CPAP Research

Research FAQs

  What Surgery or Surgical Treatments are available for Sleep Apnea?

There are several different types of surgeries available for Sleep Apnea, depending on the person, but any surgery comes with inherent risks or possible complications, and it can be painful. CPAP machines are still the most effective treatment for Sleep Apnea with very minimal risk to the end-user. Often the surgery success rate is relatively low and many people report being back on a CPAP machine, or the like, within a year, albeit often at a lower pressure.

Here are some of the more common surgeries available, although doctors are always innovating and coming up with new procedures. Not all are covered here. Talk to a sleep doctor to find out more about the newest and best options specifically chosen for you.

Tonsillectomy or Adenoidectomy

This is performed to increase the size or opening of the air passage in the treatment of sleep apnea.

Uvulopalatopharyngoplasty

UPPP is performed to reduce or remove or reshape parts of the soft palate and the uvula. It may also involve removal of part of the soft tissue from the pharyngeal areas.

Laser-assisted Uvulopalatoplasty

LAUP is similar to the above description of Uvulopalatopharyngoplasty however it uses lasers or radiofrequency waves to remove and shape the tissue.

Maxillomandibular Advancement

MMA, also known as (MMO) Maxillomandibular Osteotomy or (Bi-Max) Bimaxillary Advancement, is usually reserved for severe cases which have not responded to other surgeries or CPAP therapy or where craniofacial syndromes or structures are suspected as the cause of the problem. It is more invasive and involves removing the top and bottom jaw and moving them forward or restructuring the chin, maxilla or mandible. Often it is performed in conjunction with Genioglossus Advancement.

Genioglossus Advancement

This procedure, commonly known as tongue advancement, is designed to move or pull the tongue forward to increase the size of the airway. It is sometimes performed along with Maxillomandibular Advancement (see description above).

Hyoid Suspension

This procedure involves pulling forward the hyoid bone in the neck to place it in front of the larynx. The hyoid bone is one of the attachment points for the tongue.

TAP Implant (Pillar Procedure)

The Pillar system is different from other treatments. It is specifically designed to produce a lasting reduction in snoring after a single office procedure. Unlike other procedures, the Pillar procedure does not require heating or removing tissue, or the use of any sclerosing agents, which means the procedure causes minimal discomfort and recovery time is short. In fact, most patients resume a normal diet and activities the same day.

During the Pillar procedure, no tissue is removed. Instead, three tiny inserts are placed in your soft palate during a brief office visit using local anesthetic. The inserts support and stiffen the palate, which has been shown to reduce snoring in individuals with very moderate sleep apnea. In addition, the inserts are made of a polyester material that causes a stiffening response in the palate tissue itself. This supporting and stiffening of the soft palate will last as long as the inserts are in place.

Unfortunately, this is not a solution for those with more than mild sleep apnea. If the obstruction occurs in a place other than the site of the implants, this procedure will be ineffective.

  What Medications or Pharmaceuticals are available for Sleep Apnea?

Currently there are no drugs on the market that are effective for the treatment of Obstructive Sleep Apnea.

Methylxanthine Theophylline is often used to treat those afflicted with Central Sleep Apnea and sometimes children or infants with Sleep Apnea but is not indicated for adults with OSA.

If normal treatments are not effective, sometimes a doctor may prescribe drugs that usually are reserved for narcolepsy or to help combat somnolence, such a stimulants or amphetamines. Modafinil, an anti-narcoleptic medication or wakefulness promoting drug, is sometimes used in this capacity.

Protriptiline, a tricyclic antidepressant, is helpful for a small number of Sleep Apnea patients. Sometimes acetazolamide and Medroxyprogesterone are prescribed to stimulate normal breathing. Prescription steroids or nasal decongestants can be useful in some cases to assist in widening the upper air passage.

  What Orthodontic Treatment and Dental Appliances are available for Sleep Apnea?

Dental Devices or Oral Devices are sometimes used to treat Obstructive Sleep Apnea. There are several dental devices or procedures available and approved for use in treating Sleep Apnea. Usually one must go to a dentist to discuss which one would be the best choice based on the individual and to have the device custom made or fitted. They are often relatively expensive and have a moderate success rate, but could be a good option for some individuals. In general it seems the dental devices have an overall higher success rate than surgery but still lower than CPAP therapy. There are often some side effects that could be uncomfortable or cause other problems. Talk to a qualified dentist about these potential issues. Here are just a few of the dental devices available:

• The most popular treatment is MAD or the Mandibular Advancement Device. It forces the lower jaw down and forward which can help keep the air passage open and it looks like a mouth or tooth guard used commonly in sports.
• Sometimes Sleep Splints are used that hold the tongue in a certain position increasing the size of the airway.
• There is a functional magnetic system as well that places two magnets opposite each other on the sides of the jaws to help keep the airway open.
• Rapid Maxillary Expansion is an orthodontic procedure that involves inserting a temporary screw device which is applied to the upper teeth and then turned or tightened periodically over a 3 to 4 week period. It can help reduce nasal pressure and is a non-surgical procedure that may improve breathing in people with a narrow upper jaw.