Snoring is something that’s usually taken lightly or joked about, and while mild cases of snoring are nothing to worry about, there’s a more serious form of it called sleep apnea.
Sleep apnea is a serious medical condition that causes someone to stop and start breathing repeatedly as they sleep, and for many the only cure is surgery.
Is sleep apnea treatable with surgery and what does it involve?
There are surgical procedures available to treat sleep apnea but they should only ever be considered as a last result.
Sleep apnea surgery will usually be performed over a few different procedures on areas including the roof of your mouth, throat tissues or nasal septum, but not every option is suitable for all candidates.
In some cases, sleep apnea can be treated without having to resort to surgery and if this is an option for you, it’s something that your doctor will recommend.
Diet and exercise, treating other underlying medical issues, and sleeping with the assistance of pillows or breathing apparatuses will usually be the first option for someone with sleep apnea before they reach the surgical stage.
If you’re considering sleep apnea surgery after exploring all other avenues, there’s a lot you’ll need to know about the possible procedures.
This thorough guide will explain the surgeries involved, their success rates, and other general information about these treatments, as well as how to know whether or not you have sleep apnea and what you can do about it.
- 1 What Exactly is Sleep Apnea?
- 2 What Causes Sleep Apnea?
- 3 Common Signs and Symptoms of Sleep Apnea
- 4 What Is a Sleep Study?
- 5 Is Sleep Apnea Surgery Right for Everyone?
- 6 The Types of Sleep Apnea Surgery
- 7 General Costs of Sleep Apnea Surgery
- 8 Related Questions
What Exactly is Sleep Apnea?
Snoring is something that many of us do while we sleep, but there’s a more serious form of snoring that can be dangerous.
Sleep apnea occurs at night when you’re asleep, just like snoring, but it causes a pause in breathing sometimes hundreds of times a night. During these pauses, you stop breathing altogether and it jolts you out of your natural sleep state.
According to the American Sleep Apnea Association, roughly 22 million Americans suffer from sleep apnea in their lifetime.
The association lists a few different types of sleep apnea and each of them is treated differently. To establish which one you have and the possible ways to treat it, a health professional will usually perform a sleep study and other medical checks.
- Obstructive sleep apnea: the most common form of sleep apnea occurs when the muscles in your throat relax and result in either a complete or partial obstruction of your airways. This form of sleep apnea can lead to a drop in blood oxygen saturation and long pauses in breathing or very loud snoring.
- Central sleep apnea: Central sleep apnea is caused by misfiring brain signals to the muscles that control breathing. In this form, it’s common to stop breathing altogether or to breathe shallowly as you sleep which leads to not enough oxygen intake.
- Complex sleep apnea syndrome: This refers to a syndrome where both central sleep apnea and obstructive sleep apnea occur, and it requires immediate surgery.
Sleep apnea is dangerous due to the lower levels of oxygen saturation and the lack of sleep that the patient gets each night.
However, it can be hard to diagnose as most people don’t even realize they’re suffering from it. They usually have to be told by a partner or someone they live with that they snore loudly and gasp in their sleep before they realize it’s an issue.
What Causes Sleep Apnea?
Sleep apnea can occur in both children and adults, and many potential causes can lead to this sleep disorder.
These are some of the most common causes of sleep apnea so you can establish what might be causing this sleep condition in yourself and work to rectify it before surgery becomes a necessity.
- Obesity and excessive weight: Obesity is thought to be the most common cause of obstructive sleep apnea because the extra weight can be associated with the throat and tongue muscles. Anyone suffering from sleep apnea will usually be advised to attempt to lose weight first to see if it can help the condition.
- Tonsils or adenoids: For children, the tonsils and adenoids are the biggest cause of sleep apnea. In most cases, doctors will recommend the removal of these as the first type of surgery to see if it rectifies the sleep apnea problem as well.
- Birth defects: Conditions like down syndrome and Pierre-Robin syndrome can cause enlargement of the tongue, reduced muscle tone or smaller lower jaw anatomy which leads to breathing problems, especially at night.
