Sleep Apnea Surgery Options

Apnea is the Greek word for “without breath” and sleep apnea means the inability to breathe during sleep. More than 12 million people in United States have sleep apnea, according to the ASAA (American Sleep Apnea Association).

In an advanced stage, this condition can actually kill a person. The short-term effects are often equally as drastic as the long-term ones. Interrupted sleep is the immediate effect of sleep apnea. It happens because the person stops breathing temporarily. These pauses can be brief, but they may last for more than a minute, which cause the brain to automatically wake the person. Although, it won’t bring the person to a full consciousness, the sleep cycle can be badly disrupted. It may not sound too bad, but having restless sleep for nearly every night can affect your life quality significantly and take a drastic toll on your body.

During the day, fatigue and sleepiness will accumulate and common stimulants, such as nicotine and caffeine won’t have any effect. People with sleep apnea often find it hard to open their eyes during important events, including meetings. Driving becomes a challenge and working on details becomes a chore. Surgery to treat sleep apnea is often the last resort if other conventional methods have completely failed.

There are a few types of surgery options related to the sleep apnea treatment:

Uvulopalatopharyngoplasty

When performing uvulopalatopharyngoplasty (UPPP), the doctor removes the tonsils and reduces the size of the soft palate and uvula. It is a good option only if the doctor has confirmed that both are the cause of the obstruction. UPPP is a rather straightforward procedure and won’t be performed if there is no strong evidence that the soft palate and the uvula obstruct the respiratory tract and cause sleep apnea. In some cases, some part of the tongue must be removed in a process called uvulopalatopharyngoglossoplasty.

While UPPP can solve the majority of sleep apnea cases, some patients need to use CPAP (continuous positive airway pressure), which can force the airways to open sufficiently while the person is sleeping. CPAP can be cumbersome to use as it requires the person to wear a mask. You should ask your doctor to know whether UPPP can effectively treat your sleep apnea. Just like other surgeries, there are some risks involved with UPPP and everyone should feel certain with the decision. Damages to surrounding tissue are the most likely risk. Before choosing UPPP, you should consider other non-surgical options.

Tonsillectomy

It is a tonsils removal procedure. The sleep apnea could be caused by enlarged tonsils which block the airways. Tonsillectomy is usually performed on children who have obstructive sleep apnea and almost never performed on adults. The procedure has 75% success rate in treating sleep apnea on children. Improvements will only be noticeable six months after the procedure, which include restful sleep and less snoring. Tonsillectomy can also reduce coughing and colds on some children as well. Symptoms of behavioral problems and hyperactivity may improve after the procedure is performed, because children are better rested each night.

Other respiratory problems, such as asthma should be treated first before the surgery is performed. Children with no existing medical conditions should have low risks. Likely complications are infection and excessive bleeding. A few days after the procedure, the throat will be sore, which means swallowing and eating are a little difficult.

Adenoidectomy

Children who snore loudly during sleep, tend to have a disrupted sleep, which result in declined concentration during the day. Adenoid is located near the Eustachian tube, which is important to maintain healthy ears. As the result, children who have both sleep apnea and ear infection may need to undergo adenoidectomy. Nasal passage blockage may cause ear inflammation and an increase in fluids production. If the adenoid is not removed, it is possible for the child to continue to have poor sleep pattern, which results in overall tiredness and severe bed wetting.

Tonsillectomy and adenoidectomy may be performed simultaneously under a general anesthetic. On some children, the adenoid may grow back, but it is unlikely that the procedure must be repeated. Adenoidectomy takes about 30 minutes and in many cases, the child can go home a few hours after the procedure; however those under 4 years old may need an overnight stay. The doctor will prescribe an antibiotic to prevent nasal bacteria infection as the throat recovers. It may take 10 to 14 days for the throat to heal completely.

Tracheostomy

It is a rather drastic treatment and only performed on people with very severe sleep apnea. Tracheostomy is only necessary when CPAP and other form of treatments fail to work or if the condition is life threatening. It is basically a simple procedure, a hole is made on the windpipe and a tube is inserted. The hole is permanent and the patient should be able to breathe much more easily through the hole. Unfortunately, this procedure can cause other medical issues, because it is unnatural to have a hole on the neck. However, despite the consequences, tracheostomy is necessary due to the life and death situation.

Lung infections, speech problems, bleeding, scar tissue development and infection are possible complications of tracheostomy. Great care should be taken on people who had tracheostomy and all doctor’s instruction should be followed carefully. The patient is also required to have regular checkups to ensure everything works well. There are also psychological risks of tracheostomy. People who just completed a surgery may suffer from low self esteem due to change in appearance, if untreated, it may cause depression.

After the surgery, a valve will be closed during waking hours to allow the person to speak and breathe. Before bedtime, the valve is closed to ensure better airflow into and from the tube. The hole is made immediately below the obstruction, which can prevent the sleep apnea effectively.

Facial Reconstruction

Facial reconstruction is designed to reposition the facial bones, especially those around your tongue. It creates more pull at the tongue base and enlarges your airways. On some people, the procedure may be performed more than once.

In general, uvulopalatopharyngoplasty is the first option to treat sleep apnea on adults, while tonsillectomy or adenoidectomy are common procedures for children with this condition. If sleep apnea still occurs despite all efforts, tracheostomy should or must be performed.

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