Health Benefits of Surgery for Obstructive Sleep Apnea

Obstructive sleep apnea(OSA) is a common condition, affecting approximately 20% of the adult population.  The most common symptoms are snoring, gasping for air while sleeping, and daytime lethargy.  The health risks of untreated OSA are caused by the recurrent decrease in blood oxygen levels which strains the heart.  Obstructive sleep apnea is associated with increased risk of heart attack, stroke, abnormal heart rhythm, high blood pressure, and diabetes.

The standard treatment for moderate to severe obstructive sleep apnea is continuous positive airway pressure(CPAP).  CPAP utilizes air pressure to maintain airway patency and reduce obstruction to airflow.  CPAP is the most commonly prescribed therapy for OSA.  There is a considerable adjustment period when starting treatment with CPAP, and approximately 50% of patients are unable to tolerate the use of CPAP on a consistent basis.

The most common surgical treatment for OSA involves removing soft tissue from the back of the throat, including the tonsils if they are present and enlarged.  Until recently, the success of surgery for OSA was measured by reduction of the apnea/hypopnea index(AHI).  Often, patients noted improvement following surgery, with reduction in snoring and daytime lethargy, although the AHI was not significantly changed.

A recent study from Stanford University followed over 54,000 patients diagnosed with OSA.  Upper airway soft tissue surgery was performed on over 4000 patients.  The authors found that there was a significant reduction in cardiovascular events, neurologic events, and endocrine events.  The authors concluded that for patients who refuse or are unable to tolerate treatment with CPAP,  surgery should be considered soon after diagnosis of OSA, because is was associated with a reduction in the systemic complications associated with OSA.

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