advancement: a primary solution for sleep apnea?
If you suffer from obstructive sleep
apnea (OSA) and CPAP doesn't work for you, your doctor will start
outlining various surgical approaches to treating the disease. But will he
or she recommend a procedure that appears to be more successful than any
The answer may be no. The most commonly performed treatment for OSA
remains uvulopalatopharyngoplasty (UPPP, sometimes UP3). This is a
relatively inexpensive outpatient treatment involving surgical removal of
the uvula and adjacent throat tissue. The goal is to make more space for
air to travel through your airways.
Although not a complex procedure, UPPP recovery can be extremely painful.
Long-term results are not all that impressive. A review of 337 patients
from 37 reports showed only 41% showed significantly improved scores on
standard apnea indices.
In marked contrast, another procedure, known as maxillomandibular
advancement (MMA) has been shown to have a 95% or better success rate. MMA
is more complex than UPPP. It involves cutting through the maxillary and
mandibular bones of the upper and lower jaw, then "advancing" them
(outward from the face). The surgeon pulls forward tissues connecting
these bones to the upper airway, thereby enlarging the space inside the
MMA is an inpatient procedure. The patient's jaw will be wired shut for
some weeks (rubber bands may be used) and it may take months before the
teeth have settled enough to allow a normal diet. But, interestingly, few
patients report the extreme levels of pain that UPPP patients do. (For
first hand accounts of MMA and UPPP experiences, see
Forums in the Sleep Apnea section).
Because MMA requires more expertise -- typically involving cooperation
between the patient's dentist and ENT specialist -- and costs more, your
doctor may see MMA as a last resort. But, increasingly, MMA is being
advocated as a primary operation that may be safer, less invasive and more
effective than pharyngeal surgery (which often has to be performed in
stages). This position was explored in a cover article in the November
2002 issue of the Journal of the American Dental Association.
MMA is not for everyone, of course, but if you are headed toward a
surgical remedy for OSA, make sure your doctor considers the MMA option.
Many insurance companies will cover the costs, although it may not be easy
to find an in-network physician to perform the procedure.
Incidentally, although you wouldn't consider MMA for simple snoring, the
principle of jaw advancement certainly applies to many snorers. Many of us
have found we can prevent our snoring by wearning inexpensive dental
devices that act to hold the jaw forward at night, keeping the airways
* For more on MMA: read this
Lexington Clinic article
Is this information
useful to you?
Send us questions or feedback.
And remember, information
provided by PutanEndtoSnoring does not substitute for the
advice of your physician.
ADHD, or simply sleep-deprived?
Some children diagnosed
with attention deficit hyperactivity disorder may simply be tired because
their snoring is disturbing their sleep, researchers say.
A new study published in this month's
found that 26% of 5-7 year olds who showed signs of mild ADHD also snored
and had symptoms of obstructive sleep apnea. Those with severe ADHD
didn't snore any more than a "normal" control group of children.
A tentative conclusion: before you drug
your child to control his or her ADHD, check to see whether he or
she snores. If so, consult your doctor to see whether you need to
address a potential sleep disorder. Snoring and sleep apnea in young
children can often be addressed by tonsillectomy. You may find your
child can focus a lot better when he or she is not sleepy!
us about your experience with any type of snoring cure and we'll use
your article in this slot.
Direct from Taiwan, SnorePlugsTM
are next-generation hydrophilic foam earplugs, with
very high noise reduction (SNR 37db), softer and
more comfortable than non-hydrophilic plugs. They absorb moisture in
the ear canal, keeping them comfortable for longer periods. Take pity on
your long-suffering partner and
Buy SnorePlugs at The Snoring