Sleep Apnea Surgery

Sleep Apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing during sleep. There are three forms of sleep apnea: central (CSA), obstructive (OSA), and complex or mixed sleep apnea (a combination of central and obstructive).

Central Sleep Apnea occurs when breathing is interrupted by a lack of respiratory effort. The brain's respiratory control centers are imbalanced during sleep. Blood levels of carbon dioxide, and the neurological feedback mechanism that monitors them do not react quickly enough to maintain an even respiratory rate. The entire system will cycle between apnea and hyperpnea, even when awake.

Obstructive Sleep Apnea (OSA) occurs when the upper airway (nose or throat) temporarily collapses during sleep. OSA patients typically suffer from low oxygen levels in the blood, high blood pressure, and an overall decrease in the quality of life due to daytime drowsiness and fatigue.

If the physician believes a patient may have sleep apnea, it can be diagnosed with an overnight sleep test called apolysomnogram, or "sleep study". This test can either be done in a sleep lab or in the convenience of the patient’s home with the Watermark Medical® Apnea Risk Evaluation System (ARES™).

Uvulopalatopharyngoplasty (UPPP)

Uvulopalatopharyngoplasty (UPPP) is a procedure commonly done for patients with OSA. The surgery is done to remove excess tissue in the throat in order to widen the airway. This sometimes can allow air to move through the throat more easily when you breathe. Tissue that is removed can include the uvula (finger shaped piece that hangs from the roof of the mouth into the throat), part of the soft palate, tonsils, and/or adenoids.

Side Effects / Risks

The most common complications with UPPP include bleeding, dehydration, and temporary airway obstruction due to postoperative swelling.

  1. Post-operative bleeding may occur is some cases, which is usually immediately following the post-operative period.
  2. Dehydration is also a common risk due to painful swallowing after surgery. It is important to keep fluid intake constant to avoid dehydration.
  3. Temporary airway obstruction due to postoperative swelling is an uncommon risk that may occur. After surgery, patients are kept in a 23 hour observation period to eliminate any risk of swelling.

Pre-Operative Instructions

When the decision for surgery has been made, the office will try to determine a day that is most convenient for you. Once the surgery day is confirmed with the hospital, you will need to contact your family doctor and schedule a preoperative appointment within 30 days of your surgery day. You should obtain a History and Physical as well as any necessary blood work.

You will be contacted by the hospital on the business day before your procedure. You must arrive at the hospital two hours prior to your scheduled time. This allows the staff enough time to prepare you for your procedure.

The outcome of your surgery is as important to us as it is to you. In order to obtain the best results with your procedure, we would like you to follow a few simple rules.


Two Weeks Before Surgery

  1. Do not drink alcohol for two weeks prior and two weeks after surgery.
  2. Absolutely DO NOT take any aspirin, aspirin-containing products, ibuprofen (Advil®, Aleve®, Motrin, etc). The only “safe” pain medication that is permitted is Tylenol. Do not buy any over the counter pain medications without checking with the Doctor first.
  3. DO NOT take Vitamin E. It is known to increase bleeding during surgery. If you are on any medications that affect bleeding such as coumadin, warfarin, or plavix please notify the office as well as your primary physician to discuss important directions on how to stop the medication.

One Week Before Surgery
You will need to schedule an appointment at our office one week prior to your surgery. Please bring your History and Physical and all labs with you. At your appointment, you will be given prescriptions for an antibiotic and pain management. These will all be used following your surgery. Please fill these prescriptions before your surgery so you will have them ready for use when you return home after your surgery has been completed.

The Day Before Surgery
NOTHING TO EAT OR DRINK AFTER MIDNIGHT. No water or gum chewing either. Your procedure will be cancelled if you do not follow these directions.

Post-Operative Instructions

After surgery, no strenuous activity or play for two weeks. Avoid bending, lifting, or straining. You may still brush your teeth but no gargling or clearing your throat. An appointment should be made at our office seven days after surgery.

Diet
The most important aspect of your diet after surgery will be to avoid dehydration. You may begin with clear liquids, soft foods, and advance to a regular diet as tolerated. Try to avoid citric or pulpy juices.

Medications
Pain medication as well as antibiotics will be given at the time of the pre-operative appointment. Please note that pain can last anywhere from seven to fourteen days. Use only the medication prescribed. Do not use Advil or Motrin products for the first week of surgery. It is common to have an increase in pain after the first 5 days of surgery. Continue to take antibiotics and medication as directed.

Notify the Office

  1. If you have bleeding
  2. Are not able to eat or drink
  3. Have three episodes of nausea and vomiting
  4. Fever above 101° F