Surgery for Sleep Apnea

Benefits and Side Effects of Surgery for Sleep Apnea

Before Trying Surgery for Sleep Apnea

Before you even consider sleep apnea surgery, you should try the first two standard treatment options for sleep apnea, which include CPAP and oral appliances.

Even doctors have sometimes difficulties to recommend which treatment is the best for you. Some surgeries for sleep apnea can have serious side effects, worsening the severity of the syndrome and affecting the treatment with other options available.

For example, after UPPP surgery patients can have problems to use the CPAP machine, even if its necessary. However, nasal surgery can help you tremendously to use CPAP with success, mostly if you have nasal congestion, enlarged turbinates or deviated septum.

More about surgery in this video:

Bottom line... Consider trying nonsurgical or conservative options to treat sleep apnea, before undergoing any surgery.

Which Doctor is Right for You?

For example:

• Doctors from sleep centers (sleep doctors and sleep technicians) generally recommend CPAP therapy.
• Dentists will recommend dental devices.
• The Otorhinolaryngologist or ENT (ear, nose and throat doctor) recommends surgery for sleep apnea.

In general, patients who visit only one of these doctors, will choose his recommendation. If the patient is not successful with one of the methods, he will visit another doctor, and so on...

Other doctors don't want to risk making you a wrong recommendation, so they will give you the treatment options, and you will have take the decision. However, this is not the best approach to treat your sleep apnea.

So, what is the solution? Which doctor is the best? The best solution is to visit all these three types of doctors before taking a decision: the sleep doctor, the dentist and the ENT.

It will be best if all these doctors are working in a team, communicating with each other regarding your situation. It is possible that a sleep doctor recommends CPAP, but checking your nasal passages by an ENT will be a clever choice, because he can discover a deviated septum, which affects the CPAP therapy.

When to Choose Surgery for Sleep Apnea?

• CPAP (for mild, moderate and severe obstructive sleep apnea)
• BiPAP (for mild, moderate or severe central sleep apnea)
• oral appliances (for mild and moderate obstructive apnea)
• positional therapy (for mild and moderate obstructive apnea - Rematee is recommended)
• alternative cures for sleep apnea (including tongue and pharyngeal exercises, yoga, didgeridoo, weight loss, sleep hygiene)

After you gave one or two non-surgical options a good honest try, you have clear path to surgery for sleep apnea. Your ENT doctor will have many surgery options for you, such as:

• improvement of nasal breathing to support CPAP therapy:
• nasal surgery
• surgery for primary snoring and very mild obstructive apnea:
• UPPP,
• adenotonsillectomy,
• LAUP,
• palatal implants,
• surgery for mild and moderate OSA:
• RFT tongue base surgery,
• hyoid suspension,
• laryngeal surgery.
• surgery for moderate and severe OSA (after CPAP failure):
• multilevel surgery,
• tracheostomy,
• tongue base res.,
• GG-advancement,
• bariatric surgery.
• adenotonsillectomy in pediatric obstructive apnea.

In order to reduce the pre- and postoperative risk, sleep surgeons together with ENT will have to correctly identify the site of obstruction.

They should use pressure measurements with one or more sensors, flexible endoscopy, analysis of sounds during sleep, and various imagining techniques to identify the site of obstruction and the origin of your loud snoring.

Bottom line... Only after the identification of the site obstruction that causes your sleep apnea, you should accept the recommendation from your doctors to undergone the sleep apnea surgery.

Benefits of Surgery for Sleep Apnea

Better Than Nothing

If you cannot tolerate CPAP, surgery, despite it's lower success rates, is better than nothing. From an AHI of 40 (severe apnea) to an AHI of 9 (mild apnea) is a great improvement.

Dental devices can be successful or not. Either way, some people can't tolerate them or have specific dental reasons why they can't use them.

Furthermore, patients with mild sleep apnea have greater chances to treat permanently sleep apnea. Remember that some surgeries have 50% drop of AHI level? If your AHI is 9, and after surgery your AHI becomes 3, then you are breathing like a normal person during the night. Your sleep apnea is cured.

Bottom line... The most effective surgery for sleep apnea is tracheostomy, when your AHI levels drop to 0 regardless how severe is your breathing sleep disorder.

Anything else that's done to the soft tissues from your mouth and throat is going to be less than optimal, starting from a success rate of 80% to 40%.

As you probably realize, the more you cut from the obstruction area, the better your success rates, but the more likely the risk of complications. Your ENT should help you choosing the best solution.

Some more interesting pages for you to check out:

• Restless Legs Syndrome

• Using a portable pulse oximeter to diagnose apnea syndrome

• Severe Sleep Apnea

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