Snoring And Obstructive Sleep Apnea

[Mobi]

I have been a loud snorer for many years. This was particularly so if I slept on my back, or had been drinking excessively, but I found that if I lie on my side on a shallow pillow, this would usually alleviate the problem.

But my snoring has gradually got worse, and in the past few weeks it has given me cause for concern. I snore so badly that it continually wakes me up, and I always have a sore throat from the effects of the snoring. I can’t remember the last time I had a decent night’s sleep. It is also so bad that my wife can no longer sleep all night with me as she also can’t sleep from the noise. She tells me that often I stop breathing and she is scared that I have died, and has to shake me to start breathing again. I understand this condition is apnea, and can be quite dangerous.

Most of the private hospitals offer a ‘snoring clinic’ but I am unsure whether their treatment will work.

Anyone had any experience or knowledge of this, or can recommend a good hospital/treatment?

Thanks.

[zaphodbeeblebrox]

Do some internet research on CPAP (Continuous Positive Airway Pressure) machines. A friend of mine swears by it, and said it was portable enough to bring on a plane from the states. I'm not sure if its available in Thailand.

[Farma]

I had the laser surgery done a few years ago at a private clinic in Bangkok. It’s worked to a degree for me and the days of sore throats, tonsillitis and sleepless nights have long gone. I’m told still snore lightly for a few minutes as I nod off to sleep when I’m extra tired from a long journey etc but that’s all.

The surgeon will assess you prior to the operation which I had done under local. It was explained to me that some people only need scarring to tighten up mouth roof. In my case I had a crescent shaped piece removed. He also removed my tonsils. It was also explained that smoking and being overweight contribute to snoring.

Painkillers were definitely needed by me for a couple of weeks afterwards and the feeling of stitches rubbing on my tongue for the 4 or 5 weeks it took for them to be removed was uncomfortable, Imagine sucking on a mini hedgehog for a couple of weeks.

I used Yoskarn Clinic (no-snoring.com). It was a one off price that included the surgery, aftercare and follow up treatment if needed. I’d use their services again.

[RAZZELL]

It was also explained that smoking and being overweight contribute to snoring.

Try losing a few pounds first before you do anything drastic.

RAZZ

[sbk]

My dad uses a CPAP machine and swears by that thing. It took him a while to get used to sleeping with it on, but now he sleeps like a baby.

***edit*** a non-snoring baby

[Mobi]

It was also explained that smoking and being overweight contribute to snoring.

Try losing a few pounds first before you do anything drastic.

RAZZ

I'm not excessively overweight. (and I don't smoke)

This is something that has been going on for years and slowly getting worse. It has now reached crisis proportions.

All the major hospitals have "snoring clinics" but I'd like some recommendations, if anyone has tried one.

[Farma]

Mobi, Doctor Somros who treated me at Yoskarn is also a teaching professor at one of the major BKK hospitals. I was given the option of having the surgery done in his clinic or an overnight stay in the hospital he’s associated with. I elected to have the operation done under local in his clinic.

The cost of the treatment a few years ago was 20,000B all inclusive. It could have gone up in price since then.

I was at the stage you mention when I finally took the plunge and had the surgery. On diving trips I would sleep on the other side of small islands to give the others a chance to get some sleep. On another occasion out in the middle of the desert the guys used a GPS and could still hear me a kilometer away.

I’ve described how I felt to give you an idea there may be some discomfort after the operation. I’m glad I had the operation. The positives greatly outweigh the negatives. I sleep well, no more sore throats and my wife is no longer woken during the night from my snoring..

The negative side affects are minor and go away with time. Initially I noticed I couldn’t pronounce some sounds, a few weeks later I was back to normal. The other was I would occasionally swallow the wrong way and find myself coughing.

[Tammi]

I had the Pillar procedure done at Bumrungrad 8 months ago and am sure it has helped. There was another thread here on apnea and you should look at that and also google apnea and do some reading on the problem.