- Anatomical features: People with thick necks, round heads, or a narrow throat may be more likely to experience sleep apnea because of their natural features.
- Other medical conditions: Many other factors can also be considered including a deviated septum, seasonal allergies, hypothyroidism, and excessive size due to growth hormones.
- Lifestyle factors: People who drink alcohol, smoke cigarettes, or use sedatives to help them get to sleep will be more likely to experience obstructive sleep apnea.
Common Signs and Symptoms of Sleep Apnea
Sleep apnea is a difficult sleep condition to diagnose because it requires the person with sleep apnea to recognize it first.
As sleep apnea occurs while you’re sleeping, most people aren’t aware that they snore loudly or that pauses in their breathing wake them up multiple times through the night.
There are some symptoms you can look out for that might signal sleep apnea.
If you experience a few of these or have been told by someone that you snore loudly or gasp in your sleep, you should visit a health professional to have it checked out.
- Loud snoring that wakes you up, or is mentioned to you by someone else
- Headaches in the morning
- Restless or poor sleep
- Waking up gasping, choking or feeling as though you can’t breathe
- Waking up with a dry mouth, dry throat or sore throat
- Feeling sleepy during the day with a lack of energy
- Irritable, depressed, or feeling noticeable mood changes
- Waking through the night or suffering insomnia
If you find yourself experiencing any of these symptoms, your doctor will be able to arrange for you to partake in a sleep study.
This is the most effective way of determining whether sleep apnea is to blame or if there’s another sleep condition that might be causing it.
What Is a Sleep Study?
Before your doctor can establish whether surgery is right for you or if you should try other treatments, they first must establish whether or not you have sleep apnea, what type it is, and how severe.
This is done by conducting a sleep study which is a diagnostic tool used to determine the presence of sleep apnea.
During a sleep study, the patient will have their nightly sleep examined in a controlled environment, usually a sleep laboratory or somewhere similar where diagnostic testing can be performed.
In some cases and where the resources are available, limited channel testing or LCT can be used at home so the patient can record their own sleep from the comfort of their bed.
In the sleep laboratory during testing, the patient has their regular nightly sleep and as they do, their brain wave activity, breathing, blood oxygen levels, and body movements are recorded and measured.
Most importantly, the sleep study looks at a patient’s apnea-hypopnea index which counts how many times they experience apnea or hypopnea as they sleep.
The number is assessed on an hourly basis to determine the severity of their sleep apnea and to establish which type they experience.
Is Sleep Apnea Surgery Right for Everyone?
Once your doctor has established that you have sleep apnea, the next line of treatment will be considered.
The most common and successful treatment is with a positive airway pressure machine, referred to as a PAP machine, but this isn’t always the best option.
Surgery for sleep apnea is serious and often involves more than one procedure for adult patients. Because of its complexity, it isn’t always ideal, but some groups are better suited to it than others.
- Children who experience obstructive sleep apnea that can be rectified more easily, like with adenoids or tonsils to be removed.
- Adults who have anatomy that can be rectified with surgery, like larger tonsils.
- Adults who have tried to use a CPAP or other device and found them hard to wear because of their anatomy or are unable to breathe with one after many attempts.
Children are better candidates for sleep apnea surgery because it can usually be fixed by removing tonsils or another singular procedure.
For adults, surgery should only be considered if all other treatments have failed.
The surgeon performing the procedure will need to perform several tests to make sure you’re an ideal for surgery and it’s a decision that will be taken very seriously.
The Types of Sleep Apnea Surgery
Contrary to popular belief, there isn’t a singular surgery that will assist with sleep apnea.
Instead, you will be assessed for a range of different surgical options to determine which one would be most effective, and many times this will be more than just one procedure.
The treatment plan varies for each patient because of their airway patterns and the level of obstruction, and the success rate is different for everyone.
These are the most common options for sleep apnea surgery, according to the Sleep American Sleep Apnea Association.
Three areas of the nose can cause sleep apnea due to nasal obstructions, including the septum, nasal valves, and turbinates.
With a nasal obstruction, patients are more likely to suffer from sleep apnea or other sleep conditions so it’s one of the most common forms of surgery.
