Sleep apnea is a common sleep disorder which is associated with cardiovascular diseases, diabetes and stroke. Different studies conducted in Iran have reported different prevalence for sleep apnea. The aim of the present study was to determine the prevalence of sleep apnea in Iran. Feeling frustrated with your partner’s constant complaints of your loud snoring at night? You can’t do anything about it while you’re asleep and unconscious, but you can do one thing when you are awake. Sleep apnea surgery is a real solution to your snoring problem.
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The surgeon can trim down your soft palate and uvula, remove your tonsils, and reposition some of the muscles of the soft palate. UPPP and other soft palate procedures are the most common type of surgery for sleep apnea. But UPPP alone is unlikely to cure moderate to severe sleep apnea. Just like in children, adults with enlarged tonsils also do better after sleep apnea surgery that includes tonsillectomy. One reason seems to be that the physical removal of the enlarged tonsils immediately opens up space for breathing and improves the sleep apnea.
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The most common signs of sleep apnea are loud snoring, choking or gasping during sleep, and being very sleepy during the day. You may also wake up with headaches or a dry throat, and have trouble concentrating during the day.
Many people never know for sure if they have sleep apnea. Doctors usually can't detect it during routine office visits, and there are no blood tests for it. Most people who have sleep apnea do not really know it because sleep apnea only occurs during sleep.
Doctors diagnose sleep apnea by asking you questions about your medical history and your family's medical past, and performing a physical exam. Your doctor may also want to order a "sleep study" in which your breathing and sleep patterns are monitored.
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There are many different types of surgeries offered to treat obstructive sleep apnea uvulopalatopharyngoplasty (UPPP),nasal surgeries, and maxillomandibular surgery are the most common.
There are many different types of surgery for sleep apnea and snoring. But CPAP is the first treatment option for anyone who has sleep apnea. Oral appliance therapy also is an alternative treatment option for people with mild to moderate sleep apnea. The members of the sleep team will help you decide if surgery is right for you.
Surgery may be a multi-step process involving more than one procedure. You may need to continue using CPAP even when surgery successfully reduces the severity of sleep apnea. It is important to follow up regularly with your sleep physician after surgery.
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This mouthful of a word, also known as UPPP, is the most commonly performed surgery for sleep apnea and involves trimming or adjusting the soft palate that sits at the back roof of the mouth to increase the width of the airway. Some people may also have their tonsils and uvula (the fleshy extension that hangs in the back of the throat) removed. While a sore throat is common in the first couple of weeks after surgery, anti-inflammatory pain medications can help ease the discomfort and most people are back at work after just one week.
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Both daytime nasal obstruction and nocturnal nasal congestion have been shown as risk factors for sleep-disordered breathing. Therefore, the treatment of nasal obstruction plays an important role in sleep apnea surgery. Three anatomic areas of the nose that may contribute to obstruction are the septum, the turbinate’s, and the nasal valve. The most common nasal surgical procedure consists of septoplasty and turbinate reduction. This is an outpatient procedure that is well tolerated by most patients. It consists of straightening out the septum and reducing the size of the turbinates. This procedure creates more room in the nose and allows air to pass smoothly and without effort. For some patients, there is also nasal valve collapse. This is due to weakness of the lower nasal cartilages that hold open the nostrils. For patients who have this issue, the deviated cartilage that is removed from the septum can be strategically placed to strengthen the valve and prevent collapse.
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This procedure, and other types of soft palate surgery, targets the back of the roof of your mouth. It involves removing and repositioning excess tissue in the throat to make the airway wider. The surgeon can trim down your soft palate and uvula, remove your tonsils, and reposition some of the muscles of the soft palate. UPPP and other soft palate procedures are the most common type of surgery for sleep apnea. But UPPP alone is unlikely to cure moderate to severe sleep apnea. It may be combined with surgeries that target other sites in the upper airway.
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The Pillar Procedure is a minimally invasive approach that can help with snoring and mild cases of sleep apnea. It involves the placement of three polyester rods into the soft palate. The rods initiate an inflammatory response of the surrounding soft tissues that results in a slight stiffening of the soft palate. The stiffer soft palate is less likely to make contact with the back wall of the pharynx during deep stages of sleep as the muscles relax; snoring and apnea are subsequently reduced. This procedure can be done under local anesthesia in the clinic with the patient awake.
Hyoid suspension also known as hyoid myotomy and suspension or hyoid advancement, is a surgical procedure or sleep surgery in which the hyoid bone and its muscle attachments to the tongue and airway are pulled forward with the aim of increasing airway size and improving airway stability in the retrolingual and hypopharyngeal airway (airway behind and below the base of tongue). The horseshoe shaped hyoid bone sits directly below the base of tongue with the arms of the bone flanking the airway. Hyoid suspension is typically performed as a treatment for obstructive sleep apnea (OSA). This procedure is frequently performed with a Uvulopalatopharyngoplasty (UPPP) which targets sites of obstruction higher in the airway. Typically, a hyoid suspension is considered successful when the patient’s apnea-hypopnea index is significantly reduced after surgery.
It works by opening up the upper airway. This makes it more stable so it will not narrow and obstruct during sleep. The symptoms of OSA should then get better e.g. snoring, feeling sleepy during the day. Normally, the goal of surgery is just to lessen the symptoms of OSA, not “cure” it. A second option is surgery on the nose. This is known as “pre phase” surgery. It can be done to help CPAP, oral appliances or other treatments work better.
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What are the side effects of sleep apnea surgery?
Surgery and anaesthetics always carry a risk of side effects. But with more modern types of surgery the risk is low. In most cases, the side effects do not last for long. Some types of surgery have a greater risk, (e.g. “Laser” surgery). Your surgeon will discuss all the risks with you in detail. This means that you can weigh up the pros and cons for yourself before deciding whether to proceed.
Surgery, on the other hand, has about a 25% to 30% success rate, and patients with the most severe cases of sleep apnea traditionally are the least likely to eliminate their symptoms.
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