I have a relative, 77 years old, who has apnea and his wife is so scared of it she now sleeps in another room so she can get rest. But he is hale and hearty (tho had bypass surgery 15 years ago) and is still working - so the apnea really doesn't seem to slow him down at all. One symptom of apnea is daytime sleepiness and tiredness.

[Mobi]

I had the Pillar procedure done at Bumrungrad 8 months ago and am sure it has helped. There was another thread here on apnea and you should look at that and also google apnea and do some reading on the problem.

I have a relative, 77 years old, who has apnea and his wife is so scared of it she now sleeps in another room so she can get rest. But he is hale and hearty (tho had bypass surgery 15 years ago) and is still working - so the apnea really doesn't seem to slow him down at all. One symptom of apnea is daytime sleepiness and tiredness.

Tammi, what is the Pillar procedure?, and could you give me an idea of cost?

I have looked at the Bumrungrad website and they have details of their sleeping disorders clinic, but don't mention the Pillar procedure.

I see that they do supply CPAP devices.

[onomataho]

Snoring and sleep apnea are related, but not always.

I posted this previously on another thread...

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. The design does two things:

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

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

3) helps me to not grind my teeth while speeping.

Last Fall I broke my oral appliance and was in a world of hurt...my sleep was seriously compromised. I decided to go 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 another 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 April 9, 2008 by onomataho

[Tammi]

Pillar procedure: Doctor inserts 3 small strips of a material into the soft palate so that palate cannot fall down and obstruct the airway when one sleeps on one's back. The material is used in heart surgery and is safe.

Another poster mentioned Dr. Kaseansom. He is the man to see. I absolutely adore him! I see him for a neuro problem. I am sure he told me he uses CPAP, so that might be why he leans that way. I didn't consult him before the Pillar. If you do have a sleep test at Bumrungrad under Dr Kaseansom do speak to him beforehand about what medicines he will give you before the sleep test. Another doctor knocked me out cold with pills and I really don't see the sense of that. BTW, BPH do Pillar. Cost anywhere you go will be about 45,000 baht.

Edited April 10, 2008 by Tammi

[britmaveric]

http://www.putanendtosnoring.com/surgery.htm

[Mobi]

Thanks Brit - very informative website.

Thanks Tammi, I think I might try the good Doctor Kaseansom.

How long did it take before the Pillar started to work?

[Tammi]

Thanks Brit - very informative website.

Thanks Tammi, I think I might try the good Doctor Kaseansom.

How long did it take before the Pillar started to work?

Immediately, if I remember right. I had a lot going on at the time.

[paul1970]

Mobi,

You may want to try losing a bit of weight first as my girlfriend has confirmed with me when my weight is below 115Kg I stop snoring and as soon as I go above 115Kg it starts up again. What is happening is excess fat is getting stored around the neck and closes the airways.

Every time I go above this weight I get terrible sleep apnea resulting in me jumping awake frequently during the night when the breathing stops, it's a bloody nightmare and my girlfriend gets scared out of her wits when my breathing stops. Of course the worst thing is it's so bloody hard to lose weight.

Good luck with whatever you try, I hope it works cos I know the problem your having and it's not pleasant.

[Tammi]

Mobi,

You may want to try losing a bit of weight first as my girlfriend has confirmed with me when my weight is below 115Kg I stop snoring and as soon as I go above 115Kg it starts up again. What is happening is excess fat is getting stored around the neck and closes the airways.

Every time I go above this weight I get terrible sleep apnea resulting in me jumping awake frequently during the night when the breathing stops, it's a bloody nightmare and my girlfriend gets scared out of her wits when my breathing stops. Of course the worst thing is it's so bloody hard to lose weight.

Good luck with whatever you try, I hope it works cos I know the problem your having and it's not pleasant.

You can lose weight. A while ago Dr. Ian Corness wrote about a weight loss plan in the Pattaya Mail and for me it works and is so easy. But like any weight loss plan you have to want to do it. I also do some walking. And when I watch TV I execise during the commercials - for example can take 350 steps during each commercial break on Hallmark.

