A long-term study of patients who had upper airway surgery has confirmed the benefits for better management of moderate to severe sleep apnoea for people who failed to adapt or are not suited to continuous positive pressure airway (CPAP) therapy, say Flinders University and other experts.
Follow-up checks with 36 of the first 48 patients who had Sleep Apnoea Multi-Level Surgery (SAMS) – which involves repositioning the palate along with minimally invasive tongue volume reduction to increase upper airway flow – found consistently positive improvement in their sleep apnoea symptoms up to three years later, according to new research in Sleep journal.
Almost 1 billion people are living with diagnosed obstructive sleep apnoea (OSA) globally, with the main treatment CPAP tolerated by only about half of those who try it.
Almost 30 per cent of people with OSA wake up very easily with light sleep and other problems caused by minor airway narrowing – with the condition likely to cause adverse consequences and potential comorbidities which could take years off their life if untreated or unmanaged.
“The benefits include less disrupted sleep and daytime drowsiness, less snoring in some cases and better general health, an important consideration given we know sleep loss can lead to diabetes, cardiovascular and stroke, obesity, depression and anxiety and other issues,” says Professor Simon Carney, an ear, nose and throat (ENT) specialist at Flinders.
“It’s very exciting to see so many patients who had the surgery getting a better night’s sleep with reduced snoring that is likely to lead to fewer long-term health risks,” says Professor Carney.
“Clarity about the long-term benefits of pharyngeal airway surgery is necessary because the alternative CPAP or a mandibular advancement splint are affected by usage, and real-life effectiveness of these therapies are often suboptimal.
“If patients receive inadequately treatment, their lifestyle is impacted and they are at risk of serious long-term morbidity.”
Professor Carney says the selective use of this palate surgery can substantially reduce the number of night-time apnoea events without the need for CPAP machines which are often cumbersome to use and so not regularly used long-term or during travel while away from home.
About half the 102 people recruited for the SAMS trial were randomly assigned the surgery while the rest continued to receive the best possible medical treatment.
