Patient Information
Diagnosing and treating snoring and sleep apnea is a process that requires many steps in order to find the most effective individualized care for patients. Ear, nose, and throat (ENT) doctors can play a role in both the diagnostic and treatment processes, but typically are the doctors performing surgery if needed. Though a patient may see an ENT specialist first, it usually is recommended that patients be evaluated at a sleep lab or center before surgery is considered. UPMC’s Sleep Medicine Center is an example of one of these types of labs that performs sleep studies and is the only multidisciplinary sleep medicine facility accredited by the Academy of Sleep Medicine in western Pennsylvania. To learn more about sleep studies, tips on improving sleep, and UPMC’s Sleep Medicine Center, click on this link:
http://sleepmedicinecenter.upmc.com
Conditions/Disorders Treated
Sleep Apnea
Sleep apnea is a condition in which breathing is repeatedly interrupted during sleep. The time period for which the breathing stops is usually 10 to 30 seconds. When these episodes occur repeatedly, sleep apnea can seriously disrupt the quality of sleep.
Snoring
Snoring occurs when air cannot move freely through the air passages at the back of the mouth and nose. This causes vibration of the roof of the mouth and uvula, which creates the snoring sound. The smaller the airway, the more obstruction, and the louder the snoring becomes.
Your First Visit
It is important for a patient to be prepared for his or her first visit with an ear, nose, and throat specialist about a sleep disorder. Patients will be asked to give a medical family history, detailed sleep history, and health insurance information. During your first visit the doctor will perform a physical examination, throat examination, and may perform a flexible endoscopy. A flexible endoscopy is a painless procedure that lasts between two and three minutes in which the doctor examines inside the nasal cavity, voice box, tongue, and adenoids by inserting a tiny camera in a tube up the patient’s nose. This will allow for the doctor to have an up close perspective and provide a more thorough diagnosis.
Surgical Procedures
Sleep studies are used in the diagnosis process for patients suffering from snoring or sleep apnea. Once the results of a patient’s sleep study are reviewed and therapeutic treatment is considered and attempted, the ENT doctor will determine if surgery and what type of surgery would be beneficial to the patient. The following is a list of surgeries performed at the Center for Snoring and Sleep Apnea to treat sleeping disorders.
Surgical procedures available at Center for Snoring and Sleep Apnea:
Laser Assisted UvuloPlasty (LAUP)
LAUP is an effective therapy for snoring in some patients. This is especially true for patients with snoring due to a long uvula. The procedure is done with local anesthesia in the office.
UvuloPalatoPharyngoPlasty (UPPP)
UPPP is the most commonly preformed procedure for patients with mild to moderate sleep apnea. The procedure requires trimming of the uvula. The tonsils are removed if they are still present. This procedure is done with a general anesthetic. Most patients go home the day of the surgery.
Mandibular Advancement
This procedure is an advancement of a part of the lower jaw that helps pull the tongue forward and may help relieve sleep apnea in some patients. The procedure requires a general anesthetic. Most patients are admitted to the hospital for 24 to 48 hours. The procedure is commonly performed with UPPP.
Maxillo-mandibular Advancement
This surgery requires that both the upper and lower jaws are moved forward. The goal is to increase the room for breathing in the back of the throat. The procedure is sometimes performed on patients who have sleep apnea after performance of UPPP. The surgery requires general anesthesia and admission to the hospital. These jaw surgeries are preformed by our colleagues trained in oral and maxillofacial surgery.
Tracheotomy
During this procedure a tube is surgically inserted into the throat. The tube helps to bypass the area obstructed and is highly effective in relief of sleep apnea. Tracheotomies require hospitalization until the patient is sufficiently trained to care for the tube at home. Most patients can plug the tube during the daytime and go about their usual activities. The tube is unplugged during sleep to relieve the sleep apnea.
Bariatric Surgery
Some patients with severe sleep apnea attributable to excessive weight may benefit from surgical procedures performed to enhance weight loss. These procedures are available through the Department of Surgery.