What are My Surgical Options for Sleep Apnea?
Obstructive sleep apnea is a serious condition that can lead to cardiovascular health problems, daytime sleepiness, and depression. It is a surprisingly common condition. According to the American Sleep Association, 25 million Americans currently experience sleep apnea. When sleeping, these individuals experience disrupted sleep because their tongue repeatedly blocks the back of the throat, partially blocking the airway and triggering a sleep/wake cycle. Reduced oxygen levels and sleep disruption are the result.
Fortunately, there are a variety of options for treating sleep apnea. The most common treatment is a CPAP machine, which delivers pressurized oxygen to the patient through a mask they wear while sleeping. If the CPAP doesn’t help or the patient cannot wear an oxygen mask comfortably at night, the next step is often surgery. There are currently several surgical options available, each addressing different facets of sleep apnea.
Uvulopalatopharyngoplasty, or UPPP, is a surgical procedure done to open the throat for improved breathing. Excess throat tissue is removed, increasing the size of the airway at the back of the throat. In most cases, the uvula (the portion of the soft palate that hangs down at the back of the throat) is removed. UPPP surgery is sometimes combined with a tonsillectomy. It is done under general anesthesia and requires a hospital stay, usually overnight. Recovery takes two to three weeks.
Laser Assisted Uvulopalatoplasty is similar to UPPP surgery with a few advantages. Rather than a traditional scalpel, a laser is used to sculpt the soft palate and trim or remove the uvula. There is less bleeding, a reduced chance of infection, and a faster healing time with laser assisted surgery. It is an outpatient procedure and is most effective for patients with mild to moderate sleep apnea.
Radiofrequency Palate Treatment
Radiofrequency palate treatment administers energy in the form of heat to soft tissues in the back of the throat. The heat delivers controlled damage that leads to tightening and scarring of the tissues, resulting in a more open airway. A typical treatment involves two or three sessions spaced out over several weeks and is done in the office.
This most complex and extensive surgical intervention for severe obstructive sleep apnea is orthognathic surgery to realign the upper and lower jaw. Because this is a complicated surgical procedure, it is usually reserved for patients who have failed to respond to all other sleep apnea treatment options. The surgeon realigns the jaw and may remove part of the back of the lower jawbone to open the airway. The surgery is done in a hospital setting with a stay of two or three days to closely monitor the patient. Following surgery, a soft diet is required for four to six weeks.
One of the most exciting developments in sleep apnea treatment is AirLift, a simple implant that opens and stabilizes the airway. The device suspends the tongue and the hyoid bone (a horseshoe shaped structure that can contribute to sleep apnea) to prevent the tongue from falling back into the throat while sleeping. The procedure is performed in the office and usually takes about 30 minutes. Recovery time is minimal.
If you are frustrated by having to wear a CPAP mask that interferes with sleeping and is a hassle to keep clean, you aren’t alone. Fortunately, there are alternatives that can reduce or eliminate sleep apnea that can last a lifetime. Dr. Black and Dr. Chen are experienced at treating sleep apnea surgically and can advise you on the best approach for your level of sleep apnea. To