- Understanding Sleep Apnea: Sleep apnea is a sleep disorder characterized by interruptions in breathing during sleep. It can have serious health consequences if left untreated, including an increased risk of diabetes, heart attacks, strokes, and a shorter lifespan. It can also affect the quality of life due to disrupted sleep patterns.
- Surgical Treatment Options: Surgery is one of the treatment pathways for sleep apnea, but it’s typically considered when other non-surgical options like lifestyle changes, CPAP machines, or oral appliances have not provided sufficient relief. There are several surgical procedures available, each with its own benefits and risks.
- Variety of Surgical Procedures: The choice of surgery depends on individual factors like age, weight, medical history, and the severity of sleep apnea. Each procedure has its unique set of risks and success rates. Surgery may not always completely cure sleep apnea, but it can significantly improve symptoms in many cases.
Sleep apnea is a disorder that can not only disrupt your sleep cycle — it can also lead to serious health issues. That’s because sleep apnea actually impacts your breathing at night, causing it to periodically stop. This condition can be very serious and those suffering from severe or moderate sleep apnea might be recommended surgery in order to ensure your airways remain unobstructed.
There are different treatment pathways that you might be offered to to treat mild, moderate, and severe sleep apnea. We’ll walk you through each of the most common types then explain how they work, recovery times, risk factors, and explain other options available to you.
Sleep Apnea: Definition, Risks, and How It Impacts Your Life
Sleep apnea is a sleep disorder where your breathing starts and stops throughout the night. Sleep apnea can be caused by a variety of factors, including excess weight or obesity. In fact, sleep apnea occurs in 3% of individuals within a normal BMI and 20% of individuals who are overweight. It occurs more often in men, but an increased risk appears to be for women following menopause.
There are three types of sleep apnea — obstructive, central, and complex. Obstructive sleep apnea (OSA) occurs when air is unable to flow through your passageways, due to an obstruction, while your body attempts to breathe. Central sleep apnea occurs when your brain does not send the signal to your muscles to continue breathing. Obstructive sleep apnea is the most common, while central sleep apnea affects less than 10% of patients referred to sleep laboratories, according to the American College of Cardiology.
Complex sleep apnea is when you suffer from both obstructive and central sleep apnea.
No matter which type of sleep apnea you suffer from, ifit can lead to severe side effects. These include type 2 diabetes, heart attacks, and other heart complications, strokes, and a shorter lifespan. In severe cases, it can lead to death overnight, though in most cases, sleep apnea’s symptoms will hurt your health over time.
Why Surgery Can Treat Sleep Apnea
Typical treatments for sleep apnea include:
- Lifestyle changes to decrease weight for better sleep
- Use of oral devices or a CPAP machine
- Preventing throat tissue collapse by switching to side sleeping
- Elevating the body with an adjustable bed or wedge pillow
If sleep apnea is more severe, a BiPAP machine may be used instead of a CPAP machine. At times, medications like steroids may also be prescribed. However, in some instances, surgery may be recommended.
There are many different surgeries available for sleep apnea, and reasons for recommending one can vary. For instance, if a sufferer isn’t seeing results from traditional treatments, then a surgical procedure may be considered. Your doctor will take your individual factors including age, weight, medical history, sleep apnea severity, and current treatment methods into consideration when deciding if you’re a candidate for surgery.
While surgical procedures may be recommended for your sleep apnea, it’s important to understand that they’re not always successful in curing sleep apnea symptoms, though they can lessen them.
10 Common Procedures for Sleep Apnea
Here are ten of thethe risks to consider, and the success rates.
1. Radiofrequency Turbinate Reduction
One way to treat sleep apnea is by reducing the size of the bones in your nasal cavity. Also known as turbinates, this bone structure and lining can be enlarged in spots, leading to obstruction when sleeping. In these cases, a turbinate reduction procedure may be recommended.
Risks include bleeding, scar tissue, infections, and can lead to something known as empty nose syndrome. While empty nose syndrome is rare, it can lead to discomfort, drying, crusting, and the
While this surgery can be effective at improving your breathing, it’s not a guaranteed solution. While many patients experience reduced symptoms or no symptoms post-surgery, this procedure does not work for everyone.
2. Tonsillectomy and Adenoidectomy
This procedure is an extremely common way to treat obstructive sleep apnea in children. It can be used to treat adults in some rare cases. However, it’s typically not an effective solution for adults.
If children have swollen tonsils or adenoids and suffer from sleep apnea, this procedure can provide relief and allow them to breathe better at night. Overall, tonsillectomy and adenoidectomy procedures are considered routine and safe.
However, risks of this procedure include a sore throat, the possibility of infection, and bleeding. Eating and swallowing will also be difficult for days post-surgery. In children, these procedures can be 75% to 100% effective in treating sleep apnea symptoms such as a child’s snoring, even if the child is overweight.
This is the most common procedure performed to help sleep apnea sufferers. A uvulopalatopharyngoplasty removes excess tissue from your throat, in order to help widen the airway behind your tongue, shorten your soft palate, and allow air to flow better through your passageways at night. This can be performed with a laser or with a radiofrequency probe.