Septoplasty and turbinate reduction are usually performed together and this is the most popular nasal surgical option which can be performed as an outpatient procedure.
The procedure differs slightly for each patient but results in a straightening of the nose which creates more room for breathing without using as much effort.
UPPP or uvulopalatopharyngoplasty is the most popular surgical treatment for treating sleep apnea in recent times and it results in a great reduction in snoring.
The purpose of this surgery is to remove any excess tissue from the pharynx and soft palate, as well as the removal of the tonsils.
Once the excess tissue has been removed, sutures help to keep the upper airways open so that it doesn’t collapse.
There’s a long recovery period of about a week for this surgery which can be painful, and overnight supervision is usually required.
Soft Palate Implants
For milder cases of sleep apnea or people who want to treat problem snoring, using soft palate implants can be helpful.
Sometimes referred to as the Pillar Procedure, this is a minimally invasive surgical procedure that inserts three rods into the soft palate of the mouth.
The polyester rods help to harden the soft palate so that it doesn’t touch the back wall of the pharynx during sleep as much, and it can be performed under local anesthetic.
This is a more invasive form of surgery that involves pulling one of the tongue muscles forward by moving both the bone and the muscle and fixing it in the new position with the help of a titanium plate.
This limits the ability of the tongue to move backward during sleep which is a common obstruction leading to sleep apnea.
You’ll be required to stay overnight in the hospital following the surgery and endure about a week of pain during recovery.
Tongue Base Reduction
Another surgery performed on the tongue, this reduction procedure removes part of the tissue of the tongue to reduce its size which then prevents obstruction.
It can be done with radiofrequency waves which reduce it slowly and with minimal invasion. Otherwise, a direct excision can be made which is performed in an operating room but also has very minimal recovery time.
The hyoid is a bone in the neck situated where the tongue base and pharynx meet.
If a large tongue base is noted in the patient, this minimally invasive procedure can reposition the hyoid bone to give the airway more room and stop it from collapsing.
The procedure takes less than an hour overall and recovery pain and time are minimal.
Lower Jaw Advancement
This is an invasive surgical option that requires weeks of recovery and can be expensive to perform.
Many sleep apnea patients have narrow jaws that obstruct their airways at night, and this surgery involves mobilizing both the upper and lower jawbones and moving them around 10mm.
It involves the cutting of bones and wiring of teeth following the procedure and isn’t performed by many surgeons because of its complexity.
General Costs of Sleep Apnea Surgery
As there are many options for surgical treatments and sometimes the need to do more than one, it can be hard to determine an exact figure for the cost of sleep apnea surgery.
Depending on your insurance, you may also be eligible for reduced out of pocket payments, so it’s best to speak with your doctor for a more realistic amount.
In general, any surgery that involves the jaw and is more invasive can cost up to $100,000, however, these usually have higher rates of success.
Minor surgical options including soft palate surgery and tongue advancement surgery only cost around $10,000 due to their minimally invasive procedure.
Other nonsurgical options may be more affordable for people, including the use of a PAP machine.
A standard CPAP machine that can be worn nightly to assist with breathing and reduce the rate of sleep apnea costs around $1,500 for a quality brand.
Again, if you have insurance coverage you can reduce this cost significantly so it’s well within the reach of most people.
Sleep apnea can be a debilitating condition that affects its sufferers mentally and physically, and it’s something that people are desperate to fix.
If you suffer from sleep apnea you may have considered surgery as an option, so we’ve answered some frequently asked questions to give you more of an understanding about it.
How Effective is Sleep Apnea Surgery?
Depending on the patient and the type of surgical procedure they undergo, there are varying rates of success for sleep apnea surgery.
According to the American Academy of Otolaryngology, a procedure like a tongue reduction surgery comes with a success rate of at least 60 percent.
Is Sleep Apnea Surgery Dangerous?
There are always risks involved in any type of medical procedure but they can be heightened for people with sleep apnea.
General anesthetic can be dangerous for sleep apnea patients as it makes it harder for them to breathe so a medical team will take extra care to ensure you’re breathing correctly during surgery.