Please, anybody's Have Pre-existing fatigue improve AFTER?

[sleepygirl]

Hi there! Any replies would be EXTREMELY appreciated I'm having a pretty tough time x
I'm new to the forum and have been advised from my X-rays that I am a candidate to have either double or lower jaw advancement and am waiting to see a public surgeon for a final opinion.

My reasons are functional and cosmetically I'm pretty happy with how I look, my ortho advised that my lower jaw is pretty far back (forgot mms, sorry!) but that my lips are quite 'fleshy' and 'camouflage' the appearance to quite a degree.

I have TMJ (jaw clicking and crunching) and obstructive sleep apnea (AHI of 32, so i stop breathing twice per minute!). I'm a 21 year old female 5'2 and 50kg so I'm not overweight and an ENT said he couldn't see any soft tissue reasons. The main motivation though was intense masseter pain on both sides. It radiated all over my cheeks, to my eyes, forehead and even oxycodone couldn't help it. I would get electric shock-like spasms and eventually couldn't even chew. I gave in and got botox in my masseters to tide me over and it helped the pain immediately, but is definitely not a long term solution.

The pain alone will probably be enough of a reason to go forward with the surgery unfortunately, but I was wondering if anybody with fatigue and sleepiness found improvements after their surgery??? Its a huge problem in my life and seriously making me depressed. I've even tried prescribed dexamphetamines (not much help at all) because I'm so tired. medications have helped, but I'm still sleepy all day and if left to my own devices can sleep up to 20hours! i want to sleep every moment of the day. I've had like 2 years of medical investigations and everything else has turned out normal! hormones, vitamins, no autoimmune diseases, not thyroid, iron etc etc....

I have used a cpap machine for 2 years + now, but my theory is my jaw is shutting off my throat and I'm missing out on deep quality sleep because i need to keep pushing my jaw forward in my sleep... If I relax my jaw right now when awake i cannot breathe at all and its actually quite scary, its very hard for me to fall asleep without my cpap machine.

The cpap is meant to obviously support the soft tissue airways but ofc theres no way it could lift the weight of my jaw
I'm so miserable and darn exhausted!!!!!!!!

Any input would be so so so appreciated thank you!!!!!!!!

[snapdresser]

Orthognathic surgery is an approved treatment for sleep apnea so yes, it can improve it in certain patients. Another surgical treatment for sleep apnea is UPPP. Which is better to treat your particular situation is probably best decided by an ENT or sleep medicine doctor. Also, allergies and inflammation of the adenoids can have an impact on your ability to breathe through the nose too, so those are other items to consider.

[Jbird]

I also have sleep apnea severe. Got diagnosed 4 months ago and the cpap has helped save my life. I feel much better since using it. Sounds like you need help getting the cpap to work for you. I suggest cpaptalk.com. There's so much help there. There's software you can load that's free that can help you figure out how to make the cpap work for you and many helpful people online there.

[littlebird]

My surgeon suspects that I have severe sleep apnea due to only having a 4 mm wide airway (normal is 10-12 mm), so that's the main reason I'm having double jaw surgery + genio. My surgery is scheduled for Sept 12, so I don't have a post-surgery answer of whether or not it worked, but wanted you to know that breathing/sleeping is the main reason I'm having it done. Also, I'm 35 years old and have noticed that in the past 5 years or so my sleeping has gotten worse. I'm not overweight, either, and my surgeon has explained that it's because everything softens as we get older, so sleep apnea issues will only get worse with aging. I'm constantly exhausted, so I'm really hoping this surgery fixes that!

[Jbird]

I'm constantly exausted too, even after getting on cpap. Did you have your surgery and are you breathing better?

[SingleJawMelb]

What about a mouth piece? https://www.sleepassociation.org/sleep- ... uth-piece/

[Jbird]

I have severe OSA. The mouthpiece works for mild and moderate. Some people get good results with mouthpiece if their OSA is in that range.

[littlebird]

I'm constantly exausted too, even after getting on cpap. Did you have your surgery and are you breathing better?

Surgery was delayed to Nov. 7, unfortunately. Will post afterwards with an update!

[madblogr]

Severe sleep apnea here too. Finally went in and got diagnosed with 90+ AHI back in May Was put on CPAP and have now gone through SARPE (finished expansion in August) and now about to do MSDO for lower jaw on 11/29. I was always fatigued and never felt like I was getting any sleep, couldn't stay focused, etc. Already seeing improvement with my situation since SARPE and using CPAP. Hoping once all surgeries are complete that I won't need the CPAP anymore.

[glennstanzalone]

I will tell you that I can run way longer and lift more than I used to! Breathing is so much easier. I have more energy throughout the day too.

[Jawbreak]

Just wondering how you are doing now with the fatigue? I also had a double jaw surgery done for sleep apnea, although mine was mild, but the symptoms were affecting my entire life (chronic fatigue, constant sleepiness, never felt fully rested, etc.). My story is very similar to yours and it took 4 years to finally get a clue as to what was going on. I've had the surgery 5 weeks ago, but I'm still feeling very tired and I'm wondering if it's a lingering side effect of recovering from the surgery, or if the surgery just didn't fix my problem. My surgeon says everyone is different and it can take 3 weeks to 3 months, but it's hard to be patient, isn't it?

Hoping your surgery fixed your problem! If it did, when did you start noticing an improvement?

