Relief for People With Obstructive Sleep Apnea Who Struggle With CPAP Masks

An attempt at a simple but effective surgery has led Australian experts to promote it as an option for specialists around the world to treat difficult cases of obstructive sleep apnea (OSA).

After rigorous evaluation of the surgery, patients with sleep apnea who were unable to use Continuous Positive Pressure Airway (CPAP) treatment had excellent results, with patients experiencing relief from snoring and sleep disorders, and improved overall health. according to a new report in the American Medical Association (JAMA) Journal.

It is estimated that nearly 1 billion people worldwide have OSA, with the main treatment, CPAP, being tolerated by only half of those who try. Almost 30% of people with OSA wake up very easily with light sleep and other problems caused by a slight narrowing of the airways.

The multi-step surgical technique, which combines a new version of palatal surgery with a low-risk tongue procedure to create an improved airway, resulted in a significant reduction in the number of nightly apnea events and an improvement in daytime sleepiness and quality of life. After removing tonsils, the roof of the mouth is repositioned and the tongue treated to open the airways and reduce blockages.

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Flinders UniversityProfessor Emeritus Doug McEvoy says the surgery holds great promise for millions of people around the world who have obstructive sleep apnea but cannot get used to using a CPAP mask or similar device every night.

Doug McEvoy, a professor at Flinders University, worked with ENT surgeons, including Professor Stuart MacKay, to refine the new procedure. Photo credit: Flinders Foundation

“This study is the result of extensive previous research into the surgical treatment of sleep apnea and gives new hope to people who, without treatment, would continue to feel drowsy and depressed every day and whose lives may be shortened by the harmful effects of long-term sleep interruption,” says Professor McEvoy. Lead Author Professor Stuart MacKay of the University of Wollongong who will provide more details at the European Respiratory Society’s online global convention on September 7th and in another report on the surgical clinical trial JAMA According to the podcast, about half of patients who have been prescribed CPAP treatment do not use it long-term consistently.

“It is very exciting to see that so many patients sleep better, snore less and have fewer health risks after this operation,” says Professor MacKay.

The article “Effects of multi-step upper airway surgery versus medical management on the apnea-hypopnea index and patient-reported daytime sleepiness in patients with moderate or severe obstructive sleep apnea: The SAMS randomized clinical trial” (2020) is to be published by become JAMA on September 4, 2020.

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Important points

  • Study participants were recruited from six clinical centers in three Australian states (SA, NSW and WA) and were predominantly overweight men with severe OSA who were unable to use standard medical treatments satisfactorily.
  • Of the 102 people in the study, 51 were randomly selected for OSA surgery and the other 51 for the best medical treatment possible.
  • After six months, those who received the surgery had an approximately 60% decrease in the incidence of night throat obstruction compared to a 20% decrease in the participants who received medical attention and had significant additional improvements in snoring, Daytime sleepiness and general health status.
  • A total of seven surgeons performed the multi-stage operation in the six clinical centers using techniques developed in Australia by the late Dr. Sam Robinson and subsequently refined and standardized for the study by Professor Stuart MacKay and Professor Simon Carney.
  • The study was developed by the late Professor Nick Antic, a respiratory and sleep specialist with Flinders University and SA Health, who led the study until his death in 2016.

The project was funded by the Australian government NHMRC, Flinders University and the Repat Foundation.

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