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How a new surgical technique might finally quieten our snorers


Australian experts say simple surgery could be a dream come true for the billion people around the world struggling with obstructive sleep apnoea – the potentially serious sleep disorder in which breathing repeatedly stops and starts.

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Risk factors for the condition include age and obesity and it’s more common in men.

Symptoms include snoring loudly and feeling tired even after a full night’s sleep and often the only answer is a breathing assistance device at night, such as a continuous positive airway pressure (CPAP) machine with a mask – which can also disrupt sleep.

A report in the Journal of the American Medical Association says the surgery offers excellent outcomes for sleep apnoea patients who have been unable to use a CPAP machine, “with patients enjoying relief from snoring and disrupted sleep and improved general health”.

CPAP, the current main treatment for sleep apnoea, is tolerated by only half of those who try it. Almost 30 per cent of people with the condition wake up very easily with light sleep and other problems caused by minor airway narrowing.

The multi-level surgical technique combines a new version of palate surgery with a low-risk tongue procedure.

It creates an improved airway resulting in a substantial reduction in the number of night-time apnoea events and improvements in daytime sleepiness and quality of life.

After removing any tonsils, the palate is repositioned and the tongue treated to open up the airway and reduce obstruction.

Flinders University Professor Doug McEvoy says the surgery offers promise to millions of people around the world who suffer from obstructive sleep apnoea but can’t adapt to using a CPAP mask or similar device each night.

“This trial is the result of extensive prior research into the surgical treatment of sleep apnoea and gives new hope to people who, without treatment, would each day continue to feel sleepy and depressed and may have their lives cut short by the detrimental effects of long-term interrupted sleep,” said Prof McEvoy, from the Adelaide Institute for Sleep Health.

Lead author, University of Wollongong Professor Stuart MacKay, said about half of patients prescribed CPAP treatment were not using it consistently long term.

MacKay will give further details on the surgical clinical trial at the global online European Respiratory Society congress on Thursday and in a JAMA podcast.


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