Other reasons for CPAP machine failure.
I have had two tongue-based RFA procedures so far this year as of April 2025. I was offered the Maxillomandibular Advancement (MMA) and the Aspire procedure but reasoned with my doctor about a tongue base reduction. My drug-induced sleep endoscopy revealed that my tongue fell back to the back of my throat to the point where it blocks my epiglottis and that is probably the primary reason why I wasn’t feeling any benefit from the CPAP machine. Instead of choosing a more invasive procedure, I talked with my doctor and told him I was interested in trying to reduce the tongue base via RFA in hopes of maximizing enough space for a tongue-retaining device or CPAP machine to be effective. I’ve read that tongue-based procedures don’t always work, but it has the possibility of allowing a CPAP machine or tongue-retaining device to be more effective at the very least. Before my first RFA tongue base procedure, my ODI of 3%" (Oxygen Desaturation Index) was about 39. After my second RFA tongue base procedure, it was as low as 11.5 (with a tongue-retaining device).
The first two were a piece of cake with mild to moderate pain for a little more than a week. My follow-up to my second RFA tongue procedure indicated a significant reduction of the tongue base, although I may need one more to finalize the reduction of the tongue base. Additionally, the doctor may find it beneficial to reduce my lingual tonsils, although he said they are not really that prominent. Furthermore, the drug-induced sleep endoscopy (DISE) revealed a portion of my epiglottis collapsed (even with jaw and tongue pulled forward.) So my doctor already discussed adjusting the problem area of my epiglottis with a technique he has discovered has a high percentage success rate (this could possibly be a contributing factor as to why the CPAP has had very little success.) One good thing I heard about RFA as opposed to cautery, laser, cutting, etc. in regards to reducing the tongue base is that it can create better beneficial scar tissue in the tongue base that can decrease the overall “floppiness” which in turn could help against the tendency of the base of the tongue to fall backward while sleeping. In the meantime, I’m awaiting a sleep study to be completed before another (and hopefully my last RFA tongue reduction procedure with an adjustment of the epiglottis collapse.)
Thanks so much. I have to say even before my RFA procedure for tongue base reduction I slept a little bit better just wearing a tongue retaining device alone. But the tongue retaining device with the RFA procedures have helped even more. Unfortunately, I had to claw and scratch to get my primary doctors to listen to anything but my issue being a matter of CPAP pressure adjustments. Additionally, I have had to look up things on the internet for CPAP complications and alternatives. I was finally able to find a location that accepted my insurance and specialized in sleep medicine after 2 years of searching, paperwork and referral delays, setting up initial appointments, etc.
Wow! How exhausting! I'm glad you stuck with it and continued to advocate for yourself. I hope your story inspires others to fight for the care they need and deserve. - Lori (Team Member) Indeed. I've learned that the smallest of things can potentially set a positive trajectory. In my case, this can be significant. I'm hoping that my experience an testimony can help more people become more motivated to explore any options to improving or even curing sleep apnea. I would agree that CPAP machine usage has the greatest efficacy of any treatment or cure assuming there are minimal obstructions. However, in my case and the case of many others there are legitimate reasons why the CPAP machine is doing very little. With a little extra effort and understanding of our primary doctors people like us have a chance to look deeper into why the CPAP machine is not able to work properly.
Hi
. Welcome to the community! I'm glad you found us. I have certainly learned a thing or two from your experience. Thanks for sharing. How awesome that you have a doctor who cared enough to dig deeper and that the RFA procedure was effective. Did you go through a lot of trial and error before recognizing that the CPAP wasn't working or did you and your doctor figure out the problem fairly quickly? I can't imagine how you got any sleep at all previously. How do you feel now? I would love to hear how the sleep study goes and whether you move forward with the third RFA, if you don't mind. Warmest of wishes. - Lori (Team Member)
