Sleep Apnea and Surgery

Sleep apnea, which is characterized by cessation of breathing during sleep, is a state of sleep disorder that may have serious consequences. The most common symptom of sleep apnea, which decreases the general quality of life with reduced sleep quality and may also lead to heart diseases, paralysis, hypertension and sudden deaths, is sudden and severe snoring as well as cessation of breathing during sleep. Apart from snoring, sleep apnea also has symptoms such as dry mouth, frequent urination, restlessness during sleep, headache in the morning, insomnia, lack of concentration and poor performance, and these symptoms may differ from person to person.

What is Sleep Apnea?

Sleep apnea is a sleep disorder that causes breathing to stop repeatedly during sleep due to blocked airways. While those with sleep apnea is sleeping, their breathing is interrupted in periods of at least 10 seconds. Meanwhile, the oxygen rate in the blood decreases; the decrease in the oxygen rate in the blood prepares the ground for various health problems, including hypertension, heart diseases and memory problems.

“It is not possible for people with sleep apnea to have good-quality sleep since their sleep is interrupted during the night. Sleep apnea causes the person to have a headache during the day when waking up in the morning, and makes her/him sleepy all day long. This health problem, which triggers to distract people driving in traffic, may lead to traffic accidents.

Risk Factors for Sleep Apnea

It is divided into two different types as obstructive sleep apnea and central sleep apnea. While “obstructive sleep apnea” occurs as a result of obstruction of the airways, there is no obstruction in the airways in the central sleep apnea, but the brain cannot transmit signals to the muscles of respiration due to problems in the respiratory control center.

Risk factors that may cause sleep apnea can be listed as follows:

Obesity: Fat accumulation in the neck may cause the upper airways to become blocked while breathing.
Neck width: People with a thick neck usually have narrower airways.
Narrow airways: Some people have genetically narrow airways. Airways may also narrow due to enlarged tonsil and adenoid especially in childhood.
Being a male: Sleep apnea is more common in males than in females.
Age: If the muscles surrounding the airways start to lose their functions with advancing age, they may lead to sleep apnea.
Nasal obstruction: Nasal valve stenosis, septum deviation, or any anatomical deformity that prevents nasal breathing may increase the risk of sleep apnea.

Apart from all these factors, the abnormal enlargement of the tongue (macroglossia),small mandible (micrognathia),the posterior displacement of mandible (retrognathia),genetic factors, tranquillizers, regular sports, smoking and alcohol consumption are known to be among the risk factors for sleep apnea.

Sleep Apnea Diagnosis and Sleep Apnea Surgery

Sleep apnea test called “polysomnography” is performed in order to be able to establish a final diagnosis for people who experience symptoms of sleep apnea. During polysomnography, respiration data and brain activities of individuals are recorded during the night.

The treatment is planned for the causes of sleep apnea. Sleep apnea, which can be controlled from time to time by losing weight or changing life habits, can be eliminated by continuous positive airway pressure therapy, also known as CPAP, depending on the cause. If non-invasive treatments are at a dead end, surgery may need to be planned for the cause of sleep apnea.

As part of sleep apnea surgery, concha bullosa surgery, nasal valve surgery, endoscopic sinus surgery, septoplasty, adenoidectomy, palatal and tongue base surgery can be performed.

“After the detailed checks of my patients with sleep apnea, I recommend “anterior palatoplasty”, commonly known as the anterior hanging soft palate, when surgery is required. During this surgical procedure, which has a high success rate in selected patients, a rectangular strip is removed in order to reduce the volume and vibration of the soft palate and open the airways. After this procedure, which is performed under local or general anesthesia, the palate is stretched and the airways are opened.