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How effective are surgical options for sleep apnea?

A recent entry on the Stanford Center for Sleep Sciences and Medicine blog on the Huffington Post examines the effectiveness of surgical options for obstructive sleep apnea (OSA), from which an estimated two in 10 Americans suffer.

Robson Capasso, MD, director of sleep surgery and a clinical assistant professor of otolaryngology at Stanford, writes:

Many patients, family members, and even physicians are skeptical and question the efficacy of surgery to treat OSA. This uncertainty arises from somewhat low success rates associated with uvulopalatopharyngoplasty (UPPP), the most commonly performed surgical procedure for OSA in the U.S. In this procedure, the surgery targets only the soft palate, without improving potential collapses in other areas of the upper airway. However, recent developments in this field -- in great part pioneered at Stanford University by Drs. Nelson Powell and Robert Riley -- provide the opportunity for more complex techniques to evaluate the upper airway and to treat obstructions at sites other than the palate. These cutting-edge approaches maximize airway improvement by reducing the anatomical obstruction or decreasing the collapse of tissue causing the obstruction in the nose, throat, or tongue -- or, which is more common, in all of these sites. Currently, these procedures are offered by a limited number of surgeons in the country.

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To answer the question if surgery really works for sleep apnea, we can say that if the goal is to decrease the cardiovascular risk associated with OSA and improve the symptoms associated with the disease such as daytime sleepiness, snoring severity, and poor sleep quality, there is convincing evidence showing good results for each one of these problems. There is also a substantial amount of data suggesting improvement in quality of life and, very gratifying for the treating surgeon, frequent restoration of a more harmonious bedtime routine with loved ones.

Previously: Stanford doc talks sleep (and fish) in new podcast, Catching some Zzzs at the Stanford Sleep Medicine Center, Ask Stanford Med: Rafael Pelayo answers questions on sleep research and offers tips for ‘springing forward’ and Catching up on sleep science
Photo by Rachel Kramer Bussel

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