Common
Surgeries to Cure Snoring and Sleep Apnea
Are
Less Effective, Study Shows
DUBLIN, OH—Common
throat surgeries that are widely used to "cure" snoring
and sleep apnea problems are only truly successful in less than 10
percent of all cases, according to new research conducted by Ohio
Sleep Medicine Institute.
While many
healthcare professionals performing these surgeries have claimed a
40 percent or higher success rate, these studies have ignored the
more subtle effects of breathing problems in sleep that are
destructive to sleep quality. Because of the importance of this
discovery in sleep medicine, the American Academy of Sleep
Medicine formally the ASDA will be recognizing this piece of
research to the media, chosen from more than hundreds of abstracts
and studies that will be presented at the Associated Professional
Sleep Societies annual meeting in New Orleans June 20-23.
"Impaired
breathing in sleep and snoring are much more complex and
multifaceted problems than even many sleep specialists have so far
realized. Because these problems are potentially lifelong and
their consequences can be devastating, evaluation and potentially
helpful treatment recommendations—and outcomes—need to be
carefully examined," said principle researcher Helmut S.
Schmidt, MD, a board certified sleep medicine specialist.
To measure the more
subtle effects of breathing problems, Schmidt is using an
extremely sensitive measurement called a Respiratory Arousal Index
(RAI). The RAI measures brief micro-awakenings that occur during
the night in response to increased breathing efforts. When
patients who have undergone uvulopalatopharyngoplasty (UPPP) or
laser assisted uvulopalatoplasty (LAUP) are carefully studied
post-operatively, the RAI often shows that only the very
occasional patient is "cured" by removing the uvula and
parts of the soft palate.
The Ohio Sleep
Medicine Institute research suggests that traditional criteria for
analyzing UPPP/LAUP response, leads to results as follows:
Responders
- Patients showing significant improvement, but not
"cured" or asymptomatic. 35%
Non-responders
- No change or poor response. 40%
Worse
after surgery 25%
By using the more
sensitive RAI assessment of sleep quality or reduced fragmentation
of sleep, results find:
Responders
15%
No
change, poor response or worse 85%
"The
observations we have made in our research strongly suggest the
need for a better understanding of the underlying causes of
impaired breathing in sleep and snoring and the urgent need for
new research into more effective treatment approaches,"
Schmidt said.
Preventive medicine
may become a key in protecting individuals from the consequences
of snoring and sleep apnea. If left untreated, sleep-related
breathing problems lead to impaired daytime functioning; and
depending on severity, can lead to hypertension, heart failure and
stroke. As this research suggests, the traditional throat
surgeries for sleep apnea may be helpful only for certain
carefully selected patients. It recognizes the importance of
performing the right surgery for the right patient and the need
for new and better treatment approaches, especially with regards
to surgery in patients with sleep disordered breathing.
If you would like
additional information about this study by board certified sleep
medicine specialist Helmut S. Schmidt, MD, and oral maxillofacial
surgeon, Robert M. Hinkle, DDS.
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