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Q&A: Surgery for Sleep Apnea

I recently was diagnosed with obstructive sleep apnea (OSA). I’ve been advised by my doctor to use a continuous positive airway pressure (CPAP) device overnight, but I can’t get used to it. I’ve read that there is a surgical procedure that can help OSA—should I have this surgery?

In OSA, the muscles of the upper throat essentially collapse while you sleep, blocking the airway. This interrupts breathing, resulting in brief arousals as the brain signals the upper airway muscles to contract. A CPAP machine helps prevent this by delivering a steady flow of air through a mask or nasal cannula to help keep your airway open as you sleep. But—as you are finding—it can be difficult to get used to CPAP. You may be put off by the flow of air, or perhaps you’re waking with a sore throat after using the machine overnight. I do encourage you to stick with CPAP, though, since the surgical procedure you reference only helps about half of people who undergo it, and any benefits usually wear off over time. During the surgery, some of the tissue at the back of the mouth and upper throat is removed, including all or part of the uvula (the flap of tissue that hangs down at the back of your throat). The procedure is unpleasant and the recovery period is extremely painful (I speak from experience). As with other surgeries, there is a risk of infection and bleeding.

I have used a CPAP machine myself for years, and like you, I had difficulty getting used to it. Some strategies that I found helpful included switching from a full-face mask that covered my nose and mouth to a smaller mask that covers the lower portion of my nose. You also might want to look at machines that incorporate a humidifier, since this can help you avoid a sore throat the next day.

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