[Mobi]

Thank you Tammi and Paul.

As I have already stated I don't believe I am excessively overweight. I am 6 ft and around 85 kilos, and I used to be over 90 kilos. I would like to get down to around 81-82, but last time I did that everyone said I looked very gaunt. My face is not fat, nor is there is there any excess fat in my neck.

I have had this problem for years - even when I was a lighter. It's just gradually got worse and worse as I've got older (I'm 61), and now reached an intolerable stage. I always sleep on my side now on a very shallow pillow, and as soon as I drop off the snoring starts. Last night my wife moved out yet again, and I kept waking all night long.

I guess it's off to Bumrungrad, once I've cured my 3 week long diarrhoea problem .

[jackoneilone]

just a note here. you can also physically exercise train the muscles in that region so that it doesnt collapse once you go to sleep. its scientifically proven to work however obviously not an overnight solution and requires dedication and training. thats ofcourse so long as theres no other issues like being overweight obese obstructions or anything else.

[bluesynergie]

Hi,

Yes, I used to work for a company that sold such machines back in the UK. The cause of sleep apnoea can be caused by being overweight, alcohol consumption, smoking and of course sleeping on your back. As you are not a smoker or overweight then it could be something that runs in your family. There are various machines you can buy which are administered though a nose or face mask attached to a light head strap. The volume of gas, pressure and breaths per minute can all be keyed in. Some of them predict your breath rare whereas others are set at so many per minute.

It's probably best that you do it through a consultant so that he can do a full assessment of you. At least then you will stop snoring and get a good sleep!

[podman67]

Is CPAP available in BKK?

Ive been using it for 12 years and it has saved my life.

[rchapstick]

IF the OP has sleep apnea, then the snoring should be the least of his concerns. It can literally kill you (google Reggie White, former professional American Footballer, died at 40). Your weight can cause sleep apnea, but not always.

CPAP is the best treatment, but an admitted PITA. For some, surgery works. But for others it doesn't not work.

Best to get the sleep study done. And BTW, the study is not a treatment, but rather a diagnostic tool. CPAP, surgery, mouthguards, etc are treatment.

Edited April 14, 2008 by rchapstick

[kat]

Thank you Tammi and Paul.

As I have already stated I don't believe I am excessively overweight. I am 6 ft and around 85 kilos, and I used to be over 90 kilos. I would like to get down to around 81-82, but last time I did that everyone said I looked very gaunt. My face is not fat, nor is there is there any excess fat in my neck.

I have had this problem for years - even when I was a lighter. It's just gradually got worse and worse as I've got older (I'm 61), and now reached an intolerable stage. I always sleep on my side now on a very shallow pillow, and as soon as I drop off the snoring starts. Last night my wife moved out yet again, and I kept waking all night long.

I guess it's off to Bumrungrad, once I've cured my 3 week long diarrhoea problem .

http://autoimmunedisease.suite101.com/arti...disorders_in_ad

Sleep Disorders in AD

Sleep Disorders as Triggers and Symptoms in Autoimmune Disease

http://www.glutenfreeforum.com/index.php?showtopic=13655

Poll: How Many Have Celiac And Sleep Apnea?, POLL: How many have celiac AND sleep apnea?

http://www.celiacdiseasecenter.columbia.ed...nts/A02-FAQ.htm

[Mobi]

Today was “sleep clinic” day at Bumrungrad, and I met with the most wonderful doctor - the reasons for which I shall explain as I go along. Yet another lady – Dr Chantanok

She asked me about my history and snoring problems and then gave me a thorough examination. She told me that my jaw was miss-aligned which was one of the main causes of my problem. She then looked down my throat and said that my tonsils were very bad, and that the air opening was very small.

