Surgery Proves Effective for Sleep Apnea

Study Suggests Slight Survival Advantage for Surgery

From the WebMD Archives

Sept. 19, 2003 -- New research suggests that surgery is an effective, and too often overlooked, treatment for many people with sleep apnea.

Sleep apnea occurs when the airway repeatedly becomes blocked during sleep, causing breathing to stop for 10 seconds or longer, sometimes hundreds of times a night. Treatment is key because people with sleep apnea who remain untreated have an increased risk of dying from heart disease (resulting from a rise in blood pressure when oxygen levels drop).

The most widely used treatment for sleep apnea is CPAP -- continuous positive airway pressure. The treatment involves wearing a mask while sleeping at night -- something that many people cannot or will not do. Millions have sleep apnea and don't know it, and many others have been prescribed CPAP, but don't use it.

Researchers for the study followed a group of veterans for one to five years. Each was treated with either surgery or CPAP for obstructive sleep apnea -- named so because it's usually due to a blockage from enlarged tissues in the nose, mouth, or throat.

They found that the group treated with surgery had a slight (22-day) survival advantage over those prescribed CPAP. The findings are to be presented at the annual meeting of the American Academy of Otolaryngology Head and Neck Surgery this month.

It was not clear if the CPAP patients actually used the pressure masks, however. Even though the treatment has been proven highly effective, many patients don't like to wear the devices and compliance is a major problem. Studies indicate that most patients who use CPAP during sleep do so only about half the time.

"We can't say from these data that surgical therapy is superior to CPAP," researcher Edward M. Weaver, MD, of the University of Washington tells WebMD. "But we can definitely say that if a patient isn't using CPAP or is only using it occasionally, they should be considered for surgical therapy."

5 Times the Risk for Heart Disease

It is estimated that as many as 18 million Americans have sleep apnea. The condition is linked to an increased risk of heart attack and stroke. One study found that men with the disorder were five times more likely to develop heart disease.