Illinois Sleep Disorders Institute - In Your Local Area

Sleep Apnea Surgery: When Nothing Else Works

Sleep apnea surgery is the treatment of last resort for people with severe obstructive sleep apnea (OSA) or sleep disorders who have not found relief from other sleep apnea treatments. When it comes to surgery for sleep apnea, information is key.

In OSA, the airways become obstructed and cause the person to skip breaths and gasp for air. If methods such as lifestyle changes, CPAP machines, and oral appliance therapy are not successful in treating sleep apnea, then sleep apnea physicians may recommend sleep apnea surgery.

There are many parts of the airway (the breathing tubes) that can be obstructed. For sleep apnea surgery to be successful, the sleep apnea dentist or sleep apnea physician must identify and treat all areas with obstructions. For some patients, this may require more than one surgical procedure.

Here is an overview of the different types of sleep apnea surgery:

Maxillomandibular Advancement: This is a type of orthognathic surgery that moves the jaw forward (the same principle behind sleep apnea oral appliance therapy). Also known as bimaxillary advancement (Bi-Max) or maxillomandibular osteotomy (MMO), it's often accompanied by tongue surgery.

Tracheotomy: This is a procedure in which a sleep apnea surgeon creates a new "breathing hole" in the throat. Patients breathe and speak normally during the day, but at night they breathe through the tracheotomy tube in their windpipe. It's a dramatic procedure, but one that's certain to provide relief.

Uvulopalatopharyngoplasty: Known as a UPPP or UP3, this is a procedure in which soft tissue is surgically removed from the back of the mouth and throat. The tonsils and uvula are removed, leaving the patient with a "bigger" throat that makes breathing easier. Laser-assisted UP (LAUP) uses a laser to provide similar results. Unfortunately, these procedures are not always successful.

Tongue Reduction: Reducing the size of the tongue can leave more space in the throat and airway. This may be a surgical glossectomy or somnoplasty.

Tongue Advancement: Surgery that pulls the tongue and its muscles toward the front of the mouth. Known as genioglossus and hyoid advancement (GGA), this procedure leaves more space for breathing in the back of the mouth and throat. It is most often done in conjunction with other treatment or surgery.

Tonsillectomy and adenoidectomy: This surgery removes the tonsils and adenoids, making more space in the throat for breathing. It is especially useful in treating children's sleep apnea.

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Oral Appliance Therapy for Snoring and Sleep Apnea

Sleep apnea appliances are another way your sleep apnea dentist can help you sleep soundly. Worn while you sleep, oral appliances like CPAP masks can hold your mouth and jaw in such a way that makes breathing easier and will stop snoring. A sleep apnea oral appliance fits into your mouth like a mouth guard, night guard or orthodontic retainer.

Oral appliance therapy is a popular alternative to CPAP treatment. There are many options, and your dentist can help you choose which sleep apnea appliance will be best for your obstructive sleep apnea (OSA).

One sleep apnea remedy is the mandibular advancement system (MAS), also known as a mandibular advancement device (MAD). This oral splint is a dental appliance that moves the lower jaw slightly forward, which can effectively treat sleep apnea and also provide snoring prevention.

There are many other types of sleep apnea equipment. Generally, oral appliances for snoring and sleep apnea are made of soft plastic or hard acrylic. Some incorporate wires or rubber bands to provide the right sort of pressure. Almost all of them require a prescription and a professional fitting by your dental sleep medicine dentist or sleep apnea physician. If a dental appliance doesn't fit properly, it can lead to orthodontic problems and trouble breathing.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.