Sleep disorders are a common health problem that greatly impacts quality of life, causing fatigue, poor focus, and daily difficulties. Treatments like medications or behavioral therapy are often used, but they may fail to deliver adequate results. Here, the role of endoscopic surgery for sleep disorders emerges as an advanced medical option that significantly and safely improves sleep quality.
What are sleep disorders?
Sleep disorders are conditions that affect the quality, quantity, and timing of sleep, negatively impacting a person’s ability to function correctly when awake.
- Obstructive sleep apnea (OSA): A breathing disorder that causes you to stop breathing for more than ten seconds during sleep.
- Chronic insomnia: One of the most common sleep disorders, the patient is unable to initiate or maintain sleep.
- Periodic limb movement is a disorder characterized by repetitive and cyclical movements, often in the legs, that occur during sleep and include knee or ankle bending, and may last for several minutes or hours on a regular basis.
- Chronic snoring: A raspy sound made during sleep, snoring is an early sign of a sleep disorder.
Comparison of different sleep disorder treatments
The methods of treating sleep disorders vary according to the type and severity of the condition, and include multiple options that start with behavioral and pharmacological treatment, and may reach surgical intervention, and the following table shows a comprehensive comparison between different sleep disorder treatments in terms of the mechanism of effect, effectiveness, and the main benefits of each option:
| Therapeutic option | Effectiveness of treatment |
|---|---|
| Treatment of other health conditions | Treating medical or psychological causes to improve sleep. |
| Cognitive Behavioral Therapy for Insomnia (CBT-I) | Modify negative behaviors and thoughts to improve sleep quality. |
| Continuous positive airway pressure (CPAP) | A device that pumps air through a mask to keep the airway open during sleep. |
| Bi-level positive airway pressure (BPAP) | An alternative to CPAP, which pumps air at two different pressures for inhalation and exhalation. |
| Oral appliances | Worn during sleep to push the jaw and tongue forward and open the airway. |
| Laparoscopic surgery | These include operations to expand the upper airway, such as nose, jaw, and soft tissue surgeries. |
| Inspire | An implanted device that stimulates the sublingual nerve to prevent sleep apnea. |
| Medicines and supplements | Used for certain sleep disorders, depending on the condition. |
When is surgery used to treat sleep disorders?
Surgery is used to treat sleep disorders in a range of conditions, including:
- Failures of non-surgical treatments.
- – An anatomical obstruction in the upper airway.
- – Doctor’s recommendations based on sleep study tests.
What is endoscopic surgery?
Endoscopic surgery for sleep disorders is a medical procedure in which an endoscope is used to examine the cavity of a hollow body organ, and this type of surgery has several advantages. It is considered a minimally invasive procedure that does not require a surgical incision and does not leave visible scars despite being an operation performed inside the body. This is what distinguishes it from traditional surgery, which often leaves a scar on the skin, requires a surgical incision, and needs a longer recovery period compared to endoscopic surgery.
These features have prompted many doctors to perform endoscopic surgery for sleep disorders as a surgical procedure that provides an accurate examination inside the body. It allows quick recovery and avoids the risks of open surgery operations that may leave scars and permanent effects on the body.
Types of endoscopic procedures for sleep disorders
- Tonsillectomy & Adenoidectomy: A surgical procedure that removes the entire tonsils and adenoids from the back of the throat to solve the issue of poor nasal breathing.
- Uvulopalatopharyngoplasty (UPPP – Uvulopalatopharyngoplasty): It involves removing tissue from the back of the throat, such as the uvula, soft palate, and part of the throat walls.
- Modification of the nasal septum or nasal horns: A surgical procedure that corrects a deviated septum or reduces the size of the nasal horns to correct and improve breathing.
- Hypoglossal Nerve Stimulation: By implanting a small device in the chest that stimulates the hypoglossal nerve, the tongue can be prevented from blocking the airways.
The effectiveness of endoscopic surgery for sleep apnea
Endoscopic surgery for sleep disorders is an effective option, specifically for obstructive sleep apnea, as studies have shown that endoscopic surgery achieves high success rates in reducing apnea symptoms, especially in patients who cannot tolerate the use of a CPAP device. Success rates vary depending on the type of surgery, severity of obstruction, and other factors, and although surgery may not be equally effective for all patients, it remains an alternative and effective option for those who cannot use a CPAP device.
Studies have also shown that endoscopic surgery can improve oxygen saturation during sleep, reduce the number of interruptions, and reduce daytime sleepiness.
Benefits of endoscopic surgery for sleep disorders
The importance of treating sleep disorders with laparoscopic surgery is that:
- Less pain and shorter recovery time compared to traditional surgery.
- Return to daily life within days.
- Minimize the need for sleep medications.
Risks of treating sleep disorders with endoscopic surgery for sleep disorders
Risks of endoscopic surgery for sleep disorders include bleeding, which is common after the procedure but requires medical attention if it continues for several minutes, infection, which is often associated with all surgeries, and in some cases the need for re-intervention.
By drinking plenty of fluids to avoid dehydration, eating soft foods that can be swallowed easily, avoiding physical activity such as sports, and maintaining regular doctor’s follow-up, patients can minimize the potential risks of endoscopic surgery for sleep disorders.
Is endoscopic surgery for sleep disorders effective for all patients?
Although endoscopic surgery for sleep disorders has been shown to be effective in treating sleep disorders and improving breathing in some patients, it is not always the first choice, as it is only relied upon in the following cases:
- An anatomical obstruction in the respiratory tract (such as enlarged tonsils or a deviated nasal septum).
- Failure of non-surgical treatments such as medication or behavioral therapy.
The patient should have a thorough evaluation by a sleep specialist or otolaryngologist before deciding on surgery:
- Perform nocturnal polysomnography.
- Study the patient’s breathing and sleep patterns.
- Examine the airway.
Surgery is best suited in cases where the disorders are related to correctable anatomical factors and the patient has no other health issues that would make surgery unsafe.
In conclusion, endoscopic surgery for sleep disorders is an effective option for patients in whom pharmacological and behavioral methods have not shown effectiveness, especially when there is a clear anatomical cause obstructing the airway during sleep, and to achieve good results, it is necessary to choose a specialized medical center with a team experienced in endoscopic surgery for sleep disorders. Attention must also be paid to consulting a specialized doctor and conducting a comprehensive evaluation of the case as an essential step before deciding to undergo the procedure.
Sources:
- Gaultier, C., Terris, D., & Kouadio, M. (2019). Drug-induced sleep endoscopy: Technique, indications, tips and limitations. Retrieved from PubMed Central database (PMC6787696).
- National Cancer Institute. (n.d.). Sleep disorders (PDQ®)-Patient version. U.S. Department of Health and Human Services. Retrieved from
