If you have been struggling with the headaches, fatigue, and sleep disturbances of sleep apnea, you may be wondering if there is anything you can do besides wearing a CPAP mask. For some people, losing weight and making other lifestyle changes is enough to reduce the effects of sleep apnea. For others, surgery for sleep apnea is the only option. If sleep apnea is caused by a nasal deformity or jaw deformity, surgery can correct the underlying problem and reduce or even eliminate sleep apnea episodes. Operating on the throat or tongue can also prevent the pauses in breathing that characterize this serious sleep disorder. Talk to your doctor to find out if any of these surgical options is right for you.
Sleep Apnea and Surgery
Medical experts know that people with sleep apnea often have smaller airways than people who do not have sleep apnea. This increases the risk that someone will stop breathing during the night. Surgery for sleep apnea typically aims to correct this problem, with surgeons removing soft tissues or expanding the jaw structures to improve air flow. The type of surgery required depends on the underlying cause of the sleep apnea.
Throat Surgery for Sleep Apnea
The UPPP surgery for sleep apnea is one of the most common procedures performed to treat this condition. UPPP stands for uvulopalatopharyngoplasty. During this procedure, a surgeon removes excess tissue from the uvula, soft palate, and pharynx. If the tonsils are still intact, they may also be removed. This surgery to correct sleep apnea works best in patients who have oropharyngeal obstructions. The uvulopalatal flap surgery is another type of sleep apnea treatment surgery. This is a modified form of the UPPP surgery that allows a surgeon to widen the airway by suspending the uvula toward the junction of the hard and soft palates. One of the major benefits of this procedure is that it causes less pain than the standard UPPP procedure.
Another modification of the UPPP surgery is pharyngoplasty. The surgeon widens the airway by removing the tonsils and suturing the wounds together. This is a very conservative approach that has fewer side effects than other types of surgery for obstructive sleep apnea. Laser-assisted uvulopalatoplasty (LAUP) is a surgical procedure that involves partial removal of the soft palate and removal of the uvula. The surgeon uses a carbon dioxide laser to remove the tissue. This procedure is not as effective as other sleep apnea surgery methods.
Jaw Surgery for Sleep Apnea
Problems with jaw alignment can also contribute to sleep apnea. Maxillomandibular advancement and maxillomandibular expansion are two of the surgical treatment options available for people whose jaw problems affect their ability to breathe during sleep. Maxillomandibular advancement involves expanding the airway by changing the skeletal framework around the airway. This procedure also reduces muscle tension in the airway, which may improve sleep apnea. Researchers from the Stanford University Sleep Disorders and Research Center determined that this surgery is highly effective for obstructive sleep apnea. They asked 25 MMA patients to fill out questionnaires regarding their facial appearance, satisfaction with treatment, and discomfort following treatment. Eighteen of the 19 patients who completed their questionnaires reported satisfaction regarding their facial appearance following the surgery. All of the patients said they would recommend MMA surgery to others. Maxillomandibular expansion involves widening the mandible and the maxilla to improve air flow. This is a complicated procedure because the patient must get ongoing orthodontic treatment.
Nasal Surgery for Sleep Apnea
The nasal passages play an important role in determining whether someone will develop sleep apnea. People who have frequent nighttime nasal congestion and daytime nasal obstruction are at an increased risk for obstructive sleep apnea. During sleep apnea nose surgery, the surgeon focuses on three major areas of the nose: the septum, the cartilage, and the turbinates. While this surgery may provide some relief from sleep apnea, Dr. Kasey K. Li says that some patients only experience very slight improvements after this type of obstructive sleep apnea surgery.
Tongue Surgery for Sleep Apnea
In some people with sleep apnea, the tongue is responsible for obstructing the airway during sleep. Genioglossus advancement involves moving the base of the tongue forward. This opens up the airway and reduces the effects of sleep apnea. During the procedure, a surgeon makes an incision in the lower jaw. This area of bone, along with the attachment for the tongue, is moved forward and then fastened to the lower jaw with a screw or plate. Hyoid advancement is another type of surgery used to help sleep apnea patients. During this procedure, the physician repositions the hyoid bone by attaching it to the cartilage around the thyroid. Some surgeons use this procedure in combination with UPPP surgery or genioglossus advancement.
Sleep Apnea Surgery Success Rate
The success rate for sleep apnea surgery varies with the procedure used. Uvulopalatopharyngoplasty has a relatively low success rate of 40 percent. Hyoid advancement is successful in some patients but has very little effect on others. The success rate for this procedure ranges from 23 percent all the way to 65 percent. Maxillomandibular advancement has the highest success rate out of any of these procedures, with a 75 to 100 percent chance of success. If you are concerned about surgical success rates, speak with your surgeon before scheduling a sleep apnea surgical procedure. The risks and possible benefits will be weighed against each other to determine whether you are a good candidate for this type of surgery.
Sleep Apnea Surgery Cost
The cost of surgery for sleep apnea depends on several factors:
- Severity of the airway obstruction
- Availability of services
- Geographic location
- Insurance coverage
It is important to note that a patient typically receives several bills after a surgical procedure. The hospital sends out a bill that covers room charges, medical supplies, medications, and other in-house costs. The surgeon and any other physicians that assisted in patient care send bills from their own practices. Anesthesiologists and radiologists often bill separately from hospitals and clinics. Before scheduling sleep apnea surgery, talk to an insurance representative to discuss how much you can expect to pay out of pocket.