Posted on 10/24/2007 12:11:25 PM PDT by crazyshrink
Oral surgery can reduce CPAP needs in patients with sleep apnea (Chicago, IL, October 24, 2007) — A procedure known as uvulopalatopharyngoplasty (UPPP) may help some patients improve or even eliminate their obstructive sleep apnea (OSA), according to a new study. The research, presented at CHEST 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians (ACCP), says the procedure, which removes excess tissue in the throat or mouth to widen the airway, can reduce the amount of treatment required by patients with OSA. In addition, researchers say UPPP also can eliminate OSA completely in some patients.
“Continuous positive airway pressure, or CPAP, is a well-established treatment for sleep apnea,” said lead study author Akram Khan, MD, Assistant Professor, University of Florida Jacksonville, “and while most patients tolerate it well, some are unable to tolerate it or don’t want to, and those patients need alternative means of treatment.”
To determine if UPPP provided improvement in sleep parameters, Dr. Khan and his colleagues from the Mayo Clinic, Rochester, MN, evaluated the success of the procedure in 63 patients aged 18-80, with OSA, over a 7-year period. All patients underwent UPPP and were assessed with polysomnography within a 6-month period, pre-procedure and post-procedure.
Results showed that UPPP eliminated OSA in approximately one quarter to one-third of patients, depending on the definition of success. Of those who experienced residual OSA and returned to CPAP use, the required CPAP setting was modestly lower. In addition, researchers reported that UPPP also reduced the mean apnea-hyponea index in patients.
“The apnea-hyponea index basically tells us the number of times a patient with sleep apnea quits breathing per hour,” Dr. Khan explained. “We found that the surgical procedure reduced patients’ apenic (nonbreathing) episodes by more than half.” According to Dr. Khan, UPPP provided an improvement in oxygen levels and other parameters of sleep, as well.
First described in 1981, UPPP has been used widely with varying results. Though researchers are unclear on what characteristics make up the ideal UPPP candidate, they suggest that patients with mild OSA, who are relatively young, lean, and healthy, may have the best results with this procedure. Researchers also believe that a decrease in CPAP requirements would likely improve compliance in patients who don’t have their OSA completely resolved.
“Obstructive sleep apnea increases the risk of other illnesses, such as heart disease, high blood pressure, and stroke, among others,” said Alvin V. Thomas, Jr., MD, FCCP, President of the American College of Chest Physicians. “Patients and physicians need to work together to recognize the signs of sleep apnea and to identify which method of treatment is most suitable.”
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Suddenly awakening gasping for air, heart racing then going into full blown cardiac arrest probably isn't a pleasant way of getting into such state.
Very much appreciate your reply to my article post. I posted it because it was a new study and hoped to get people talking about their SA experiences and provide some education to each other along the way. Again, thanks.
But it’s dramatic.
thanks for the information. I actually talked to the doc who diagnosed me about that right after I got my machine. She said that it only had about a 25% success rate and likely wouldnt work for me because of all the tissues in my throat.
I actually dont mind the machine. It is a pain in the butt to drag along when traveling but other than that it is no bid deal.
About the only surgery which may help would be a bimaxillary advancement with suspension of the hyoid bone in your case. It really works but is a major hit. It involves moving both the upper jaw (maxilla) and lower jaw (mandible) forward enough to advance the tounge base plus open the oro/naso pharynx to allow laminar air flow. Other than tracheostomy that is about the only surgical way to address lower airway obstruction.
I had a UPP, as well as a Roto Rooter of the nose “turbinates” back in 1985. - BC - Before the CPAP football helmets!
Yeah, I sleep somewhat better than before, and I snore less than before, and my Apnea gasping has decreased.
Now, if I was truly smart, I’d lose about 30 pounds (5’8”, age 66, 205 lbs”) and my wife would be a lot happier.
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