Obstructive sleep apnea (OSA) is a breathing condition that negatively affects the quality of life for many individuals. Left untreated, OSA may lead to the development of additional health conditions affecting the lungs and heart, and cause cognitive decline, including problems with memory, attention, and critical thinking.
Symptoms of Obstructive Sleep Apnea
Individuals with obstructive sleep apnea may experience the following symptoms:
- Chronic fatigue
- Inability to become fully rested
- Need to take frequent daytime naps
- Difficulty staying awake during the day
- Difficulty staying awake while driving
- Headaches
- Mood swings
- Low sex drive
- Memory loss
- Lack of energy
How OSA is Diagnosed
A sleep study, or polysomnogram, involves monitoring patients overnight in a sleep study facility or in the comfort of their home. The sleep specialist begins by attaching electrodes to the patient’s body in various locations to measure body and brain activity. As the patient sleeps, sensors keep track of numerous important processes, including heart rhythm (EKG), brain activity (EEG, if the patient is in a sleep facility), blood oxygen levels, movement, sleep state, and the number and duration of apnea episodes. All of this information is analyzed and used to determine whether the patient has a snoring problem or sleep apnea.
Sleep Apnea Treatment
Patients with OSA caused by problems of the palate may benefit from the following treatment options.
Uvulopalatopharyngoplasty (UPPP). For many years, UPPP was the main surgical treatment for sleep apnea. It was first introduced in the United States by Dr. Fujita in the early 1980’s.
The surgeon begins the procedure by removing the tonsils (if they are still present) and goes on to trim a portion of the palate and remove the entire uvula. The area is then closed with dissolvable sutures. The entire procedure is performed under general anesthesia, and may require an overnight hospital stay for observation.
Postoperatively, patients may experience a severe sore throat and some difficulty swallowing, lasting up to 10 to 14 days. Patients may also experience temporary changes affecting their voice and swallowing.
Expansion Pharyngoplasty. This is a recently-developed technique used to prevent the palate from falling back into the airway, while preserving muscle integrity to optimize swallowing, breathing, and voice quality. The procedure begins with the removal of the tonsils on both sides. Then, a muscle in the outer aspect of the palate and throat, the palatopharyngeus muscle, is mobilized and some of the fibers are cut. A series of dissolvable sutures are inserted, pulling the palate forward and outward in the throat. The result is an enlarged airway behind the palate that is kept from falling back into the airway.
Lateral Pharyngoplasty. This procedure involves moving muscles of the roof of the mouth to open the outer walls of the back of the throat. Patients are put under general anesthesia and the surgeon removes the tonsils. Then, the surgeon makes small cuts in the outer muscles of the throat and soft palate, and moves the muscles to open the throat. Dissolvable sutures are inserted to hold the muscles in place with.
The goal is to open the throat while keeping the muscles and lining of the throat and palate mostly intact. Swallowing and talking are mostly unaffected because the muscles and tissue are preserved as much as possible.