Are Surgical Treatments An Effective Option For Sleep Apnea?
If you suffer from obstructive sleep apnea (OSA), you’ve likely been presented with treatment options including a CPAP machine and/or an oral appliance. But for many, the CPAP machine is intolerable, and others may not like having to wear an oral appliance every night. For those patients, surgical treatments do offer an excellent option with a high rate of success. Long considered the gold standard of sleep apnea treatment, the CPAP machine’s prominence is being reconsidered. According to a study conducted by the acclaimed National Center for Biotechnology Information (NCBI), surgical treatments can provide a better overall outcome for many patients, in large part due to the lack of adherence to CPAP. Additional studies reveal that just 42% still use their CPAP after five years (and only 48% still wear their oral appliance). What are the advantages and benefits of surgical treatments for sleep apnea?
- Permanence: For young patients with mild and even severe sleep apnea, surgery can be a permanent solution. Although it’s always a possibility that sleep apnea may return, surgical treatments are geared at providing a permanent anatomical fix to the issue causing your apnea.
- Effectiveness: Even if the surgical option doesn’t completely resolve your sleep apnea, it can still be extremely effective in reducing the severity of your condition. In fact, it’s not unusual for surgery to result in a 50% drop in the Apnea-Hypopnea Index (AHI), the measure used to indicate the severity of sleep apnea. For example, if your AHI pre-surgery level is at 40 (severe apnea) and then drops to 9 (mild apnea) post-surgery, that’s a significant improvement.
- Convenience: If surgery does reduce the level of your sleep apnea, you’ll no longer have to deal with the inconvenience of a CPAP machine or oral appliance. A surgical solution means no more devices at home or when you travel.
- Peace-of-mind: Most of all, surgical treatments, when successful, will let you literally and figuratively breathe easier, knowing that the risk of serious side effects of sleep apnea has been significantly diminished. It means better sleep, increased energy – and a reduced risk of cardiac problems associated with sleep apnea.
What are the surgical treatment options and do they require hospitalization?
The surgical treatments for sleep apnea are typically in-office procedures and generally take one hour or less. It’s essential to keep in mind that no matter what surgical option you choose, the surgery should be performed only by a Board Certified Oral and Maxillofacial Surgeon with extensive experience in sleep apnea surgical procedures and protocol. Other procedures may last longer and may need to be performed in a hospital setting. There are several surgical treatment options for sleep apnea. Some of the most common include:
- UPPP (Uvulopalatopharyngoplasty): Perhaps the most common procedure for sleep apnea, UPPP involves trimming the soft palate and uvula, and removing the tonsils and other tissue.
- Laser Assisted Uvulopalatoplasty: This procedure is useful in cases of mild to moderate apnea and also helps to relieve snoring. The doctor uses a laser or electric current to remove some of the soft palate and part or all of the uvula.
- Radiofrequency Ablation (RFA): In this procedure, the doctor uses radio waves to reduce the size of the turbinates or uvula, nearby tissue, and sometimes the back of the tongue.
- Septoplasty: A surgical procedure to correct a deviated septum – a displacement of the bone and cartilage that divides your nostrils. During septoplasty, your nasal septum is straightened and repositioned in the middle of your nose.
- Tonsillectomy: A common procedure for children that removes tonsils prone to becoming infected and enlarged. According to the American Society of Otolaryngology, more than 80% of tonsillectomies performed today are done to lessen the severity of sleep disorders affected by breathing.
- Adenoidectomy: Typically done at the same time as a tonsillectomy, an adenoidectomy removes adenoids that become frequently enlarged and block an individual’s airway during sleep.
- Pillar Procedure: A simple, safe and effective procedure that stiffens the palate in order to help relieve snoring and symptoms of mild to moderate sleep apnea.
- Turbinoplasty: A procedure to decrease the size of the turbinates, which are structures along the side wall of the nose that can swell and cause obstruction. By reducing their size, your breathing can be improved. A turbinoplasty is often done at the same time as a septoplasty.
- Frenectomy: A simple and painless procedure that releases the frenum under the tongue or upper lip. Well-known as a treatment for newborns with tongue-tie, it offers several short and long term benefits, including ease of breastfeeding, aid in speech, and reduction of airway difficulties.
- Hyoid suspension: A procedure in which the hyoid bone and its muscle attachments to the tongue and airway are pulled forward with the goal of increasing airway size and improving airway stability.
- Genioglossus advancement: A procedure in which the base of the tongue is pulled forward, usually to increase airway size due to deformity or a sleep breathing disorder.
- Tori reduction: A procedure in which a tori (a bone growth within the mouth) is reduced or removed in order to eliminate a breathing obstruction that can make an individual more susceptible to snoring and sleep apnea.
- Orthognathic surgery: Also known as jaw surgery, the procedure moves the upper and/or lower jaws forward in order to enlarge the airway in both the palate and tongue regions. Maxillomandibular advancement, which moves both jaws forward, has a high success rate for those suffering from sleep apnea.
- Palatal expansion: An orthodontic treatment that increases the width of the maxilla (jaw) in order to reduce nasal resistance and improve breathing.
- SARPE: Surgically Assisted Rapid Palatal Expansion is a procedure that enlarges the maxillary dental arch (upper jaw) and the palate (roof of the mouth) in order to re-establish balance between the width of the jaws and help ease breathing.
If you have sleep apnea and the other treatments haven’t worked, don’t give up!
Remember that sleep apnea is much more than snoring. It’s about potentially life threatening side effects including heart failure, type 2 diabetes and more. If you’ve been diagnosed with the sleep apnea and neither CPAP nor an oral appliance has worked for you, schedule a consultation today at NYC SleepWell to explore our proven surgical treatment options. Our goal at NYC SleepWell, plain and simple, is to help you sleep well – and be healthy!