Risks of an uvulopalatopharyngoplasty include damage to the muscles of your soft palate and throat, velopharyngeal insufficiency (inability to prevent fluid from coming up through your nose), change in your voice, pain when swallowing or speaking (usually for the first few weeks), disruption to tastes, tongue numbness, or the development of silent apnea. With silent apnea, snoring is no longer an indicator of sleep apnea, but the airway problem remains.
While snoring is commonly cured by this procedure, only 40% of sufferers report a reduction or alleviation of sleep apnea symptoms.
4. Maxillomandibular Advancement (MMA)
Ais often done by an oral surgeon and requires fracturing both the upper and low jaw in order to move them forward and widen your airway. This surgery can be extremely effective for sleep apnea sufferers, since it widens the airway at different points, starting at the nasal cavity to the hypopharynx.
Risks of this procedure include infection, teeth damage, nonunion of bones (when cut bones fail to heal together), mandible fracture, nasal obstruction (specifically one side of the nose), numbness in face, joint discomfort, and in less than 1% of patients, palatal necrosis requiring another operation. Healing takes about six weeks in total. You should expect changes to your face, though most patients report improvements in facial appearance.
This surgery is often successful at eliminating sleep apnea or significantly improving the symptoms for the majority of patients.
5. Anterior Inferior Mandibular Osteotomy
This is another popular treatment method performed for sleep apnea sufferers. During anyour chin is separated in two, which gives your tongue more room to move forward and can lead to an improvement in breathing during sleep. infection, bleeding, teeth damage, joint discomfort, and other symptoms. It also results in a change to the facial appearance and can make the chin appear more prominent post-surgery.
On the downside, this procedure is not as effective as treating severe sleep apneas as maxillomandibular advancement surgery, particularly for obese patients.
6. Genioglossus Advancement
This procedure pulls the tongue muscle attached to your lower jaw forward. A genioglossus advancement surgery during sleep and can prevent the blocking of air for sufferers of sleep apnea. A small screw or plate is inserted to hold the tongue in place with your lower jaw’s bone surface.
Risks for this operation include pain for up to two weeks, liquid diets, bleeding, risk of infection and more.
While this procedure is less risky than others and has a shorter recovery period, it’s also not as effective at treating sleep apnea symptoms in all patients. This surgery typically has a 53% success rate,
7. Hypoglossal Nerve Stimulator Surgery
This relatively new procedure takes a different approach to treating sleep apnea. During the procedure, theis implanted in patients. This stimulator can sense the movement of your chest walls while sleeping, and can contract your genioglossus muscle, which causes your tongue to protrude. This allows air to flow more freely through the airway. Settings can be controlled by remote, allowing patients to turn this on at night and off in the morning.
Infection and the migration of the device are the two most commonly reported side effects, buttongue stiffness or abrasion, discomfort, and swelling. Patients also recover faster than with other sleep apnea procedures.
While this procedure is still relatively new,between this procedure and increased quality of life, brought on by decreased sleep apnea symptoms.
During this procedure, an opening is cut into your trachea, just underneath your larynx. Aallows you to breathe freely at night. During the day, this hole can be plugged, so you can talk normally. This operation is only used for very severe cases of sleep apnea that cannot be treated through other means. include bleeding, trapped air in the lungs, trapped air in the chest, trapped air under the skin, injury to vocal cord nerves, esophageal damage, and blockages caused by blood clots, airway pressure, or mucus. Infection and windpipe damage are additional risks.
While it’s considered 100% effective for sleep apnea, it will alter a sufferer’s quality of life and should not be done without the patient fully understanding the risks and ways they’ll need to adjust their lifestyle habits post-operation.
Additional Procedures for Sleep Apnea Sufferers
While the above are some of the top procedures for treating sleep apnea and its symptoms, there are other nasal surgeries, tongue procedures (such as tongue reduction surgery), and other operations that may be recommended for your specific sleep apnea symptoms. Procedures can vary in complexity and recovery time, while risks also depend on the severity of the surgery.
Getting Diagnosed with Sleep Apnea
If you think you’re suffering from sleep apnea and may require surgical intervention, talking to your doctor should be your first step. Your doctor will run your medical history, ask about your sleep behaviors, and may inquire about your family’s medical history.
From there, a sleep study is usually ordered, though other procedures like an electrocardiogram, may be conducted to determine if you’re suffering from sleep apnea. This usually is done in a sleep center, with specialists monitoring your vitals throughout the night.
A home sleep test could also be prescribed, though it typically will not collect as much information as a sleep study at a specialty center or laboratory. Still, you may need to do a home study first, to see if the results rule out or confirm sleep apnea or if further study is needed.
You may be referred to other doctors or specialists depending on the severity of your sleep apnea and your particular symptoms. Treatment recommendations will depend on your medical history, age, health, severity of symptoms, and other lifestyle factors.
Can Non-Surgical Treatments Help?