We discussed my sleeping problems and snoring and apnea, and based on what my wife and I told her, she suspects I have a serious case. Amongst other things she explained why, these days, I always remember my dreams vividly (because the apnea and snoring is waking me up), and why my blood pressure and blood sugars are very high in the morning, despite taking a large amount of overnight drugs. (She was shocked at the amount of blood pressure drugs I am taking) She explained that it’s due to the stress etc brought about by lack of proper sleep, and sudden awakening. She told me it was very common for people to have stroke and heart attacks in the early morning for this very reason. There was much more, but I won’t bore you with it.

She was a terrific person who spoke wonderful English and had a great sense of humour.

She asked me about my drinking habits, and I tried to play it down – as we are wont to do. My wife chimed in and told her I had drunk every day for a month before I stopped drinking to take the Flagyl. She asked if I was going to stop, and when I said not really, she said in that case, when you come for your test next week, make sure you have been drinking as usual; otherwise we won’t get an accurate result!

So next Tuesday I will sleep at the hospital and they will monitor me with EKG leads and all manner of contraptions and try to determine how serious my condition is.

More next week.

[Mobi]

I have mentioned this on my "Falling Apart" thread, but thought I would provide a detailed update here, for those who may share this problem.

I did the hospital 'sleepover' test a couple of weeks ago, and they wired me up to all kinds of machines and had a camera on me. I was given a mild sedative and slept at about 12.30 a.m.

I was woken at 3 a.m. and told I had been snoring very loudly, and that i had had 3 separate apnea incidenst, when my breathing stopped for over 50 seconds.

They put a breathing mask on me, and I slept until 7.am and they told me the snoring and apnea had stopped after I used the mask.

I had the follow up with the doctor the next day, and she told me my apnea was severe and that stops in breathing can/may have damage my organs, including my brain, as they were being starved of oxygen.

She recommended a CPAP breathing mask.

Last Thursday a breathing mask rep came to my home and gave me a ResMed APAP machine on a 7 day trial basis. She spoke very poor English, and didn't explain anything to me, and there was no handbook or instructions with the machine. However I managed to download an instruction manual from the internet, which explained everything to me.

I have been trying to use the machine for 5 days now, but I just can't seem to get on with it. The longest time I have kept the mask on is 2 hours. After that, I wake up and find the mask very uncomfortable, and I am unable to go back to sleep. Eventually I take it off and can then sleep. My enlarged prostate means I have to pee maybe 2 times each night, and the need to put the mask back on, and the discomfort I feel stops me from dropping off again. I shall persevere for a few more days, but I am feeling that it just isn't going to work for me.

Maybe I should consider some kind of surgery, or the Pillar treatment, that Tammi suggested?

Edited May 20, 2008 by Mobi

[Ulysses G.]

Mobi, please, how much is the CPAP breathing mask in Thailand?

Edited May 20, 2008 by Ulysses G.

[Mobi]

The one they are trying to sell me seems to be the fully automatic , top of the range job, that costs 70,000 Baht, plus 9,000 for the mask.

When I saw the specialist, she told me the prices range from around 20,000 for a basic machine, to 40,000 for a decent Ausssie made machine and up to 80,000 for the top of the range. I told her I would try the 40,000 Aussie one, but that didn't seem to happen.

There are load of CPAP web sites, and in particular the ResMed site, which is Aussie but seems well established throughout the world, including the United States, and probably the leading brand.

I have found some much cheaper brands on the web, but no idea how good they are.

I will call the company in BKK tomorrow and see if they have the full range of ResMed brands available or just the most expensive one!

In any event I'm not sure that I'm going for this solution.

[Ulysses G.]

I have a problem with sleep apnea too, but if I lose about 25 lbs, it goes away. The problem is that losing the weight and keeping it off ain't easy.

[Lost in LOS]

Mobi, I have the same problem as you and about as severe. do you recommend i go to this doctor and get the test done? did she offer you any other fixes besides the mask. i know the mask will not work for me and wont even bother trying it, i am highly claustrophobic and will never be able to wear it for any length of time. did she suggest surgery might help? I am in good shape and not overweight [by much]. what did this test cost and can I book it online? I live in pattaya and bangkok will be a pain to go to if I have to go twice

thanks

[autonomous_unit]

I guess I'm making this my little cause...

