Sleep Apnea Treatments

There are various treatments for sleep apnea, from lifestyle modifications, to breathing machines and surgery. The latest include the non-invasive, in-office treatment, the Pillar Procedure, and the inventive new treatment that provides a comfortable alternative to the CPAP, the Provent Device.

The Provent Device
The Manhattan Snoring and Sleep Center announces a new, FDA-approved treatment for Obstructive Sleep Apnea that eliminates the need for the CPAP mask. Featuring innovative MicroValve technology, the Provent Device provides discreet comfort, and uses the power of your own breathing to restore natural airflow to treat OSA. The Provent Nasal Device is small and powered by your own breathing, so it requires no mask or machine. The device is clinically proven to treat obstructive sleep apnea and is effective for mild, moderate, and severe OSA..

The Pillar Procedure
The Pillar Procedure is available for the treatment of snoring and mild to moderate symptoms of obstructive sleep apnea. It is performed in our center, and takes approximately fifteen minutes under local anesthesia. During the pillar procedure, three small polyester rods are implanted in the soft palate of the patient's throat. The inserts lend more support to the soft palate, and over time the body’s natural fibrotic response stiffens the upper keeping it from totally relaxing when you sleep.

Oral Appliance Therapy
Oral appliance therapy (OAT) is a non-invasive treatment for snoring and obstructive sleep apnea, accepted and recommended by the American Academy of Sleep Medicine (AASM). Oral appliances are similar in appearance to mouth guards or retainers and are worn only while you sleep. The appliances are custom fit and work by advancing the lower jaw to keep the airway open during sleep. They also keep the soft tissue in the mouth from collapsing and obstructing breathing, significantly improving sleep apnea symptoms including oxygen saturation and daytime sleepiness. They are small, comfortable, silent and easy to carry when traveling.
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Continuous Positive Airway Pressure (CPAP)
The continuous positive airway pressure, or CPAP unit delivers a continuous flow of air through the upper respiratory tract and acts as a stent, keeping the tissues from collapsing. The CPAP unit consists of a small air pressure generator connected by tubing to a snug-fitting nasal mask that is worn while sleeping.

Although extremely effective, compliance with the use of CPAP units is also a significant issue. Many people are uncomfortable sleeping with the nasal mask, and they describe a claustrophobic feeling. Humidifying equipment attached to CPAP units reduces the sensation of throat dryness. Also, individuals with significant nasal congestion may require treatment of their underlying nasal condition to comfortably tolerate the nasal mask.

Bi-level Positive Airway Pressure (Bi PAP)
A similar device to the CPAP, bi-level positive airway pressure, or Bi PAP, delivers pressurized air flow only during the inspiration. CPAP and Bi PAP units are customized to the individual’s needs by respiratory therapists. Proper fit of the nasal mask is necessary, and appropriate air pressure settings should be established for each individual. The units are portable and may be used when traveling..

Surgical Procedures

After other sleep apnea treatments have been considered and tried, surgical intervention is an addition option for the treatment of obstructive sleep apnea. Some common surgical procedures include:

Uvulopalatopharyngoplasty, or UPPP
The best candidates for UPPP are patients whose tonsils can be visualized when they open their mouths fully. This reduces the possibility that a large tongue is the primary source of obstruction. Although short-term results following UPPP have been encouraging, in some individuals scarring produces narrowing of the airway, leading to recurrent obstruction. Under general anesthesia, UPPP is performed by removing the uvula and a small portion of the soft palate. If enlarged tonsils are present, they will be removed at the same time. Often individuals with obstructive sleep apnea have concurrent nasal obstruction, which contributes to their condition. Many physicians will surgically correct a deviated nasal septum and/or reduce the size of the turbinates at the same time as performing a UPPP.

Genioglossal Advancement and Hyoid Suspension
For patients who do not improve following UPPP, or are not candidates for that procedure, maxillofacial surgical techniques have been developed to reduce airway obstruction at the base of the tongue, below the level of the palate and tonsils. Candidates for these procedures have severe obstructive sleep apnea and usually have short, thick necks. Genioglossal advancement pulls the base of the tongue forward by repositioning a muscle attached to the tongue. Hyoid suspension lifts the tongue and pulls it forward, opening the airway at the base of the tongue. The most radical surgical option for repositioning the tongue is maxillomandibular advancement, when the bones of the upper and lower jaw are cut and moved forward with the use of surgical plates and screws.

Tracheotomy
The ultimate surgical treatment for severe obstructive sleep apnea that has the highest success rate is tracheotomy. A surgical opening is created in the windpipe, through which a tracheotomy tube is placed. Because air flows directly into the trachea, bypassing the pharyngeal tissues and tongue, obstruction is eliminated. Tracheotomy requires significant lifestyle adaptation, and is generally reserved for the morbidly obese patients who are at risk for the severe health complications associated with severe obstructive sleep apnea.

If you suspect you may have sleep apnea and are in the New York City area, schedule your appointment for an examination at Eos Sleep today, and start on the road for treatment for this life threatening condition today.

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