Surgery Options for Sleep Apnea
Dr. Angel Rivera
Sleep apnea is a sleep disorder that affects both men and women of all ages and is characterized by pauses in breathing during sleep.
These pauses can last for a few seconds to over a minute, and they can occur over 30 times per hour. Sleep apnea can cause a number of health problems, including daytime fatigue, headaches, and cardiovascular issues.
Surgery is usually not the first option for sleep apnea treatment; however, it can be an effective treatment when other therapies fail.
In this article, we will discuss the surgical treatment options for sleep apnea and detail other treatment options too so you can make an informed decision with your doctor about the right treatment plan for you.
What is sleep apnea?
Sleep apnea is a sleep disorder in which you have pauses in breathing or shallow breaths while you sleep.
This can be caused by a number of different reasons but usually happens because there is a blockage in the upper airway during sleep.
Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. It usually is a chronic condition that is present for years but is treatable.
Both men and women can suffer from it although being a man, obese, or elderly increases your chances of having it.
Not all apneas, which are the name for the pauses in breathing, are the same. Three different types exist and which one you have may affect your treatment plan.
Obstructive sleep apnea (OSA) is the most common type and occurs due to a blockage in your upper airway while sleeping.
Central sleep apnea (CSA) occurs when your brain fails to send signals to the muscles that control breathing.
Complex sleep apnea or mixed sleep apnea (MSA) is a combination of obstructive sleep apnea and central sleep apnea and is the rarest form.
If sleep apnea continues, it can lead to serious health problems including high blood pressure and heart disease. It is important to get sleep apnea diagnosed so you can find the treatment that works best for you to improve your quality of life.
What are the symptoms of sleep apnea?
The most common sleep apnea symptom is loud snoring. You may also experience:
- Choking or gasping during sleep
- Pauses in breathing
- Excessive daytime sleepiness (EDS)
- Trouble staying asleep at night which is also known as insomnia
- Dry mouth or a sore throat
- Trouble concentrating due to tiredness
- Irritability or mood changes while awake
- Morning headaches
If you have sleep apnea you may experience one or more of these symptoms. Please talk to your doctor or healthcare provider if you experience these effects of sleep apnea.
What causes sleep apnea?
Your airway can become narrow or blocked for various reasons. Normal sleep may cause your throat muscles to relax more than usual, causing a blockage in the airway.
The tissue at the back of your throat can also be oversized which increases the risk of sleep apnea.
In adults, obesity increases the chances of sleep apnea but is not the only risk factor. Other risk factors include:
- Being male or postmenopausal female
- Having a large neck circumference (17 inches or greater in men and 16 inches or greater in women)
- A narrowed airway due to enlarged tonsils, tongue, adenoids, or uvula
- Family history of sleep apnea
- Smoking tobacco
- Drinking alcohol or taking sedatives at night
The sleep apnea risk factors are not the only causes of sleep apnea. Some people have sleep apneas that have no obvious cause, though they may still benefit from Sleep apnea treatment options.
How do doctors diagnose sleep apnea?
There are a couple of different ways that your doctor can diagnose sleep apnea.
One way is to ask you a few questions about your sleep habits and then have you complete a sleep test. A sleep test or overnight sleep study, also known as polysomnography (PSG), is the most common type of sleep test used to diagnose sleep apnea.
It is a painless, noninvasive procedure that records how well you sleep and can diagnose all types of sleep apnea.
Another way to diagnose sleep apnea is with a home sleep test. A home sleep test is a portable sleep monitor that you use at home for one or up to three nights. This type of sleep test is used usually to diagnose obstructive sleep apnea.
Home sleep tests are not as accurate as sleep studies done in a sleep lab, so if you are diagnosed with sleep apnea from a home sleep test, you may still need to have a sleep study done in a sleep lab to confirm the diagnosis.
What are the surgical Treatment Options For Sleep Apnea?
There are different types of surgery for sleep apnea that can be performed to help you sleep. The type of surgery that is best for you will depend on the type of sleep apnea that you have and its cause. It should be noted that surgery is usually only used for severe sleep apnea.
UPPP is the most common surgery performed for sleep apnea. It is used to remove excess tissue at the back of your throat, including your uvula and parts of the soft tissues of your palate and tonsils. This sleep apnea surgery widens the airway, making it easier to sleep at night.
