QUESTION 1: How is sleep apnea treated?
ANSWER: It is possible to treat sleep apnea surgically or with non-surgical medical treatments. The most effective treatment of the disease is the application of positive airway pressure, known by the abbreviation PAP. In this treatment, the upper airway is kept open by giving compressed air through the patient's nose or mouth and nose with the help of a mask. The aim of surgical treatments is to prevent obstructions that cause respiratory events by expanding the upper airway at the level of the palate and tongue root.
QUESTION 2: Can everyone use PAP treatments?
ANSWER: Despite their effectiveness, PAP treatments, often called mask treatments, have significant disadvantages. Almost half of the patients recommended PAP treatment cannot use this treatment. Various reasons such as the feeling of suffocation, inability to fall asleep with a mask, and difficulty in breathing against pressure limit the use of PAP therapy. Another reason that negatively affects the use of PAP therapy is the necessity of using this treatment every night and for life. Many patients reject the idea of being dependent on a device for life, especially in younger patients, PAP usage rates are known to be low; Some of the patients who start using the device stop the treatment after a certain period of time. However, it should not be forgotten that PAP applications are the most effective treatment for sleep apnea.
QUESTION 3: Does nasal congestion interfere with PAP treatment?
ANSWER: In the treatment of PAP, compressed air is given to the patient through the nose, so it is essential that the patient's nose is healthy. ENT examination is essential before PAP treatment, even if patients do not have complaints. PAP therapy can be used more comfortably and effectively when the problems of patients with blocked nose for any reason are resolved.
QUESTION 4: Are surgical treatments successful in the treatment of sleep apnea?
ANSWER: Surgical treatments are definitely included in the treatment of sleep apnea. With surgical treatments, it is aimed to alleviate the severity of the disease, reduce the complaints and reduce the risk of cardiovascular disease. These goals are often achieved with appropriate surgical treatment. The success of surgical treatments largely depends on appropriate patient selection. The success rate is high when patients with a high probability of responding to surgical treatment are selected and correct surgical interventions are applied.
QUESTION 5: Is the same surgical treatment applied to every patient with sleep apnea?
ANSWER: The surgical treatment of sleep apnea is individual. The upper airway structure of each patient is different. The location and shape of the obstructions that lead to respiratory events differ from person to person. Naturally, it is not possible to obtain the same results in all patients with the same surgical methods.
QUESTION 6: How is the appropriate surgical treatment determined in a patient with sleep apnea?
ANSWER: Patients with sleep apnea undergo a detailed ENT examination, in which the entire upper airway (palate level, tongue root level) is evaluated by endoscopic methods. A number of special inspection methods can be applied to determine the areas where the blockage occurs. If a more detailed examination of the location and form of the obstruction is required, sleep endoscopy, that is, endoscopic examination while the patient is put to sleep with medication, can be applied.
QUESTION 7: What interventions does the surgical treatment of sleep apnea include?
ANSWER: We can group surgical interventions as “nose”, “palate level” and “tongue root level” surgeries.
The aim of nasal surgeries is to widen the patient's nasal passage and to remove obstructions. Septoplasty, nasal valve surgeries, endoscopic sinus surgeries can be applied when needed.
Palatal surgeries are generally classified under the title of "pharyngoplasty" surgery. Procedures such as removal of the tonsils, repositioning of the palate muscles, interventions for the uvula, some suturing techniques and enlargement-stretching of the palate are selected in various combinations according to the needs of the patient.
The aim of tongue root surgery is to reduce the excess tissues in the tongue root and to position the tongue root in a way that expands the airway. For this purpose, partial removal of the tongue root or surgery that will change the skeletal structure of the lower jaw can be applied.
QUESTION 8: Is high technology used in sleep apnea surgery?
ANSWER: High technology is frequently used in apnea surgery. Radiofrequency, coblator and robotic surgery applications have become indispensable in apnea surgery.
QUESTION 9: What else can be done in treatment other than PAP treatments and surgery?
ANSWER: It is possible to achieve very successful results when oral appliances that allow the lower jaw to be positioned forward and positional treatments that allow the patient to lie on their side are applied correctly.
Although intensive studies continue today, there is no drug treatment with proven efficacy yet. Weight loss bariatric surgeries are very useful in overweight or obese patients. Regardless of which surgical or non-surgical treatment is applied; It is beneficial to lose weight, quit smoking and alcohol use, and exercise regularly.
QUESTION 10: Do surgical treatments that change the skeletal structure work in sleep apnea disease?
ANSWER: Surgery in which the lower jaw or the lower and upper jaws are brought forward together is very effective in the treatment of sleep apnea. However, these surgeries are performed after a long and laborious preparation period. The application is much more difficult than the soft tissue surgeries mentioned above. Highly effective results can be achieved in selected patients.