Surgical Treatment for Sleep Disorders
Certain sleep disorders may be best treated with minimally invasive surgical interventions or medications. In many cases, these are not the first choice, but may become necessary in the event of failure of other treatments.
Uvulopalatopharyngoplasty, more comonly known as UPPP, is a procedure used to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate).
UPPP is offered to sleep apnea patients who opt for a more comprehensive surgical procedure called "The Stanford Protocol", first attempted by Doctors Nelson Powell and Robert Riley of Stanford University. The Stanford Protocol is essentially a "cocktail" of surgeries that aim to address the entire airway and thereby treat (or possibly cure) sleep apnea. It has been found that obstructive sleep apnea usually involves multiple sites where tissue obstructs the airway; the base of the tongue is often involved. The Protocol successively addresses these multiple sites of obstruction.
Correction of Deviated Septum (Septoplasty)
The most common symptom from a deviated septum is difficulty breathing through the nose which may also result in sleep issues. The symptoms are usually worse on one side, and in some cases the drainage of the sinuses is curtailed and results in repeated sinus infections. A deviated septum may be present at birth, caused by an injury, or result from damage from previous medical treatments.
Septoplasty is a reconstructive plastic surgery performed to correct an improperly formed nasal septum. The procedure is performed entirely through the nostrils. During the procedure, badly deviated portions of the septum may be removed entirely or they may be readjusted and reinserted into the nose.
Septoplasty may be performed with the traditional open surgical technique from inside the nose. When open surgery is performed, small scars will be located on the base of the nose, but they usually are not noticeable. Scarring is not visible when internal surgery is performed. Depending on the severity of the deviation, septoplasty may be performed in:
- A surgeon's office
- An outpatient surgery center
- A hospital as an outpatient
- A hospital as an inpatient
The surgeon will provide guidelines for resuming normal activities. Many patients are up and around within a few days and able to return to school or sedentary work in a week or so.
Medicinal Treatment of Sleep Disorders
In some cases, doctors may prescribe drugs for the treatment of sleep disorders. Advances in pharmaceuticals have allowed doctors to prescribe sleeping medications to patients that do not negatively impact their lives. Sleeping medications have become more effective and less addictive over the years – allowing individuals to use them with greater confidence. It is important to take all medication as prescribed, and understand each medication's impact on your cognitive and physical abilities. Be sure to talk with your healthcare provider about all medications (over the counter and prescriptions) that you may be taking. Medications should be used in combination with good sleep practices.