problem I had was a dreadful throat infection after it that the prof doctor refused to treat! I got antibiotics from another doctor and it cleared within a few days.

Cost was 44,000 baht.

Was his name Dr Chairat Neruntarat?

Yes, that's him. You can also have Pillar done at Bangkok General for same price. But read up about it on the internet and make sure doctor knows what he is doing. I read about a guy who had it done in Singapore and the strips that are inserted were spaced wrongly.

Of course the Prof probably didn't like me telling him what to do but what the hel_l - it was my mouth and my money.

Edited February 8, 2008 by Tammi

[thaimeup]

There was a recent topic on sleep clinics - you should search for it and read. I have been in the sleep clinic at Bumrungrad (which is on the 9th floor unless they have moved it) and was not impressed. I suffered from sleep apnea and snoring and sleep paralysis.

I don't think I could have tolerated CPAP.

Then I heard about the Pillar procedure and had it done at Bumrungrad by (sorry, can't give you his name at the moment because that part of B'grad site not working but he is a prof) and have had no problems since. You should read about it on the internet and decide if it is for you. Only problem I had was a dreadful throat infection after it that the prof doctor refused to treat! I got antibiotics from another doctor and it cleared within a few days.

Cost was 44,000 baht.

Was his name Dr Chairat Neruntarat?

Yes, that's him. You can also have Pillar done at Bangkok General for same price. But read up about it on the internet and make sure doctor knows what he is doing. I read about a guy who had it done in Singapore and the strips that are inserted were spaced wrongly.

Of course the Prof probably didn't like me telling him what to do but what the hel_l - it was my mouth and my money.

Hi Folks,

I just bought a cpap machine four months ago in Germany (an arm and a leg actually)because my doctor though it would help my breathing (long history....) After a few sleepy nights and a strong desire to smash it off the nearest wall I got the hang of it....well just. Yet I did feel the benefit from it, so much so that I'm trying to find somewhere here to have it repaired. During the night a warning message tells me that there's a mask problem. I can't find. Now the thing has stopped blowing thanks to some local chappie saying he was a technician....that should have been the warning sign. Any ideas out there among you well travelled souls? I could send it back to Germany, but...... there goes the other leg.

[onomataho]

I have sleep apnea. When it was first diagnosed (after an overnight sleep study) I was doubtful, but the more I learned about the condition and how to recognize the symptoms, I came to realize that it needed to be treated.

Taking a proactive approach has changed my life and greatly improved my sleep and daytime energy. So far I have avoided using a CPAP machine...to me it is just too intrusive to my traveling lifestyle, but in the future when I am a bit more settled in somewhere I may try one.

Instead of the CPAP, I use an oral appliance (made by a dentist in the US) that looks like two mouth guards (upper and lower) held together by a titanium pin. It cost over $4000us to have the appliance made. The design does two things:

1) keeps my mouth closed while sleeping (mouth breathing is a problem directly related to apnea), and

2) keeps my jaw from sliding back and obstructing the airway.

Last Fall, while staying on Koh Lanta, I broke my oral appliance and was in a world of hurt...my sleep was seriously compromised. I decided to go to Bangkok to the Bumrungrad Sleep Clinic for a consultation. I met with Dr. Kaseansom Viranuvatti, MD. He told me two things:

1) I needed to have a overnight sleep study to determine the amount of oxygen that would be need to correct my apnea if I was to go on a CPAP;

2) the oral appliance was not a realistic approach and the CPAP was the "Gold Standard" for treating sleep apnea; and

3) I'd be better off buying a CPAP in my home country in case I needed it serviced.

Based on my previous experience with a well-known sleep clinic in the US, I felt that Dr. Kaseansom knew what he was talking about. I was a little surprised at his negative opinion about oral appliances, but I have found that there area as many opinions about sleep apnea as there are doctors. One thing that I did note was that the sleep study/CPAP treatment program is much less expensive in Bangkok versus the US. No surprise here.

During this same trip to Bangkok I also consulted with my dentist about replacing the oral appliance. He referred me to Dr. Amornpong at Rama IX Hospital. I didn't follow up on this referral due to a time constraint, but I plan to do this in the future as I want to have a back-up appliance made in case I break the one I now have (I sent the original back to the US for a rebuild).

