- Nasal surgery to remove polyps or straighten a crooked partition between your nostrils (deviated nasal septum). This is often successful if needed.
- Surgery to remove enlarged tonsils or adenoids
August 3, 2014
Sleep Apnea Surgical Treatments
Even though many articles mention treatment and drugs for sleep apnea, as of yet there are only devices that FDA approved and no drugs. Some drugs are approved for other sleep disorders, but they are ineffective for sleep apnea.
I should say for the next part of this that I have a strong bias and dislike for even bringing this up. That would be surgical procedures for the treatment of sleep apnea. I now know two people that have had surgery and regret every day that they had the surgery. It did not end their sleep apnea and both had several months of pain and discomfort. One has had trouble swallowing food every since his operation and the other has more trouble sleeping even using a BiPAP machine. The best warning I can give you is that surgery is not for everyone. Keep reading for those that it may be appropriate.
Surgery should be the option of last resort when other treatments have failed. Normally, it will depend on the doctor, but most doctors do not recommend surgery until they find something requiring surgery.
Jaw repositioning. In this procedure, your jaw is moved forward from the remainder of your face bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely. This procedure, which is known as maxillomandibular advancement, may require the cooperation of an oral surgeon and an orthodontist, and at times may be combined with another procedure to improve the likelihood of success. This surgery is not done that often, but for some people is recommended and is one of the more successful is x-rays indicate a need.
Implants. This is probably the most reasonable and least problematic. Plastic rods are surgically implanted into the soft palate while you're under local anesthetic. This procedure may be an option for those with snoring or milder sleep apnea who can't tolerate CPAP.
Creating a new air passageway (tracheostomy). You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea. In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe. You keep the opening covered during the day. But at night you uncover it to allow air to pass in and out of your lungs, bypassing the blocked air passage in your throat. We have all seen these in people that have had throat cancer.
Tissue removal. During this procedure, which is called uvulopalatopharyngoplasty (UPPP), your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring. However, it may be less successful in treating sleep apnea because tissue farther down your throat may still block your air passage. UPPP usually is performed in a hospital and requires a general anesthetic.
Removing tissues in the back of your throat with a laser (laser-assisted uvulopalatoplasty) isn't a recommended treatment for sleep apnea. Radiofrequency energy (radiofrequency ablation) may be an option for people who can't tolerate CPAP or oral appliances.
This procedure has the least success and seldom stops sleep apnea. Other types of surgery may help reduce snoring and contribute to the treatment of sleep apnea by clearing or enlarging air passages:
Treatments for central and complex sleep apnea may include: (These types of sleep apnea can be a dangerous as obstructive sleep apnea.)
Treatment for associated medical problems. Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions may help. For example, optimizing therapy for heart failure may eliminate central sleep apnea.
Supplemental oxygen. Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs.
Continuous positive airway pressure (CPAP). This method, also used in obstructive sleep apnea, involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway to keep it from collapsing. CPAP may eliminate snoring and prevent sleep apnea. As with obstructive sleep apnea, it's important that you use the device as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor so that adjustments can be made. All the different types of CPAP machines may be used with success.
Along with these treatments, you may read or hear about different treatments for sleep apnea, such as implants. Although a number of medical devices and procedures have received Food and Drug Administration clearance, there's limited published research regarding how useful they are, and they aren't generally recommended as sole therapies.