When Surgery Is the Best Option for Your Sleep Apnea

When you involuntarily stop breathing while asleep, you have a condition called sleep apnea. It affects about 26% of adults between 30-70. There are different forms of sleep apnea, and the complications that come with it can range from mild to life-threatening.

At Oasis Ear, Nose, and Throat, our board-certified ENT specialists Dr. James Osborne and Dr. Bryan Smedley treat all manner of sleep apnea at our Surprise, Arizona, office. While several effective conservative treatments exist, sometimes surgery is the best option. Here’s what you need to know.

The different forms of sleep apnea

There are two primary forms of sleep apnea.

1. Obstructive sleep apnea (OSA)

Obstructive sleep apnea is the most common form, affecting about 10-30% of adults in the United States. It develops when the muscles in the back of your throat relax while you’re asleep.

As the muscles relax, the tissues of the soft palate, the side walls of the throat, the tongue, and other nearby structures collapse into the open space, narrowing or closing off your airway. When the oxygen level in your blood drops, your brain registers the problem and sends your body a signal to partially wake you up and clear your airway.

You snort, choke, or gasp, then fall back asleep until your airway closes again, and the cycle repeats. This pattern may occur five to 30 times or more each hour, and it can continue all night. You’re not awake enough to remember anything, but the cycle impairs your ability to reach the deep, restful phases of sleep, and you get up exhausted in the morning.

2. Central sleep apnea

Affecting less than 1% of the population, central sleep apnea happens when your brain doesn’t transmit signals to your breathing muscles, preventing you from inhaling for a short period. Some people feel short of breath when they wake up, while others have a difficult time falling asleep or staying asleep.

It’s also possible to have sleep apnea that combines the two forms, though it’s rare.

Continuous positive airway pressure (CPAP)

CPAP is perhaps the best-known treatment for OSA. You wear a device that fits over your nose and mouth while you sleep that sends out a steady stream of air. The air pressure holds your airway open. If you find the device uncomfortable (and many people do), bilevel positive airway pressure (BPAP) devices are also available. They increase the pressure when you inhale and decrease the pressure when you exhale.

When surgery is the best option for your sleep apnea

If you can’t use a breathing device like a CPAP or BPAP, surgery might be a better option for treating your sleep apnea. There are many procedures, each targeting a different part of the mouth, tongue, or surrounding structures to ease your breathing. Two of the most common are:

1. Radiofrequency volumetric tissue reduction (RFVTR)

This procedure uses radiofrequency waves to remove tissues in the back of your throat, opening your airway and restoring breathing. It’s primarily used to treat snoring (a common symptom of OSA), but it can also help with sleep apnea.

2. Uvulopalatopharyngoplasty

This surgery removes extra tissue from the top part of your throat and the back of your mouth. Like the RFVTR, it’s usually only performed if you can’t use a CPAP machine or other device, and tends to be used more as a treatment for snoring than for sleep apnea.

Other treatment options include:

• Mandibular advancement device: an oral appliance that moves the jaw forward to create space behind the tongue
• Anterior inferior mandibular osteotomy: divides chin bone in two, allowing the tongue to move forward and open airway
• Genioglossus advancement: slightly tightens tendons in front of the tongue, preventing it from rolling back
• Lingual tonsillectomy: removes both tonsils and tonsillar tissue at back of tongue

Sometimes, we combine procedures to maximize the benefits.

If you’re dealing with the noise and fatigue of sleep apnea, it’s time to come into Oasis Ear, Nose, and Throat for an evaluation and determination of your best treatment option(s). To learn more, or to schedule a consultation with one of our specialists, call us at 623-207-7560, or book online with us today.