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Learn About Sleep Disorders and the Latest Treatment Options

June 22, 2010

Advanced Surgical Procedures Bring Relief from Sleep Apnea

Millions of Americans suffer from obstructive sleep apnea, a common disorder in which the upper airway collapses briefly during sleep, causing lapses in breathing that interrupt the person’s sleep. Left untreated, sleep apnea can lead to serious complications such as high blood pressure, heart attacks, strokes and irregular heartbeats, as well as increased risks for obesity and diabetes.

"Many sleep apnea sufferers are able to gain relief by using a Continuous Positive Airway Pressure (CPAP) device, which delivers a constant stream of air through a nasal mask to keep the airway open," says Dr. Jason Van Tassel, an otolarygnologist (ear, nose and throat specialist) at Washington Hospital. "Others may benefit from special orthodontic mouthpieces that move either the tongue or the upper jaw forward. For some sleep apnea patients, though, surgical treatment may be their best option, and recent advances in minimally invasive surgical procedures have dramatically improved the results."

To help people in the community learn about the latest treatment options of sleep apnea, Washington Hospital is sponsoring a special free seminar featuring Dr. Van Tassel and Dr. Nitun Verma, medical director of the Washington Township Center for Sleep Disorders on Tuesday, June 29 from 1 to 2:30 p.m. The seminar will be held in the Conrad E. Anderson, M.D. Auditorium at 2500 Mowry Avenue in Fremont. To register for the seminar, visit www.whhs.com.

"Years ago, the only surgery performed for sleep apnea was a procedure called a ‘uvulopalatopharyngoplasty,’ also known as UP3," Dr. Van Tassel explains. "The word ‘uvulo’ refers to the small, fleshy mass hanging from the roof of the mouth above the root of the tongue. ‘Palato’ refers to the soft palate, the fleshy tissue at the back of the roof of the mouth. ‘Pharyngo’ refers to the pharynx, the part of the throat just behind the mouth and nasal cavity. And ‘plasty’ means plastic surgery. So the UP3 procedure basically is used to remove excess amounts of these tissues from the throat to allow air to move more freely."

Dr. Van Tassel notes that UP3 procedures have been effective in some, but not all, cases.

"During the past 10 to 15 years, we have learned that obstructions resulting in sleep apnea can also be found in other areas of the airways, such as the nasal cavity, the base of the tongue and the larynx – also called the ‘voice box’ – in the throat," he says. "As a result, we have developed several new minimally invasive procedures that greatly enhance the success of sleep apnea surgery.

"In my experience, these new procedures have a 70 to 80 percent success rate in dramatically reducing the incidence of sleep apnea, compared to only 40 to 50 percent of patients who had only the older UP3 procedure," he adds.

Some of the new minimally invasive surgery procedures for sleep apnea – which do not entail the overnight stay in the hospital generally required with UP3 surgery – include:

· Radiofrequency tongue reduction, using temperature-controlled radiofrequency energy to reduce the volume of the base of the tongue.

· Hyoid myotomy and suspension – pulling the hyoid bone (a horseshoe-shaped bone in the neck where the tongue muscles attach) forward in front of the larynx.

· Septoplasty to straighten out an extremely crooked (deviated) nasal septum, the partition between the two sides of the nose.

· Turbinate reduction, to reduce the size of an abnormally large turbinate, a structure that projects from the side wall of the nose into the nasal cavity.

In addition to these surgical procedures, Dr. Van Tassel also will discuss a recent clinical study that indicates various exercises to stretch and strengthen muscles of the throat may be beneficial – either in combination with surgical treatments or on their own – in treating sleep apnea.

"Obviously, one of the first steps in dealing with sleep apnea is to perform a comprehensive physical examination to determine what physical obstructions may be contributing to the disorder," Dr. Van Tassel says. "Sometimes it will require a combination of these procedures to provide effective, lasting relief."

Washington Township Center for Sleep Disorders

Lack of sleep can seriously impact your health. Yet millions of Americans walk around each day half asleep or worse - suffering from chronic illnesses - because they aren't getting enough sleep.

At the upcoming seminar, Dr. Verma will discuss how the Washington Township Center for Sleep Disorders uses a comprehensive approach to treating sleep apnea and other sleep disorders.

"Sleep medicine does not provide a one-size-fits-all approach to treatment," Dr. Verma emphasizes. "In our practice, we work closely with dentists, surgeons, pulmonologists and other specialists to create a treatment plan tailored to each patient's needs. For example, some patients with sleep apnea might benefit from using a Continuous Positive Airway Pressure (CPAP) device that delivers a flow of air into the airway through a specially designed facial mask. Other sleep apnea patients may do better with a special orthodontic device or surgery. Other sleep disorders also require determining which treatments are appropriate for specific patients."

Since there are more than 200 types of sleep disorders that have been diagnosed, Dr. Verma continues to research innovative ways to determine the most appropriate treatment plan for each patient.

"New ideas and concepts on how to treat sleep disorders are constantly evolving and the upcoming seminar is a great opportunity for me to share this information with the community," Dr. Verma says.

In December 2009, the Washington Township Center for Sleep Disorders was accredited by the American Academy of Sleep Medicine (AASM) and the facility is one of only two accredited sleep labs located between Oakland and Sunnyvale.


Learn More About Sleep Disorders
For more information about diagnosing and treating sleep apnea and to learn more about various sleep disorders, visit the Washington Township Center for Sleep Disorders website at www.washingtonsleep.com. To find a physician near you, visit Washington Hospital's website at www.whhs.com and click on "Find a Physician."