Sleep surgery refers to a range of procedures used to treat a variety of conditions that affect your breathing and your ability to sleep, including the following:
- Adenoid hypertrophy (enlarged adenoids)
- Allergic rhinitis
- Gastroesophageal reflux disease (GERD). Many people with obstructive sleep apnea also have GERD. Some studies have shown that treating obstructive sleep apnea can improve GERD symptoms.
- Nasal obstruction, such as a deviated septum or nasal valve collapse
- Obstructive sleep apnea (OSA)
- Tonsillitis (infected tonsils) or tonsil hypertrophy (enlarged tonsil tissue)
Sleep surgeons at Rush offer advanced surgical treatments, including minimally invasive options, for people with obstructive sleep apnea and other disorders who can't tolerate nonsurgical therapies, such as continuous positive airway pressure (CPAP). These procedures can help you safely breathe when you go to sleep at night, dramatically improving the quality of your sleep.
Rush is now a treatment site for patients to receive upper airway stimulation therapy with the Inspire device, which was FDA approved in 2014.
How are sleep disorders diagnosed?
If a sleep study reveals that you have an anatomical cause of your sleep problems (such as obstructive sleep apnea), we recommend that you have a full upper airway evaluation with specialists in the Section of Sleep Surgery at Rush. More advanced tests, including the following, will help us pinpoint the exact type and severity of the problem.
- Drug induced sleep endoscopy: an outpatient procedure that enables doctors to evaluate your airway while you sleep. This study shows why and where your breathing is being blocked, which helps the sleep surgeon choose the best treatment options.
- Nasal endoscopy: a procedure that is performed in the doctor's office to examine your nasal cavity. This test helps doctors diagnose conditions such as sinusitis, deviated septum, turbinate hypertrophy and nasal polyps.
- Awake flexible laryngoscopy: also performed in the doctor's office, this procedure helps doctors examine your nasal cavity, throat and larynx (voice box). It helps diagnose conditions such as sinusitis, deviated septum, turbinate hypertrophy, GERD, obstructive sleep apnea, throat cancer, difficulty swallowing (dysphagia) and hoarseness.
Do I need sleep surgery?
Not everyone who snores or has obstructive sleep apnea needs sleep surgery. You could be a good candidate for sleep surgery if the following statements are true:
- You have been diagnosed with an obstruction in the nose and/or mouth that is affecting your ability to breathe, especially while you are asleep
- You are not able to tolerate nonsurgical treatments, such as continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) therapy
- You do not have any major medical problems that would make any type of surgery high risk
Types of sleep surgery
Breathing problems occur in three main areas:
- Soft palate (the soft tissue toward the back of the roof of the mouth)
Sleep surgeons at Rush are dedicated to helping you find the right procedure to address your individual needs. They offer a variety of surgical procedures to treat both common and complex problems, including the following:
- Used to treat adenoid hypertrophy, a condition in which the adenoids (glands in the back of the nose) are enlarged, causing difficulty breathing, obstructive sleep apnea or chronic sinus disease
- Most commonly performed in children, but some young adults may need to have their adenoids removed
Endoscopic sinus surgery
- May be recommended for people with sinusitis who do not respond to medical therapy
- A minimally invasive procedure used to open blocked sinus drainage pathways and allow mucus to flow more freely
- Also used to treat nasal polyps or inflammation in the nose, which can affect the quality of a person's sleep
- Usually done under general anesthesia as an outpatient procedure
Nasal turbinate surgery
- Used to treat turbinate hypertrophy, a condition where the tissue lining the large bones in the nose becomes enlarged, causing nasal airway obstruction and difficulty breathing
- May be recommended to reduce the size of the nasal bones
Nasal valve surgery
- Used to treat severe nasal obstruction due to nasal valve collapse, a common cause of airway obstruction. Many people who feel relief with Breath-Right strips have this problem.
- A variety of techniques are available; your surgeon will work with you to determine which one is right for you
- Used to treat a deviated septum, when the wall (nasal septum) that separates the nostrils is off center, causing difficulty breathing through the nose
Soft palate procedures
Palatopharyngoplasty (originally known as uvulopalatopharyngoplasty, or UPPP)
- May be recommended if the palate is a major source of airway obstruction
- Involves repositioning muscles in the throat and/or removing excess palate tissue to open the space in the back of the throat for improved breathing at night
- There are different ways to do the procedure, and your sleep surgeon will work with you to determine which one is right for you. Sleep surgeons at Rush offer the most current techniques, including expansion sphincter pharyngoplasty and lateral pharyngoplasty.
Radiofrequency ablation of the palate
- Used to treat snoring caused by issues with the palate
- An outpatient procedure performed under local anesthesia in the doctor's office
- May need to be repeated to achieve desired results
Throat surgery and procedures
- Used to treat obstructive sleep apnea caused by enlarged tonsil tissue at the back of the tongue
- Surgeons either reduce the size of the tissue or remove part of it to help open the airway and allow for better breathing at night
Radiofrequency ablation of the tongue base
- Used to treat obstructive sleep apnea caused by an enlarged tongue
- Under general anesthesia, a small probe is inserted into the tongue and used to heat the tissues, reducing the size of the tongue
- May need to be repeated to achieve desired results
- Used to treat tonsillitis (infection) or tonsil hypertrophy (enlarged tonsils)
- Tonsils are removed through the mouth using a heated energy device that minimizes bleeding
- Although it is an outpatient procedure, if you have obstructive sleep apnea or other serious health conditions, you may have to stay overnight for observation
- Used in very rare circumstances to treat OSA when all other treatments have failed and your sleep apnea is causing severe medical complications
- Used to create an opening in the windpipe (trachea) and place a plastic tube to help you breathe
- Most often used for people with severe respiratory disease who need a ventilator to breathe, as well as those with head and neck tumors that are blocking the airway
Upper airway stimulation therapy (e.g., Inspire)
- An innovative treatment for patients with moderate to severe obstructive sleep apnea who cannot tolerate CPAP therapy
- Involves implanting a small stimulator under the skin that stimulates the throat muscles while you sleep to prevent them from collapsing
- Rush is one of only a handful of sites in the U.S. to offer this treatment using the Inspire hypoglossal nerve stimulator implant
Why choose Rush for sleep surgery
- Experienced specialists: The Section of Sleep Surgery is dedicated to treating conditions that affect breathing and sleep. Our multidisciplinary team has the experience and expertise to diagnose and address your problem, whether it's mild snoring, an isolated nasal or tonsil obstruction, or severe obstructive sleep apnea.
- Advanced treatments: Sleep surgeons at Rush offer all of the latest treatments. This includes minimally invasive procedures that can reduce pain and side effects, and innovative treatments like upper airway stimulation therapy that are not yet widely available.