In summary, it is my personal opinion and experience that sleep apnea is not something to take lightly. Do your homework...there's a lot of good information on the web. Try to understand the way it affects your sleep and what treatment options are available to you. You'll be thankful that you did.

Edited February 10, 2008 by onomataho

[thailoneus]

CPAP doesn't necessarily mean one needs oxygen. Th macine simply blows air so that the throat stays open and prevents snoring.

[RPSGT]

There was a recent topic on sleep clinics - you should search for it and read. I have been in the sleep clinic at Bumrungrad (which is on the 9th floor unless they have moved it) and was not impressed. I suffered from sleep apnea and snoring and sleep paralysis.

I don't think I could have tolerated CPAP.

Then I heard about the Pillar procedure and had it done at Bumrungrad by (sorry, can't give you his name at the moment because that part of B'grad site not working but he is a prof) and have had no problems since. You should read about it on the internet and decide if it is for you. Only problem I had was a dreadful throat infection after it that the prof doctor refused to treat! I got antibiotics from another doctor and it cleared within a few days.

Cost was 44,000 baht.

Was his name Dr Chairat Neruntarat?

Yes, that's him. You can also have Pillar done at Bangkok General for same price. But read up about it on the internet and make sure doctor knows what he is doing. I read about a guy who had it done in Singapore and the strips that are inserted were spaced wrongly.

Of course the Prof probably didn't like me telling him what to do but what the hel_l - it was my mouth and my money.

Hi Folks,

I just bought a cpap machine four months ago in Germany (an arm and a leg actually)because my doctor though it would help my breathing (long history....) After a few sleepy nights and a strong desire to smash it off the nearest wall I got the hang of it....well just. Yet I did feel the benefit from it, so much so that I'm trying to find somewhere here to have it repaired. During the night a warning message tells me that there's a mask problem. I can't find. Now the thing has stopped blowing thanks to some local chappie saying he was a technician....that should have been the warning sign. Any ideas out there among you well travelled souls? I could send it back to Germany, but...... there goes the other leg.

You can buy CPAP machines over the internet for less than $300 USD. Is that considered expensive?

RPSGT

[pubba]

I have been using a CPAP machine for the last 7 years and it has made a huge difference. I had terrible sleep apnoea even before I became obese due to a thyroid problem.

The first machine that I used was dreaful. It was basically like a vacumn cleaner sized machine that pumped air continually into my face. I got used to it though and it improved my daytime energy. I used to fall asleep whilst watching tv or movies, and sometimes started to doze off when driving. That was the major incentive to get treatment.

Nowadays I'm using an excellent machine (designed in Australia I think?) called the S8 Resmed Autoset II. It's small enough to easily take travelling, has multi power input (which switches automatically), and has a humidifier on the front. When you take the humidifier off the unit is even smaller.

I'm going to look into the pillar operation mentioned here to see if it's a good idea for me. Perhaps it would be wise to wait another few years until they improve the end result. Sleep apnoea treatment has come a long way in the last decade.

[pubba]

I have been using a CPAP machine for the last 7 years and it has made a huge difference. I had terrible sleep apnoea even before I became obese due to a thyroid problem.

The first machine that I used was dreaful. It was basically like a vacumn cleaner sized machine that pumped air continually into my face. I got used to it though and it improved my daytime energy. I used to fall asleep whilst watching tv or movies, and sometimes started to doze off when driving. That was the major incentive to get treatment.

Nowadays I'm using an excellent machine (designed in Australia I think?) called the S8 Resmed Autoset II. It's small enough to easily take travelling, has multi power input (which switches automatically), and has a humidifier on the front. When you take the humidifier off the unit is even smaller.

I'm going to look into the pillar operation mentioned here to see if it's a good idea for me. Perhaps it would be wise to wait another few years until they improve the end result. Sleep apnoea treatment has come a long way in the last decade.

Ah-just saw that the pillar technique is only suitable for mild to moderate apnoea.. Back to the waiting game for a while then..