Obstructive Sleep Apnea Surgery

Most adults need between seven and nine hours of restful sleep per night, sleep experts agree. However, it’s likely that you may not be getting enough sleep and that can negatively affect your quality of life.

There are many reasons people might not get enough rest at night, ranging from adjusting to a new baby at home, experiencing anxiety or having too much screen time. Sometimes, however, a diagnosable sleep disorder might be responsible for your lack of sleep.

If you think you have a sleep disorder, the ear, nose and throat (ENT) and sleep specialists at The Ohio State University Wexner Medical Center can work with you to determine the cause of your sleep issues and find treatments, whether lifestyle changes, medications or surgery, that will help you achieve healthy sleep at bedtime.

What are sleep disorders?

Sleep disorders and other sleep disruptions cause sleep debt, the accumulated effect of not getting enough proper sleep. This can result in serious physical and mental consequences. Not getting enough proper rest can cause you to be less alert during waking hours, leading to vehicle accidents and other similar events. Sleep disorders can also lead to serious health risks, including heart attack, stroke and obesity.

Signs of having a sleep disorder are:

• Difficulty falling asleep or waking up and not being able to fall back asleep
• Excessive daytime sleepiness or falling asleep at inappropriate times
• Snoring that interrupts normal breathing or wakes you up
• Feeling unrefreshed after waking

Nearly 40 million Americans have a sleep disorder and one of the most common is sleep apnea, which causes your breathing to stop or become very shallow during sleep. There are different forms of sleep apnea, and the most common type is obstructive sleep apnea. It occurs when your airway collapses or becomes blocked during sleep. Your normal breathing will typically start again with a snort or choking sound.

Is surgery the only option to treat obstructive sleep apnea?

Obstructive sleep apnea is often treated with nonsurgical intervention first. Some of those less-invasive treatments include:

• Lifestyle changes – Avoiding alcohol or smoking, as well as losing weight, can help manage your sleep apnea.
• Mouthpieces and other devices – A continuous positive airway pressure (CPAP) machine is a common treatment recommended for sleep apnea.

If these methods don’t help, we’ll determine if a surgical option is best to address your sleep apnea.

Who is a candidate for sleep apnea surgery?

Sleep apnea surgery is an intervention option available to people with obstructive sleep apnea. There are multiple sleep surgery procedures. A surgeon specializing in sleep surgery will work with you to determine which one best suits your diagnosis and preference.

To be eligible for sleep apnea surgery, you must be:

• Over 18 years of age
• Not significantly overweight
• Suffering from moderate to severe obstructive sleep apnea
• Unable to tolerate or properly use a CPAP machine or oral appliance.

Surgical treatments for obstructive sleep apnea

Because we’re an academic medical center, you have access to the latest medical research, technology and procedures. We offer sleep surgery treatments ranging from those that are relatively simple, such as the removal of tonsils, to those that use the latest technology approved by the Food and Drug Administration (FDA).

Alternatives to oral devices and CPAP machines to treat obstructive sleep apnea include:

Upper airway stimulation (hypoglossal nerve stimulation)

Upper airway stimulation uses an implantable device similar to a pacemaker, to deliver mild stimulation to the hypoglossal nerve and prevent the tongue from blocking the airway. The upper airway device is implanted during an outpatient surgical procedure. You’re able to turn the device on and off using a handheld remote.

Learn more

Palatal procedures

The sleep specialists at the Ohio State Wexner Medical Center offer palatal procedures to treat obstructive sleep apnea by modifying the palate area near your throat, mouth and nose. Our expert team will work with you to determine which palatal surgical option is best for you. Those options include:

• Uvulopalatopharyngoplasty (UPPP or UP3) is a surgery that opens the upper airways in the throat by removing extra tissue that may be blocking the opening. This may be an option if you have moderate to severe obstructive sleep apnea and your surgeon considers it necessary to remove redundant or excess tissue from the throat.
• Expansion sphincter pharyngoplasty (ESP) is a surgical technique that adjusts the opening to the throat to make breathing easier during sleep. The surgical procedure includes a tonsillectomy, expansion pharyngoplasty, rotation of the palatopharyngeus muscle, a partial uvulectomy and closure of the anterior and posterior tonsillar pillars.
• Lateral pharyngoplasty is a surgical option that changes the shape and function of the soft palate and the area around it called the pharynx. This increases breathing space during sleep and can potentially reduce your symptoms.
• Anterior palatoplasty is a surgery used to reconstruct the soft palate and correct snoring.

Hyoid suspension

Hyoid suspension is a surgical procedure that addresses the hyoid bone, or the u-shaped bone in the neck. The bone is suspended forward to the jawbone (mandible), preventing displacement of the tongue during sleep and creating a more open space in the throat for breathing.

Why come to Ohio State for sleep surgery?

When determining if you’re a candidate for obstructive sleep apnea surgery, our surgeons will meet with you to conduct a physical exam and discuss your medical history. Our sleep specialists and ENT physicians can also work with other specialists in the medical center to ensure that a safe and effective treatment plan is in place for you. Treatment for sleep disorders is critical for your health and well-being, and the sleep specialists at the Ohio State Wexner Medical Center care about giving you the best quality of life possible.

The Ohio State Wexner Medical Center is one of the few facilities, both in the state and the region, that is able to offer some of these procedures, and our specialist staff has been on the leading edge of sleep medicine treatments for decades.