Upper Airway Surgery for Sleep Apnea Benefits Equal to CPAP Treatment

According to researchers, adults who struggle with CPAP treatment for obstructive sleep apnea could be considered candidates for reconstructive surgery on the upper airway, because it holds the same quality-of-life (QOL) benefits as CPAP treatment, but with more permanence.

Obstructive sleep apnea is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. Obstructive sleep apnea occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that last at least 10 seconds during sleep.

Most people with obstructive sleep apnea snore loudly and frequently, with periods of silence when airflow is reduced or blocked. They then make choking, snorting or gasping sounds when their airway reopens.

Obstructive sleep apnea can occur in any age group, but prevalence increases between middle and older age.

Continuous positive airway pressure (CPAP) therapy is a highly effective means for treating obstructive sleep apnea, but because it involves a mask and set of hoses, and can be frustrating and uncomfortable for some obstructive sleep apnea patients, and compliance may be short-lived.

The authors of the study discovered that among moderate-to-severe obstructive sleep apnea -suffering patients, those treated through upper airway surgery experienced the same level of long-term quality-of-life improvement as their peers who were treated with CPAP therapy. Among the QOL benefits were improvements in snoring, sleepiness, and neurocognitive impairment. In contrast, those patients who were prescribed, but did not adequately use CPAP, had minimal QOL improvement.

The upper airway includes nose and throat (pharyngeal) areas, particularly behind the soft palate and tongue. Reconstructive surgery to treat obstructive sleep apnea involves clearing any blockages in those areas that might be hindering breathing.
References:
1. Sam Robinson, et al. Upper airway reconstructive surgery long-term quality-of-life outcomes compared with CPAP for adult obstructive sleep apnea. Otolaryngology-Head and Neck Surgery, Volume 141, Issue 2, Pages 257-263.e1. doi:10.1016/j.otohns.2009.03.022.

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