Surgery for a sleep disorder is not always possible, however, in cases where less invasive measures prove unsuccessful surgery may provide relief for patients with sleep apnea. In children, for example, apnea may be treated by removing the tonsils and adenoids. The reduction of excess soft tissue reduces or eliminates the apnea all together.
For adults, the surgery may involve uvulopalatopharyngoplasty, maxillomandibular advancement or tracheostomy. The first, also called UPPP requires the physician to remove tissue from the top of the throat and rear of the mouth (including tonsils and adenoids). This surgery is performed under a general anesthetic in a hospital and it can reduce snoring but may be ineffective in stopping all apnea episodes due to softer tissue further down the throat closing. The second procedure adjusts the jaw and pulls it forward in order to create more space beyond the tongue and soft palate. This reduces the amount of obstruction. Typically this procedure requires an oral surgeon to participate.
The third procedure, tracheostomy, is performed only when all other procedures have failed or in the case of life threatening apnea. A surgeon inserts a tube directly into the throat that may remain closed during the day, but is uncovered at night to allow breathing which bypasses any other obstructions. Newer procedures include the Pillar Procedure which inserts rods into the soft palate under local anesthetic and strengthens the soft tissue to prevent collapse.
Sleep apnea can be a debilitating condition, but many options exist for patients to treat, reduce or eliminate the sleep disorder.