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Comment by armatav | Hacker News Reader

Absolute slow death - underweight, 50 AHI, CPAP pressure any higher resulted in aerophagia, any lower resulted in the soft tissue compressing my throat.

Had the MMA done after three TPD expansions, now no longer need the CPAP, sleep a lot better and run every day.

No joke, I would rather have fought a bout of cancer than have been slept to death like that for years.

My solemn advice to anyone with a severely high AHI is to go grab Dr. Li and have him move your jaws forward, don’t bother with the CPAP, you have a structural issue that requires a structural solution.

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I have Sleep Apnea, use CPAP daily since about 6 years now and it has been a life-changing experience.

Sucks to have been sleepy and tired for all the years I can remember.

Can you elaborate on what MMA and TDP expansions are? Where are you (or the doc you refer) located?

I am completely fine with using CPAP, but if I don’t need it at all, that would be even better.

(Not the OP)

For those of us who are not overweight or don't have deviated septums (the usual culprits), we probably have underdeveloped lower jaws and recessed chins.

These collapse on the airway when we sleep on our backs. MMA (maxillo mandibular advancement I think) is a surgical way of moving your jaw bones forward.

I had this done in a clinic in Seoul, as my US insurance was crappy and wouldn't cover the peocedure.

It's an uncomfortable recovery process but there's been improvements.

Sure, I’m in Palo Alto - so’s the doctor.

MMA is maxomandibular advancement. They make fine cuts in the upper and lower jaw, move them forward, and secure them in place with titanium bars. Sounds painful, really was the least painful surgery I have had so far - but the most logistically challenging (chocolate milk for 6 weeks straight).

TPD is transpalatial distraction. He makes a fine cut down the palate and inserts a small device on it, then every couple days you use a little tool to activate it, and it moves the palate apart horizontally, giving you more nasal breathing room.

Wild ride, but I’d do all of those surgeries twice if I had to; they weren’t actually that bad at all, but the results are amazing. Being able to run and breathe through my nose is great, sleeping without the machine is great too.

I had the jaws moved forward. But the surgeon had noted beforehand that I had bad TMJs. So when I'm lying on my back, my lower jaw still tends to open, sitting on my airway.

So I mostly sleep on my side nowadays. And sometimes use mouth tape.

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