Sleep apnea may cause a variety of symptoms, such as:
- Persistent “tired” feeling
- Inability to achieve the feeling of being fully rested
- Taking frequent daytime naps
- Difficulty staying awake during the day
- Difficulty staying awake while driving
- Headaches
- Memory loss
- Mood swings
- Lack of energy
- Low sex drive
Left untreated, sleep apnea may lead to heart attack, stroke, high blood pressure, and even premature death.
Treatment Options
Some patients may need treatment involving the nose to address obstructive sleep apnea.
Septoplasty. The septum is a sheet of cartilage and bone that separates the nostrils. Some patients may have a curvature to one or both sides of the nose, called a septal deviation. This can cause a blockage that inhibits breathing through the nose, especially at night, and contributes to closure of the airway. There can also be an outcropping, called a septal spur, that can cause further blockage of the nose.
Septoplasty is a surgical procedure that involves removing a portion of the septum and/or moving the underlying cartilage and bone so that the septum is in the middle of the nose. Moving the septum to the middle of the nose helps eliminate the blockage and allows the individual to breathe easier through the nose. A septoplasty is performed entirely inside the nose, with no external incisions, through a small surgical opening near the front of the septum. During the procedure, the physician separates the lining of the nose from the underlying cartilage and bone, makes structural changes, and sews the lining back in place. Some patients may need supports, or splints, to help the nose heal properly; they are removed a few days later.
Turbinate Reduction. Nasal turbinates are lateral structures in the nose that may become enlarged and contribute to snoring or OSA. There are three turbinates on each side of the nose, with the lowest one (inferior turbinate) typically responsible for most of the blockage. A few different procedures can help reduce the size of the nasal turbinates.
Radiofrequency ablation involves delivering radiofrequency energy to the turbinate tissue, thereby reducing the size of the tissue over time and increasing the size of the airway. The turbinate may also be trimmed in a procedure called a submucous resection.
Some patients may benefit from having the tissue of the turbinates removed using a ‘microdebrider’ device. A few of these procedures may be performed in the office using local anesthesia, while others may be combined with other procedures and performed in the operating room under general anesthesia.
Rhinoplasty. Some patients may have obstruction caused by an external portion of the nose. In these cases, patients will need a functional rhinoplasty to improve nasal breathing. Deformed or enlarged cartilage, and sometimes bone, can be trimmed, re-positioned or supplemented with cartilage from the ear or rib to open the nasal passages. Rhinoplasty can be done inside the nose or through small incisions in the base of the nose. During the procedure, the skin covering the cartilage and bone is lifted, the cartilage and/or bone is adjusted and the skin is replaced and sewn together.
Nasal Valve Surgery. The nasal valve, located just inside the nostril, is the narrowest portion of the nasal airway. Small changes in the area of the valve can make a big difference in breathing. The traditional approach to surgery involves placing small grafts of cartilage through an incision inside the nose. This helps to strengthen the nostril so the nostril does not collapse when breathing.