Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is a condition that affects nearly 18 million Americans. It is a result of multi-level airway collapse, resulting in a cessation or reduction in breathing during sleep. This causes a decrease in blood oxygen levels. The most common finding in OSA is increased daytime fatigue. Patients are also known to suffer from mood disturbances and decreased productivity. OSA is also linked to many medical problems as well, such as high blood pressure, heart disease and hearing loss, to name a few.

CPAP was intolerable for me for 2 years. I tried multiple masks without improvement. I never had my airway examined and after Dr. Anand found my source of blockage, a tonsillectomy and septoplasty were performed. My tolerance of CPAP has greatly improved and my wife and I sleep better as a result.  –JM

Many patients are accurately diagnosed with OSA, however, few patients actually undergo a full airway examination to precisely locate their sources of airway collapse. By accurately defining the nature of a patient’s obstruction, specific treatments can be discussed to improve a patient’s breathing during both day and night.

The Role of Surgery for Sleep Apnea
Case Studies

Initial Visit

During your initial visit, a focused history is carried out to assess your level of daytime fatigue. In addition, a complete airway examination is performed using flexible laryngoscopy. This office procedure allows us to examine the entire upper airway and determine your likely sources of airway obstruction contributing to obstructive sleep apnea.

Diagnosis

After completing the initial history and physical exam, a sleep study may be recommended to classify the severity of your obstructive sleep apnea. Sleep studies can be performed in a designated sleep lab or in the comfort of your own home. If you have already been diagnosed with obstructive sleep apnea via an outside sleep study, we request you bring the results of that study during your visit.

Treatment

After reviewing your sleep study results, treatment recommendations are made based on your anatomic exam and severity of obstructive sleep apnea. These include oral appliance therapy, CPAP, in-office procedures or surgical treatments. All options are discussed to fully educate the patient on every treatment option.

Obstructive Sleep Apnea FAQ

What type of pain control is provided after Sleep Apnea Treatment?

At GNO Snoring and Sinus we have developed a unique postoperative pain protocol that combines both anesthetic and narcotic medications. As patients with Obstructive Sleep Apnea should not utilize high level of narcotic medication, we rely mainly on compounded anesthetic medication. With the assistance of a local compounding pharmacy, we have developed anesthetic popsicles and lollipops that provide significant pain relief for patients in the postoperative period. This decreases a patient’s reliance on narcotic medication, as well as the associated risks.

How many surgeries are required to perform multi-level airway surgery?

One! We do not require patients to endure multiple trips to the operating room to complete treatment. We have pioneered a treatment protocol that allows us to perform multi-level airway surgery in a single trip to the operating room, thereby decreasing the risk associated with multiple surgeries at different times.

What is the difference between in office and surgical treatment options for Obstructive Sleep Apnea?

The overall principle is the same, namely, multi-level treatment. In the office we have the ability to treat nasal, palatal, and lingual obstruction. This does not require general anesthesia and the post procedure discomfort is less than surgical intervention. In office treatments are reserved for those patients with select anatomic findings and a certain level of obstructive sleep apnea.

What is the difference between single level and multi-level surgery?

Single level airway surgery addresses one site of obstruction, whereas multi-level airway surgery addresses multiple sites. In terms of obstructive sleep apnea, the levels are broken down into nasal, palatal, lingual, and laryngeal. An in office airway exam is used to determine your likely source of obstruction and treatment is discussed afterwards. Studies have shown that multi-level airway surgery is more effective at managing sleep apnea than single level surgery. This makes sense as Obstructive Sleep Apnea is a condition of multi-level airway obstruction.

What is the difference between a home sleep study and an in-lab sleep study?

In-lab sleep studies are a comprehensive tool in the diagnosis of sleep disorders. They are conducted and supervised by a sleep technologist, an expert in the field of administering sleep studies. Home sleep studies do not provide the level of data that an in-lab study does, nor are they supervised by a sleep technologist, however, they provide enough data to arrive at a diagnosis of OSA. Studies have shown that in certain patient populations, home sleep studies are just as accurate as in-lab sleep studies. As a result, home sleep studies are an excellent diagnostic tool for most patients, with in-lab sleep studies reserved for patients who require more extensive testing.

Metairie Office of ENT doctor