Do I need surgery for obstructive sleep apnea (OSA)?

Obstructive sleep apnea (OSA) is considered a potentially serious sleep disorder, where breathing stops and starts throughout the night due to relaxation of the throat muscles. OSA can lead to loud snoring, waking up gasping, headaches, dry mouth in the morning, and excessive daytime sleepiness. 

Obstructive sleep apnea can not only lead to extreme sleepiness but also more severe problems such as high blood pressure, strain on the cardiovascular system, type 2 diabetes, liver problems, and metabolic syndrome. 

How does surgery correct obstructive sleep apnea?

Surgery is often a treatment option for those with severe sleep apnea that don’t respond to treatment with a CPAP device. How surgery will work to correct the problem, will largely depend on which type of surgical procedure your doctor recommends. Surgical procedure options for the treatment of obstructive sleep apnea include:

Uvulopalatopharyngoplasty (UPPP)

This is the most common type of procedure associated with sleep apnea and involves removing excess tissue from both the pharynx and the soft palate. In the event the patient still has their tonsils, those will be removed as well. Once the tissue is removed, the area will be sutured to reduce the risk of collapse and keep the area open so that air can easily pass through the upper airway. 

Nasal surgery

Nasal obstruction can play a critical role in sleep apnea. The three components of the nose that can be affected include the septum, the nasal valve, and the turbinates. The most common nasal procedures include reducing the size of the turbinates or straightening out the septum. By correcting these areas, air will be able to pass more freely through the nasal passages. 

Pillar Procedure

The Pillar Procedure, also referred to as soft palate implants, is a simplistic surgical procedure where three polyester rods are placed into the soft palate. Once placed, an inflammatory response will occur within the surrounding tissues that will cause the soft palate to stiffen. When this occurs, the soft palate will be less likely to come into contact with the pharynx during sleep. 

Hyoid advancement

The bone in the neck where the tongue base and pharynx attach is called the hyoid bone. If you have sleep apnea, you likely have a larger tongue base, and when you enter into a deep sleep and your muscles relax, your tongue can fall back, coming into contact with the pharynx. When this occurs, the air will be obstructed. During a hyoid advancement, the bone will be repositioned surgically using a suture attached to the front jaw bone, which will extend the airway. 

Tongue advancement

During this procedure, the genioglossus, one of the main tongue muscles, will be moved forward so that it can not slip as far backwards during sleep. A cut will be made in the jaw bone, and it will be fixed in place with a titanium plate. Once positioned, the tongue will be less likely to be able to retract toward the back floor of the mouth. 

If you struggle with sleep apnea, and CPAP therapy does not help you get a better night’s sleep, then a surgical procedure may be your best option. Discuss with your doctor which surgical procedure may work best for your specific situation. 

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