For patients with Obstructive Sleep Apnoea (OSA) who cannot tolerate CPAP therapy, modern surgical treatments offer a lasting alternative. A personalised surgical plan is developed after a thorough assessment to identify the precise location of the airway collapse.
This guide explores the modern surgical options that go beyond CPAP, helping you understand how a personalised approach can offer a lasting solution to sleep apnoea.
Obstructive Sleep Apnoea is more than just loud snoring. It is a serious medical condition where the upper airway repeatedly collapses during sleep, partially or completely blocking airflow. These pauses in breathing, called apnoeas, can happen hundreds of times a night.
This constant disruption starves your body of oxygen. It has significant health consequences. These include:
A diagnosis is typically confirmed with a sleep study. This measures the Apnoea-Hypopnoea Index (AHI) to determine the severity of your condition.
CPAP therapy works by using a machine to deliver a continuous stream of pressurised air through a mask. This effectively splints the airway open. When tolerated, it is extremely effective.
However, the challenges are very real for many patients. Common reasons for CPAP intolerance include:
If these issues sound familiar, you are not alone. It does not mean you have to live with untreated OSA. It simply means it is time to explore other evidence-based treatments.
Successful surgical treatment is not a one-size-fits-all approach. The key is to precisely identify where your airway is collapsing. Obstruction can occur at one or multiple levels. This includes the nose, the soft palate, or the base of the tongue.
To create a personalised surgical plan, an ENT specialist performs a comprehensive assessment. This may involve:
Based on your unique anatomy, a targeted surgical plan can be developed. The goal is to physically open or stabilise the parts of your airway that are prone to collapse.
For some patients, nasal obstruction from a deviated septum or enlarged turbinates is a major contributing factor. Procedures like a septoplasty or turbinate reduction can significantly improve nasal airflow. This may be enough to treat mild OSA. It can also improve your ability to tolerate CPAP therapy if you choose to continue with it.
If the obstruction is at the level of your soft palate or uvula, surgery can be performed to stiffen or remove excess tissue. The most common procedure is a Uvulopalatopharyngoplasty (UPPP). This surgery trims and repositions tissue at the back of the throat to create a wider airway.
When the airway collapses behind the tongue, a different set of procedures is needed. These can include:
It is important to have realistic expectations. The goal of surgery is not always a complete “cure”. Instead, it is a significant improvement in your health and quality of life. Success is typically defined as reducing your AHI by at least 50% and achieving an AHI of less than 20.
Success rates vary depending on the procedure and the individual patient’s anatomy. They are often high in carefully selected candidates. Critically, factors like your Body Mass Index (BMI) and the severity of your OSA play a significant role in the outcome.
You may be a good candidate for OSA surgery if you meet the following criteria:
If you are struggling with CPAP and feel trapped by your sleep apnoea, you have other options. A comprehensive assessment is the first step towards finding a lasting solution that works for you.
If you are ready to explore alternatives to CPAP, contact us today to schedule a consultation with Dr Nguyen at one of his convenient locations in Gledswood Hills, Liverpool or Forster.
