Surgery for Obstructive Sleep Apnea

Obstructive sleep apnea(OSA) is a common disorder, affecting 24% of men and 9% of women between the age of 30 and 60.  Snoring, gasping and daytime sleepiness are symptoms of OSA.  OSA is caused by repeated upper airway collapse and obstruction during sleep.  The complications associated with OSA are due to recurrent lowering of blood oxygen saturation.  OSA is associated with hypertension, coronary artery disease, stroke, atrial fibrillation, diabetes, cognitive dysfunction and hypertension.

The first-line and gold standard treatment for OSA is continuous positive airway pressure(CPAP), in which a continuous stream of air is delivered through a mask covering the nose or nose and mouth, which prevents the upper airway from collapsing during sleep.  Unfortunately, long term adherence to treatment with CPAP is less than 50%.

Surgical treatment of OSA relieves upper airway obstruction by removing excess soft tissue and/or enlarging the upper airway space.  The most common procedure is uvulopalatopharyngoplasty(UPPP), which has been utilized in OSA patients unwilling or unable to use CPAP since 1981.

A recent article in the journal Otolaryngology, Head and Neck Surgery evaluated the long-term efficacy of UPPP for OSA.  Eleven studies were reviewed that evaluated surgical results at least 34 months following the procedure.  The authors concluded that there was significant improvement is apnea index, snoring and oxygen saturation that persisted over the long term.

There are multiple treatment options for OSA.  Treatment improves quality of life(daytime sleepiness, alertness) and reduces health risk(heart disease, stroke).  Anyone who snores regularly, is witnessed gasping while sleeping, or suffers from frequent sleepiness, should be evaluated for OSA and offered treatment if the diagnosis is confirmed.

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