There is a reported increase in adults seeking surgery to cure sleep apnea. The most common surgery used for this is uvulopalatopharyngoplasty (UPPP).The surgery removes tissue in the throat to expand the airway, reducing the risk of airway collapse. Typically, the surgery removes all or part of the tonsils, adenoids, and soft upper palate. In addition, lasers might be used to try to stiffen tissues that remain so they are less likely to interfere with breathing.
Although the potential promise of this procedure is high, it’s important to understand many aspects of the surgery before deciding that sleep apnea surgery is right for you.
Overall Success Rates Are Low
First, it’s important to understand that the overall success rate for this procedure is generally low. There are many studies out about the effectiveness of the procedure, but you have to look at their results carefully.
This 2009 study published in the Mayo Clinic Proceedings illustrates the point nicely. It looks at the surgery results for 63 patients who had UPPP for sleep apnea. Defining surgical success as a 50% reduction in sleep apnea incidents and/or reducing apnea/hypopnea index (AHI) to 20 or less means the success rate is 51%. If you have been researching sleep apnea, you realize that this leaves a person with relatively significant sleep apnea–at least moderate sleep apnea that still needs treatment.
If you define success as curing sleep apnea so a person doesn’t need treatment, then the success rate is only 24%, or less than one in four.
However, initial surgical success does not guarantee long-term success. For many people, the effectiveness of surgery for sleep apnea and snoring declines over time. About a quarter of patients who see initial success might see symptoms return after several months.
When deciding to get this surgery, you have to balance the true possibility of success against the expense, recovery, and risks associated with surgery.
Your Condition Can Worsen
In addition to a relatively low overall success rate, UPPP has the potential to make your snoring and/or sleep apnea worse.
Removing tissues from the throat should open up the airway, but adverse scarring and tissue regrowth can mean that 10% of people have worse sleep apnea than they did before getting surgery.
In addition, some people who get UPPP for simple snoring (without sleep apnea) develop sleep apnea after surgery.
Understand Cost, Recovery, and Complication Risks
Even a one-in-four chance of eliminating sleep apnea might seem like good odds to some people. However, you have to balance this against the cost and risks associated with UPPP. UPPP is a relatively expensive approach to sleep apnea treatment. It can cost $10,000 or more without insurance, and it can still cost thousands with insurance, depending on the terms of your insurance.
Recovery for UPPP is difficult. Patients generally report high levels of pain during recovery, though this is subjective and varies widely. Recovery can take up to three weeks, and for at least two weeks of that time, you will have a very limited diet.
In addition, there are significant risks of serious complications associated with the procedure. Depending on the type of procedure, serious complications occur in 1.5-4.6% of patients. Fortunately, the risk of death after this type of surgery has declined significantly in recent years. The risk of death following UPPP and variants ranges from 0.09% (9 in 10,000) to 0.19% (19 in 10,000).
Success Rates Can Be High for the Right Candidate
Admittedly, much of the information above seems negative for people considering UPPP. However, there is some good news. Success rates depend on your anatomy. If a doctor properly evaluates your anatomy before surgery, your odds of success can be much higher. When a doctor properly evaluates your anatomy before surgery, your odds of successful treatment go up considerably. For some people, surgical success rates might be as high as 80%.
At the Michigan Center for TMJ and Sleep Wellness, we work with a network of sleep physicians, ear, nose, and throat (ENT) surgeons, and other doctors who we trust to properly evaluate your anatomy and make science-based recommendations on the proper treatment to resolve your sleep apnea.
Oral Appliance Therapy Can Help Residual Sleep Apnea
Many people who get surgery for sleep apnea accept that it won’t cure their condition. They are happy to accept a reduction in sleep apnea because this will decrease their reliance on CPAP.
In fact, for many people getting off CPAP is their main goal for getting surgery. With less severe sleep apnea, oral appliance therapy becomes a much better option for most people.
If you are considering UPPP or another sleep apnea surgery, talk to your physician about this option for support after surgery.
Learn about Sleep Apnea Treatment Near Detroit
If you are looking for a balanced perspective on sleep apnea treatment, sleep dentist Dr. Jeffrey S. Haddad can help. He wants every person with sleep apnea to get the best sleep possible, no matter what treatment they need. He can help you understand your options and will refer you to the appropriate doctor to provide that treatment for you.
Please call (248) 480-0085 or email us today for an appointment at the Michigan Center for TMJ and Sleep Wellness.
