Answering the question: Who should have surgery for sleep apnea?
Even as more and more people in the United States are diagnosed with obstructive sleep apnea (OSA), there remains a disconnect as to who can benefit from corrective surgery. Leading experts in the field of sleep medicine will attempt to answer the question of who could benefit from surgery, during a moderated discussion at the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in Chicago, IL.
Sleep apnea, which affects more than 10 million American, with an estimated additional 10 million undiagnosed, is characterized by loud snoring interrupted by frequent episodes of totally obstructed breathing (obstructive sleep apnea). Serious episodes last more than ten seconds each and occur more than seven times per hour.
Almost everyone is likely to snore at one time or another, and while most people with apnea snore, not everyone who snores has apnea. It has been found in all age groups. Estimates of snoring vary widely based on how it is defined.
Habitual snoring has been found in about 24 percent of adult women and 40 percent of adult men. Both men and women are more likely to snore as they age. Men, however, become less likely to snore after the age of 70.
Obstructive sleep apnea is best treated by the use of a positive airway pressure device, such as a continuous positive airway pressure device, or CPAP, or a bi-level positive airway pressure device, or bi-level. Some people mistaken refer to all bi-level devices as BiPAP machines, although the word BiPAP is a registered trademark of Respironics, Inc., for a specific line of bi-level devices. The term xPAP is used when speaking of positive airway pressure machines, overall, when one specific type of machine is not being discussed.
Other treatments for apnea exist, though the success rate at eliminating the apneas — especially without surgery — are not close to the almost 100 percent success rate of xPAP devices. They include oral devices, including custom devices made by dentists; surgeries; and an implant that’s been on the market for a few years with mixed comments.
While many people with obstructive sleep apnea snore loudly and frequently, following by periods of silence when airflow is reduced or blocked, and then come to a conclusion when the person begins to make choking, snorting, or gasping sounds when the person’s airway reopens.
Apnea patients may experience 30 to 300 such events per night. These episodes can reduce blood oxygen levels, causing the heart to pump harder.
The discussion, Who Should (Not) Have Surgery for OSA?, led by Eric J. Kezirian, M.D., MPH., as moderator, saw Allan I. Pack, MB, ChB, Ph.D., and Edward M. Weaver, M.D., MPH, focusing on understanding what treatments are best suited for different patient populations, while seeking to clarify whether non-surgical options are helping or hindering a patient’s treatment.
/Health – Surgery/who-should-have-surgery-for-apnea/2008-09-25.1431
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