[madblogr]

Just wondering how you are doing now with the fatigue? I also had a double jaw surgery done for sleep apnea, although mine was mild, but the symptoms were affecting my entire life (chronic fatigue, constant sleepiness, never felt fully rested, etc.). My story is very similar to yours and it took 4 years to finally get a clue as to what was going on. I've had the surgery 5 weeks ago, but I'm still feeling very tired and I'm wondering if it's a lingering side effect of recovering from the surgery, or if the surgery just didn't fix my problem. My surgeon says everyone is different and it can take 3 weeks to 3 months, but it's hard to be patient, isn't it?

Hoping your surgery fixed your problem! If it did, when did you start noticing an improvement?

I can't speak for the others on here but for me I think it took several weeks as well to really start noticing and I blame it on the healing process. Takes lots of energy to heal up from these surgeries and rebuild the bone. My team kept telling me it can take 4-6 months to fully heal the bone solid enough to remove any supporting devices. I know I immediately stopped snoring after getting home from the SARPE surgery or if I did snore it was very light and wouldn't last. However, I also slept between 45 degrees and almost upright while healing for the first couple of weeks and then at 35-45 degrees for several more weeks before getting back down to my original sleeping positions and then I found I still don't really snore much any more. I take at least one night off from using the CPAP now (couldn't even use it for a while after the surgery due to risk of blowing sutures) to see what the effect is and I almost feel the same the next day. So I'd guess I was closer to the later part of your surgeon's estimate. In the 2-3 month range before I really started noticing I wasn't as fatigues any longer. I do notice if I don't get enough sleep still that I'm more sensitive to it and will get fatigued/sleepy quicker so I still have to watch my hours of sleep for now; however, I also just went through my second surgery and am healing up on the lower jaw now, lol.

I know it's hard to be patience but that is the only thing I can recommend at the moment, patience and try to get those 8hrs of quality sleep Even after healing, the body is already use to the restless sleep so it has to get accustomed to sleeping properly again. I found for a bit I was waking up sooner (meaning less hours than even before) because my body was getting better quality sleep; however it wasn't enough hours, so again, need to re-learn the body. At least that is my experience. Good luck and I hope you start seeing improvements soon!

[EHA]

I'm dealing with similar issues now. Would love an update on everyone's progress at this point. Surgery is a year away. Hard to manage the sleep apnea (with Cpap) and subsequent exhaustion in the meantime.

[Jbird]

I had my surgery in April. I'm just now getting to feeling almost normal. It's a hard few months to go through. Good news, my airway went from 3 mm to 15 mm. No more snoring, no more sleep apnea. I'm sleeping better
Don't need cpap anymore. Something to think about is when you have chronic sleep problems you get in a lot of bad habits that need to be changed. I'm dealing with some of those, but the surgery helped me and I would do it again. Also I look better, so it was worth it.

[koros]

YES - surgery would definitely help this issue.

From what I hear you have a recessed lower jaw tightening the airways. This isn't uncommon, but for some people its severe. If this airway, which rest behind your lower jaw kind of in your throat was tight enough, it would cause you sleep deprivation, improper breathing, and of course OSA. Now FIRST, get a scan where you can determine if your airways are small, because if that turns out to not be the issue, you just broke half of your face, spent thousands of dollars on nothing! Some people have problems merely because of septal deviation, large uvulas, large tongue, oversized tonsils or adenoids, or possibly turbinates.

You see, Fatigue comes from lack of sleep, or lack of oxygen during sleep. There is an obvious reason you are not breathing right. Your answer will either lie in the nose, the throats, the jaws, or the mouth - or all of them! Jaw surgery is way too extensive for you to not look carefully into every possible obstruction before you go through with this surgery. A: Because it may be too invasive for your case B: if it is right for your case, you may have other issues you could get fixed during your jaw surgery. (this would be wise to cut down on future doctors appointments and surgeries) Most patients with small airways also have nasal obstruction because the airway connect both to the nose and the mouth. If it is closed, both will not be able to capture oxygen will. Lack of breathing nasally overtime will result in some sort of nasal problems that should probably be addressed as well.

As I'm sure your aware the machines they offer are a bit of a blanket fix, but never really a sure way of fixing the problem. A maxillomandibular advancement will open the airway in your throat as well as the airway leading up to your nose. This should help ALOT. Lower jaw only wouldn't be too wise unless you have a really large overbite. But the both jaws should move together. It'll be more cosmetically pleasing as well. People with overbites and severe chin and jaw definceny usually see the most improvement in breathing. An underbite (which is what I had) leaves you with TOO much jaw and makes it impossible to close the mouth and breathe nasally.

My advice:

Get that airway scan if you haven't already.

Visit an ENT (ear, nose & throat doctor) and have them look into other obstructions.

I know many people have had their ENT and Maxofacial doctor work together in the surgical room and have many procedures at once. Any nasal surgery would be under an hour, possibly 30 minutes. And most throat related obstructions would also be about that long. Also this may help insurance cover your hospital fees as most ENT surgeries are always medically necessary and jaw surgery is rarely approved cause of its expense and cosmetic value. SO you would still have to pay for the surgeon fee from your surgeon, but you would have the hospital covered if you happened to find something wrong with your nose, throat, or mouth - anything aside from your jaws.

Even if it's JUST your jaws that are the root of your problems, it is better to be safe.Bad breathing habits cause obstruction in many places, and it is usually rare that it would only effect one area. I know from experience. Hope that helps. Good luck!