Archive for May 2008


  The intention of surgery is to open the airway sufficiently to eliminate or to reduce obstructions to a clinically insignificant level. In order to do so, surgical therapy in adults often must reconstruct the soft tissues (such as the uvula and the palate) or the bony tissues (the jaw) of the throat.

If you have been diagnosed with OSA and are considering surgery, talk to a sleep specialist and/or experienced surgeon about the different procedures, and the chances they will be effective to you, with your anatomy and why, and most of all the risks involved with surgery. Untreated sleep apnea can be harmful to your health, and surgery cannot always address all the points of obstruction. Eliminating the snoring does not necessarily eliminate the apneas. Sometimes surgery does not cure sleep apnea but reduces the number of apneas so that more treatment options are available to you and/or more comfortable. Yet in some circumstances, surgery may actually worsen the apnea.Insurance typically covers surgery for sleep apnea but not all surgical procedures. However, insurance companies that initially refuse to pay for a surgery may be convinced otherwise upon an appeal that demonstrates the efficacy and appropriateness of the surgery in your case. Throat pain from the major surgeries varies but is generally significant, often for one to two weeks. Most surgical procedures for sleep apnea are conducted in a hospital under general anesthetic. (People with sleep apnea must be cautious about general anesthesia–no matter for what medical condition the surgery is–because of the effects anesthesia has on the airway.)The most common surgery for sleep apnea is the uvulopalatopharyngoplasty, or UPPP procedure, which is intended to enlarge the airway by removing or shortening the uvula and removing the tonsils and adenoids, if present, as well as part of the soft palate or roof of the mouth. (The uvula is the tissue that hangs from the middle of the back of the roof of the mouth; the word comes from the Latin “uva” meaning “grapes.”) According to the “Practice Parameters for the Treatment of Obstructive Sleep Apnea: Surgical Modifications of the Upper Airway,” issued in 1996 by the American Academy of Sleep Medicine, the overall efficacy is 40.7%. A more recent surgery using a laser (laser-assisted uvulopalatoplasty or LAUP, a modification of the UPPP where the surgeon cuts the uvula with a laser) is performed for snoring. There is not yet enough information to say whether LAUP is effective for OSA. 

There are other surgical procedures where a part of the tongue is removed, and two which try to enlarge the airway by moving the jaw forward. These surgeries do have very high success rates but are long and involved (lasting several hours) with a significant recovery period and potential complications that patients may reject. As a rule, success rates for these complicated surgeries are higher when preformed by an experienced surgeon. You may have to undergo more than one procedure to eliminate the apneas sufficiently. In review, when weighing surgery, consider whether the safety and efficacy of the procedure have met the medical journals and cases studied are similar to yours. Surgery helps many, but effectiveness varies from person to person. It is also highly recommended that with surgery you have follow up sleep studies often, to evaluate your current conditions. If unsure about proceeding, you should seek a second opinion. Only a doctor who has examined you and your airways/complications can advise you on finding the correct surgery best for your needs.

 **Physicians who perform surgery for sleep apneas are most commonly otolaryngologists (specializing in the ears, nose, and throat) and oral and maxillofacial surgeons. If you are seeking a referral to a surgeon or a second opinion, you may find one through your physician or through a sleep center, and keep in mind that your insurance policy may require you to get a referral for a specialist and/or to see a specific provider.**






OTC sleep aids    

     Many people experiencing sleep problems understandably want a quick fix for their suffering. The thought of a pill that can solve the problem quickly is very appealing. Unfortunately, sleep medications don’t cure sleeplessness, and they can often exacerbate the problem over the long term. If you are contemplating on taking Over-the-Counter sleep aids, you should speak with your doctor or pharmacist, and get the right understanding of your sleepiness, and not self-diagnose.

I bet you didn’t know: The main ingredient of Over-the-Counter sleep aids is antihistamine (which is used to treat allergies) and is what causes you to become sleepy or drowsy.

     There are large amounts of side effects when it comes to taking OTC sleep aids. In reality you being tired or feeling that you’re not retaining a good nights’ sleep is because you might actually have sleep apnea induced sleep deprivation. Although, you can be completely unaware that you have sleep apnea, and that your are just waking up throughout the night. The metal and physical side effects of your own body going through sleep deprivation fighting with the side effects of the OTC sleep aids is an extremely dangerous cocktail. You can jeopardize your well-being and that of others around you.

*Most common side effects of Over-the-Counter aids:

 .Drowsiness                   .Forgetfulness   

 .Constipation                 .Urinary retention     

 .Dizziness                     .Blurred vision   

 .Lack of coordination     .Dry mouth and throat

*Most common side effects of Sleep Apnea/Sleep Deprivation:

 .Depression                 .Increased blood pressure     

 .Irritability                  .Learning difficulty/forgetfulness  

 .Sexual dysfunction      .Dry mouth and throat   

 .Drowsiness                .Lack of  coordination/falling asleep while performing simple tasks   

     Over-the-Counter sleep aids can create a tolerance and need to increase dosage within use of only a few days. Putting yourself in such a sedated sense, you’re relaxing your muscles even more, which are the main causes of sleep apnea, thus, making your arousal to breathe much harder, and causing more danger to your body.

**Check out the link below, to see a story of a woman addicted to sleep aids, and the life she lived, until she got help.


sleep aid

snoring.jpgWhere would you feel more comfortable sleeping? Studies show that at home testing is now just as qualifying as going to a sleep lab, although if it is deffinante that you have a form of sleep apnea or sleep disorder,  it will be requested that you spend a few nights at an overnight sleep lab for further documentation to proceed with the proper treatment. A home sleep test involves the use of a portable monitoring system that is small enough for you to use at home. The system consist of a small recording device, senors, belts and related cables and accessories. A typical home sleep test does not detect other sleep disorders such as restless legs syndrome. Having anoher sleep disorder or major medical problem also may affect the results of a home sleep test.

   Find out if a sleep study is right for you! Answer these questions below:

  1. Do you think you have a snoring problem?
  2. Has someone told you that you snore almost everynight?
  3. Has someone complained about your loud snoring?
  4. Do you tend to feel tired, even after a full nights sleep?
  5. Do you fight sleepiness durning your normal daytime routine?
  6. Has anyone ever told you that you seem unusually sleepy?
  7. Are you overwieght?
  8. Has anyone ever told you that you stop breathing in you sleep?
  9. Are you free of other sleep disorders?
  10. Are you free of other mdical problems that may affect your sleep?

If your answer to most or all of these questions is “Yes,” then you may be a good candidate for a home sleep test. Answering “NO,” to many of these questions indicated that an overnight sleep study at a sleep lab may be more appropriate for you.

 sleep-study-doc.jpgAn overnight sleep study at a sleep disorders center is useful for detecting many other sleep disorders. It also remains effective even if you have multiple medical problems or sleep disorders. The results of an overnight sleep study give your doctor the most detailed information about your sleep. Doctors call this study a polysomnogram. It charts your brain waves, heartbeat, and breathing as you sleep.  It also records your eye and leg movements as well as muscle tension. Sensors are placed on your head, face, chest and legs. They send tiny electrical signals to a computer. A clip will also be placed on your finger to note changes in the level of oxygen in your blood. The clip monitors the color of your blood.  As blood loses oxygen, it turns from red to blue.

Although a home sleep test can be convenient, it may not be the best option for you. Many sleep centers are accredited by the American Academy of Sleep Medicine (AASM). The AASM sets strict standards for centers to maintain. This is to make sure that patients with sleep disorders get the highest level of care. In these centers, a board-certifired sleep specialist always reviews the results of a sleep study.