There are many people who find continuous positive airway pressure, or CPAP, very troublesome and they can’t tolerate it. CPAP is the most common treatment for obstructive sleep apnea, but if you can’t come to terms with it, what other treatment options are there? Well, there are a number of surgical treatments. However, there don’t seem to be for everyone and can have limited effectiveness. Nevertheless, let’s take a closer look at all surgical options available for sleep apnea.

Surgical Options for Sleep Apnea

Uvulopalatopharyngoplasty (UPPP)

The UPPP is the most common surgical treatment in people who have mild and moderate obstructive sleep apnea, but can’t tolerate CPAP or other medical management option. It is the surgical removal of excess tissue in the upper  airway, including the back of the mouth at the soft palate and along the throat. Hence, this surgical procedure removes the tissue from the tonsils, uvula, and the soft and hard palate. As these tissues might be the reason behind the airway obstruction so removing them will clear this obstruction.

However, the procedure itself comes with a number of complications. Thus, there are risks of bleeding, pain, and infection. Some people might experience changes in the voice, a sensation of a foreign body in the throat, a narrowing of the pharynx, or velopharyngeal insufficiency. Sometimes CPAP is required after this surgical procedure, which can be quite bothersome.

It has been estimated that only 50% of adults treated with UPPP have a reduction in apnea and hypopnea events by half or more. These improvements might be gone after some time, especially as the person ages or gains weight. So, uvulopalatopharyngoplasty is considered a second-line therapy, after CPAP treatment, and only for those who have tissue obstruction of their airway.

Nowadays, it isn’t a favorite procedure to be made, due to pain and limited benefits. Instead, other surgeries might be performed, such as the pillar procedure.

Inspire Nerve Stimulator

The inspire nerve stimulator is an implantation of a pacemaker for the tongue, which is a new and very promising treatment option. This treatment acts on the hypoglossal nerve and reduces the collapse of the airway by contracting the muscles of the tongue and upper airway. It’s a great treatment option for people who have moderate to severe sleep apnea and have failed using CPAP therapy. Hence, prior to determining whether you can have an inspire nerve simulator, you need to undergo a sleep endoscopy, which will evaluate whether you will benefit from it.

Tracheostomy

This is a surgical incision in the front of the windpipe, with the placement of a plastic tube to keep this open. Tracheostomy is a highly effective treatment of obstructive sleep apnea and it was the preferred option of treatment in severe sleep apnea before the invention of CPAP therapy in 1981.However, this treatment option is very invasive in nature and thus, it is rarely used any longer. It is used only in people with life-threatening disorders, including cor pulmonale, arrhythmias, or severe hypoxemia, which can’t be controlled with any other treatment available.

The Tongue, Jaw, and NoseSurgical Options

Based on which is the cause of sleep apnea, tongue, chin bone, and jaw advancement might be performed. These procedures aim at fixing anatomical defects related to the muscle and bones supporting the tongue and lower jaw. Nowadays, these procedures are rarely performed because the effectiveness varies and the intensity of the procedure may be high. A person with a deviated nasal septum might also undergo a nasal surgery, but it will be likely ineffective in resolving sleep apnea.

In a nutshell, if you cannot get used to CPAP or you simply cannot tolerate the therapy, there are several surgical options available. Talk with your sleep specialist if you are curious or interested in surgical treatments helpful to improve sleep apnea.