Most doctors will recommend nonsurgical treatments before turning to procedures to treat sleep apneas. If you’re overweight, changing your diet to lose weight will often be recommended. Increasing physical activity may also be prescribed, and (regular exercise is tied to better sleep, too). In some cases, this is enough to eliminate sleep apnea, if you’re able to keep the weight off.
Other treatments may include medications like steroids, particularly for those withNasal steroids have been found to effectively reduce sleep apnea symptoms for many sufferers.
One of the most common treatments is a CPAP mask, or continuous positive airway pressure machine. This device sends air through your nasal passages while you sleep, keeping your airways open and preventing blockages. You’ll need to wear a mask connected to theeach night when you go to bed. While this treatment may seem difficult at first, it can be extremely effective at reducing or eliminating sleep apnea symptoms.
Oral appliances might also be prescribed to keep your tongue forward in your mouth, which also helps to keep your airways open. You may need to be fit for an oral device by your dentist in order to ensure a more comfortable experience while sleeping. Less commonly, sleepers may be advised to try mouth taping for snoring.
Lastly, in some cases, your sleep apnea might be caused by another medical issue, in which case, treating that disorder could eliminate your sleep apnea symptoms. For example, allergies can affect sleep apnea, though they are not a direct cause of sleep apnea. Taking steps to manage allergies can include:
- Sleeping on a hypoallergenic mattress
- Wrapping yourself up in hypoallergenic sheets
- Keeping warm with a hypoallergenic duvet during the cooler months
- Using a bed skirt to prevent dust and dust mites from collecting underneath the bed
- Looking into medication and natural remedies to manage seasonal allergies
Similarly, asthma can increase the risk of sleep apnea. You need to research tips for sleeping better with asthma to minimize the effects that respiratory issues can have on sleep apnea.
This may be as simple as not sleeping with a fan on. Or it may mean looking into ways to control your bedroom’s environment more thoroughly.
You may need to consider the benefits of an air purifier, which can trap many of the allergens that might trigger an asthma flare-up.
Similarly, you may need to be careful about your bedroom temperature for sleep, along with your room’s humidity. Cold, dry air can irritate people with asthma and worsen their symptoms.
“Careful treatment pathway needs to be considered which will then lead to optimize your health, daytime and cognitive functioning.”
Dr. Dagmara Dimitriou, Professor of Sleep Education and Research
Frequently Asked Questions
Can sleep apnea be cured by surgery?
Surgery can relieve sleep apnea, but it’s rarely the first treatment that doctors will recommend for sleep apnea. After all, surgery can be costly, come with complications, and may not even fix the issue.
Typically, less invasive treatments like CPAP machines, oral appliances, medications, and a new diet for weight loss are prescribed first. If these treatments prove inadequate, doctors may turn to surgery as a way to relieve symptoms.
Who qualifies for sleep apnea surgery?
Because there are many types of surgeries that can alleviate sleep apnea, the qualifications for each surgery will vary. For example, some surgeries may only be recommended if a person has severe sleep apnea that cannot be treated with CPAP therapy or an oral device. Surgery patients may also need to be a certain age
Talking with your doctor or speaking to a referred surgeon can help you better understand what options might work for you.
Can pediatric sleep apnea be treated with surgery?
Yes, surgery may be recommended for children with sleep apnea, though the exact surgery a doctor advises will depend on the root of the issue. For example, children who experience sleep apnea from overly large tonsils and adenoid tissue may have those removed. The removal of these blockages makes it easier to breathe at night.
Other types of surgeries, such as tongue base suspension, palate reconstruction, and nasal passage surgery, can relieve pediatric sleep apnea.
How long does it take to recover from sleep apnea surgery?
Since there’s no one surgery for sleep apnea, recovery time can range from a handful of days to a few weeks. Your age and genetics can also affect how quickly you heal after a surgery, along with how well you care for your surgical wounds. Speaking with your surgeon can give you a better idea of how long you’ll need to recover from a surgery for sleep apnea.
How can sleep apnea be treated non-surgically?
CPAP therapy is one popular way to relieve sleep symptoms without surgery. Oral appliances such as nasal strips can also be used during sleep, while performing exercises to strengthen mouth and throat muscles can prevent soft tissues from blocking a person’s airway. Losing weight can also help people with sleep apnea have a significantly easier time controlling symptoms.
The Bottom Line
There are many different surgical methods for treating sleep apnea, but all focus on improving your airway passages, so you can breathe easier at night. While some surgeries can be extremely effective at treating sleep apnea, they’re not without risks and should not be considered without weighing all of the pros and cons.
However, Professor Dimitriou adds that, “Living with sleep apnea should not be taken as an option but careful treatment pathway needs to be considered which will then lead to optimize your health, daytime and cognitive functioning.”
For this reason, many doctors recommend nonsurgical treatments first, seeking to improve sleep hygiene with lifestyle changes. Talk to your doctor if you have any questions about a particular procedure or to find out if you’re a good candidate for one of these treatment methods.