Mobi (and others): the mask isn't fun but it is your life saver! One of the biggest problems with sleep apnea patients is a denial of how serious it is, because the effects accumulate over years rather than killing you the next morning. It's rather like alcohol chronically damaging a liver in that way...

My father is getting a lot of benefit from his CPAP machine, in spite of echoing many of the complaints and "it just won't work for me" statements on this thread. It takes some practice and patience to learn to accommodate this permanent change in your life, but it has very practical and positive benefits.

Mobi even described how the mask at the sleep clinic allowed him to sleep the rest of the night without further incident. To then rule out the treatment after the home trial doesn't make sense. Push them and ask why the mask at the clinic worked and this one did not! Maybe it is ill-fitting, or the various pressure settings are wrong.

My dad also has prostate problems along with his diabetes and apnea. He complained about getting "hooked back up" after night trips to the bathroom, but then he also started to notice that he didn't make as many trips once he started getting regular and healthy sleep. He still has problems some nights, for example when he throws his arm across his face in the night and pushes the mask sideways to break the seal. My mother can usually nudge him back into working order if this happens, since the mask starts making a lot more noise when air leaks around the sides...

[Mobi]

Mobi, I have the same problem as you and about as severe. do you recommend i go to this doctor and get the test done? did she offer you any other fixes besides the mask. i know the mask will not work for me and wont even bother trying it, i am highly claustrophobic and will never be able to wear it for any length of time. did she suggest surgery might help? I am in good shape and not overweight [by much]. what did this test cost and can I book it online? I live in pattaya and bangkok will be a pain to go to if I have to go twice

thanks

I am also a bit claustrophobic about things over my nose and mouth, but am trying to conquer this. The main problem, frankly is just a general feeling of discomfort, which stops me from sleeping, or if I do manage to drift off, once I wake again ( as I always do) it becomes impossible to go back again with the mask on. After lying there for ages , to no avail, as soon as i take the mask off I immediately feel relieved and fall asleep.

Jimmy, there is a lot of information available on the web on snoring and sleep apnea, and all the various ways to cure it or relieve it. There are a number of links on this thread if you look back.

There seems little doubt that masks are reckoned the most effective treatment, but other treatment includes laser surgery, etc.

The cost of my sleep package was around 14,000 Baht. You can contact Bumrungrad via their website where there is quite a lot of information about this problem I believe that Bangkok Pattaya hospital also have a sleep clinic, so you may want to try there, but get a price first.

As to whether I can recommend the doctor - it is too early to say, as I will go and see her again and report my problem and see if she has any solutions. I will then let you know.

autonomous_unit Mobi even described how the mask at the sleep clinic allowed him to sleep the rest of the night without further incident. To then rule out the treatment after the home trial doesn't make sense. Push them and ask why the mask at the clinic worked and this one did not! Maybe it is ill-fitting, or the various pressure settings are wrong.

You may recall I reported sleeping at around 12.30 am, when I was very tired from lack of sleep over the previous few days, and I had been drinking a moderate amount of alcohol (on my doctor's instructions as this was the norm for me). I was also given a sleeping pill.

I slept fitfully until 3 a.m. and then put the mask on and slept for another 3 hours or so with a sleeping pill and alcohol to help me.. I actually woke up myself after 3 hours, and couldn't drop off again so the trechnician came in and suggested we called it a night. So I don't think it was a very good test of my ability to sleep with the mask as I was pretty exhausted and other external factors aided my sleep.

I hear what you are saying about giving it a fair trial, am still trying every night. Last night I couldn't sleep at all and by 2 a.m. I gave up and took it off. The machine I have is pretty sophisticated (it aught to be for 80k Baht!!), and I can check on the machine if the mask is fitted properly, and the pressure is automatically adjusted according my breathing/sleeping patterns.

I'll see what the doctor has to say.