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Surgery is not considered a first line treatment for obstructive sleep apnea in adults. There are prospective, randomized, comparative clinical trials, [ 135 ] and also a systematic Meta-analysis, [ 120 ] showing evidence that conservative uvulopalatopharyngoplasty (UPPP) with or without tonsillectomy is effective in selected patients failing ...
Most obstructive sleep apnea sufferers have multiple points of obstruction in their airway and therefore require multilevel sleep surgery in order to maximize the efficacy of treatment. A systematic review of the literature and meta-analysis showed that multilevel sleep surgery achieves a 60.3% apnea hypopnea index (AHI) reduction. [2]
Several surgical procedures (sleep surgery) are used to treat sleep apnea, although they are normally a third line of treatment for those who reject or are not helped by CPAP treatment or dental appliances. [22] Surgical treatment for obstructive sleep apnea needs to be individualized to address all anatomical areas of obstruction. [10]
The first involves surgery of the soft tissue (tonsillectomy, uvulopalatopharyngoplasty) and the second involves skeletal surgeries (maxillomandibular advancement). First, Phase 1 or soft tissue surgery is performed and after re-testing with a new sleep study, if there is residual sleep apnea, then Phase 2 surgery would consist of jaw surgery.
Treatment with supplemental oxygen may improve their well-being; alternatively, in some this can lead to the adverse effect of elevating the carbon dioxide content in the blood (hypercapnia) to levels that may become toxic. [3] [4] With normal lung function, a stimulation to take another breath occurs when a patient has a slight rise in PaCO 2.
Positive airway pressure, initially in the form of continuous positive airway pressure (CPAP), is a useful treatment for obesity hypoventilation syndrome, particularly when obstructive sleep apnea coexists. CPAP requires the use during sleep of a machine that delivers a continuous positive pressure to the airways and preventing the collapse of ...
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