New Options Offered for Sleep Apnea

ByABC News
May 18, 2009, 8:52 PM

May 19 -- MONDAY, May 18 (HealthDay News) -- Two new treatments -- one surgical and the other an appliance that adjusts the jaw -- might help people with sleep apnea, which has proven tough to treat.

In sleep apnea, the upper airway becomes blocked, and people stop breathing during sleep, usually in 10- to 20-second bouts that can occur 30 or more times an hour. The problem is usually treated with a device that increases air pressure in the throat, keeping the airway open. Called continuous positive airway pressure, or CPAP, the therapy involves wearing a mask attached to a machine.

Though effective, many people find it uncomfortable.

"Whilst continuous positive airway pressure is the gold standard treatment, it does not adequately serve all patients, with some that fail to tolerate treatment and others that simply refuse treatment," said Dr. Neville Patrick Shine, of St. Johns Hospital in Edinburgh, Scotland, and the lead author of a study that tested a surgical treatment for sleep apnea.

The surgery, called transpalatal advancement pharyngoplasty, enlarges the space behind the roof of the mouth.

When the obstruction is significant, "the choice may lie between surgery or no treatment, with the potential attendant cardiovascular and neurocognitive sequelae of sleep apnea," Shine said. "So in this cohort, transpalatal advancement surgery offers a reasonable treatment option."

For the study, Shine and his colleague Dr. Richard Hamilton Lewis, from the Royal Perth Hospital in Perth, Australia, reviewed the medical records of 60 people who had this surgery to treat sleep apnea.

The researchers looked for reductions in sleep disturbances and increases in the amount of oxygen in the individual's blood. With these criteria, the surgery was deemed successful in 38 people. Sleep apnea was cured in 21 people.

"One of the limitations of the procedure is the inability to accurately predict the positive responders to surgery from preoperative characteristics, and all patients undergoing this surgery must be made aware of this fact," Shine said.