Surgery

In one review of studies, 20% of patients who had UPPP required tracheostomy afterward. Most of these complications can be avoided with proper technique and experienced surgeons.

Laser-Assisted Uvulopalatoplasty (LAUP)

A variation on UPPP called laser-assisted uvulopalatoplasty (LAUP) is being increasingly performed to reduce snoring. It removes less tissue at the back of the throat than UPPP and can be done in a doctor's office. At this time, however, long-term success rates from LAUP are very modest, particularly for reducing apneas. Some doctors, in fact, are concerned that if LAUP eliminates snoring, then a diagnosis of apnea may be missed in patients who have the more serious condition.

More than 50% of patients complain of throat dryness after surgery. Throat narrowing and scarring have also been reported. In a minority of patients, snoring becomes worse afterward.

Pillar Palatal Implant

The pillar palatal implant is a noninvasive surgical treatment for mild-to-moderate sleep apnea and snoring. It helps reduce the vibration and movement of the soft palate. In this procedure, a doctor inserts 3 short pieces of polyester string into the soft palate. The procedure can be performed in a doctor’s office and takes about 10 minutes. Unlike uvulopalatopharyngoplasty (UPPP), the pillar procedure requires only local anesthesia. Studies indicate it works as well as UPPP, with less pain and quicker recovery time.

Tracheostomy

Tracheostomy used to be the only treatment for sleep apnea. It is quite straightforward:

• The surgeon makes an opening through the neck into the windpipe and inserts a tube.
• It is almost 100% successful, but it requires a quarter-size opening in the throat. This produces a number of medical and psychological problems associated with recovery.

Today, this operation is performed rarely, usually only if sleep apnea is life-threatening.

Radiofrequency Ablation

A technique called radiofrequency ablation uses radiofrequency energy to shrink tissues in the upper airways:

• The radio waves heat, stiffen, and shrink a small amount of tissue at the base of the tongue.
• The therapy takes about 20 minutes and can be done in a doctor's office.
• It typically requires 10 treatments within five or six sessions. (A newer form requires fewer treatment sessions, and it appears to be effective.)
• It is far less invasive than standard surgery and results in far less pain and fewer complications. Discomfort can be controlled with simple pain relievers.