Healthy Living

Surgery May Help Sleep Apnea when CPAP Machine Fails

There are few things more frightening than noticing your bed partner doesn’t seem to be breathing – and then all of a sudden there’s a gasp of air and breathing restarts. This could be sleep apnea, something that affects up to 9% of adults in the United States, according to SleepFoundation.org, although there could be more people who haven’t been diagnosed.

There are a few types of sleep apnea, including one that occurs when the brain doesn’t send or receive the right signals to keep people breathing while they sleep. But the most common type is obstructive sleep apnea, or OSA. This happens when there is an obstruction in the throat that blocks the air from flowing into the trachea (windpipe). The obstruction could be the tongue, falling back as you sleep on your back or how your mouth and throat are shaped. It could also be caused by obesity, smoking, drinking alcohol, using sedatives, even having nasal congestion. There can also be a family history of OSA.

OSA Can Cause Serious Problems

Sleep apnea can significantly affect a person’s quality of life because of the lack of good, restorative sleep. The symptoms of sleep apnea include:

  • Snoring
  • Waking up feeling tired, not refreshed
  • Sore throat or dry mouth on waking
  • Excessive sleepiness during the day
  • Headaches in the morning
  • Difficulty concentrating
  • Irritability

People with OSA are often advised to try some lifestyle changes before trying any medical interventions, such as changing their sleeping position. But if avoiding alcohol, sleeping on your side and losing weight don’t work, you may need to try something else.

Other options include a mouthpiece worn at night or a CPAP machine. CPAP stands for continuous positive air pressure. The user places a fitted mask over the face. This mask is attached to the machine, which pushes pressurized air into the nose. This keeps the airway from collapsing and causing a blockage. But both of these can be uncomfortable and not everyone can tolerate them. And if they’re not used, they can’t do any good. For these people, surgery may be the solution.

Small Study Found Surgery Reduced Sleep Apnea Periods

The results of a small study investigating if surgery on the palate and tongue to enlarge the airway would relieve sleep apnea were published in JAMA. All patients were overweight or obese. Half of the 102 volunteers had surgery while the other half followed medical treatment, which involved lifestyle changes and medications for nasal obstruction if required. The results showed that volunteers who had surgery had 27% fewer sleep apnea episodes than the other half, who only had a 10% decrease. There were other benefits too. Those who had surgery snored less and were more awake during the day.

As with all surgeries, there are risks. One patient in the surgery group had a heart attack after surgery, and postoperative bleeding. Three other patients also had complications. There were no serious issues in the medical treatment group.

This was a preliminary study and the researchers called for more study using surgery as a treatment for sleep apnea.

 

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