Adenoid or tonsil removal
These surgeries are also called adenotonsillectomy and tonsillectomy. They are sleep apnea surgeries that remove your tonsils and adenoids, which can cause sleep apnea if they become large enough to block the airway in your throat.
Laser or cautery-assisted uvulopalatoplasty (LAUP)
LAUP sleep apnea surgery is a minimally invasive procedure that uses a laser or cautery to remove parts of your uvula and soft palate.
Palate implants are sleep apnea surgery that uses small, permanent implants to help keep your airway open. The implants are placed in the roof of your mouth and help to keep the tissues in that area from collapsing during sleep.
Nasal sleep apnea surgery includes a variety of procedures that are used to improve airflow through your nose by removing a nasal obstruction.
These sleep apnea surgical treatment options include septoplasty for a deviated septum, turbinate reduction or nasal conchae resection, and nasal polyp removal. All of these surgeries help clear your nasal passage.
Tongue sleep apnea surgery is a procedure that is used to reduce the size of your tongue. The surgery may be done alone or in combination with other sleep apnea surgeries, such as UPPP or LAUP.
This sleep apnea surgery involves implanting a device under the skin on your chest that sends electrical impulses to your muscles that control breathing. The impulses stimulate the nerve that controls your tongue and helps keep it from falling back into your throat during sleep.
These sleep apnea surgeries are procedures that are used to correct problems with your bones and joints. They include maxillomandibular advancement (MMA) and orthognathic surgery which both involve surgery to the jaw to help with sleep apnea.
Bariatric surgery is a type of surgery that reduces your weight. Bariatric sleep apnea surgeries include gastric bypass and lap band sleep apnea surgeries. Since obstructive sleep apnea can be caused by obesity, this is one option for quickly reducing your weight. It is recommended that you have regular exercise and a healthy diet to try to lose weight first and also to maintain your healthy weight after surgery.
This sleep apnea surgery is a procedure that is used to create an opening in your windpipe (trachea) so you can breathe without using your nose or mouth. A tracheotomy may be necessary if sleep apnea is severe and other treatments are not effective.
What are other Treatment Options For Sleep Apnea?
Other treatment options for sleep apnea include lifestyle changes, such as changing your diet to lose weight, positive airway pressure devices, oral appliances, and positional sleep therapy.
These sleep apnea treatment options include weight loss if you are overweight or obese, avoiding alcohol and smoking before bedtime, and sleeping pills that cause sleepiness during the day.
Positive airway pressure devices
Continuous positive airway pressure (CPAP) machines are the most popular treatment option for sleep apnea and are devices that provide a constant stream of air through a mask to your nose and mouth while you sleep.
CPAP devices are not the only positive airway devices as there is also automatic positive airway pressure (APAP), bilevel positive airway pressure (BiPAP), and adaptive servo-ventilation (ASV) machines too.
These are similar to CPAP machines in that they use a mask and provide air through the nose and mouth to help keep your throat open during sleep. The pressure is not constant and adjusts to your breathing.
These sleep apnea treatment options are devices that you wear in your mouth to help prevent sleep apnea symptoms while you sleep.
They can include a mandibular advancement device (MAD), which is worn like a retainer and moves the jaw forward to keep your airway open.
Another sleep apnea oral appliance is a tongue retaining device (TRD) that holds your tongue in place so it does not fall back into your throat during sleep.
Positional sleep therapy
This sleep apnea treatment option helps keep you from sleeping on your back as you are more likely to have sleep apnea in this position.
Doctors will ask you to sleep on your side or stomach to combat apneas while on your back. This can be accomplished in several ways including special pillows or even tennis balls in a sock tied around your waist.
Severe obstructive sleep apnea can be life threatening if left untreated. The best way to treat sleep apnea is by talking to your sleep doctor about what treatment options are right for you.
Sleep apnea is a condition that causes you to stop breathing while you are sleeping and affects people of all ages.
The most common symptoms are loud snoring and gasping or choking for air while you sleep although there are numerous other symptoms too.
If you have sleep apnea, there are a number of treatment options available to you including several surgical procedures that can help. Surgical options are usually the last resort after several other treatment options are tried and there are quite a number of different surgeries available.
Which surgery is best for you is dependent on your cause for sleep apnea. If you have more questions please talk to your doctor or sleep specialist about your treatment options.
References and Sources:
American Sleep Apnea Association
Stanford Health Care