Surgical Sleep

Sleep Expertise Includes Innovative Treatments

If you or a loved one is having issues with getting restful sleep, it is important to see a specialist to resolve sleep problems that may also affect your heart or critical functions. Our team of sleep medicine ENT specialists at University Hospitals are fellowship-trained in sleep medicine and surgery in addition to their board-certification in otolaryngology. This means that they fully understand the functional aspects of ear, nose and throat issues that can affect sleep – and have the additional skill and training to diagnose and treat specific sleep disorders.

University Hospitals also provides the most advanced treatments in Ohio with an innovative solution called Inspire therapy. This new surgical treatment for sleep apnea is highly effective and consists of a small pacemaker-like device implanted in the upper chest to stabilize your throat during sleep and improve airflow.

Precise Diagnosis of Sleep Problems

In addition to all other areas of ear, nose and throat specialization, UH also offers specially trained sleep medicine physicians with sleep labs throughout Northeast Ohio to help diagnose obstructive sleep apnea and other sleep problems. With obstructive sleep apnea, the throat tissue collapses while sleeping, on average 20 to 30 times per hour, resulting in repeated sleep interruptions. Effectively treating obstructive sleep apnea can have long-ranging health effects. More immediately, though, proper sleep apnea treatment allows you to wake in the morning feeling refreshed and able to engage in school, work or family throughout the day.After visiting one of our labs, where you are monitored during sleep, your ENT expert will explain your condition and its causes. From there, a non-surgical or surgical care path will be designed based on your needs and goals.

If you have severe sleep apnea symptoms, we may also perform a drug-induced sleep endoscopy (DISE). A DISE involves putting you in a sleep-like state through medication so our sleep medicine specialist can examine the inside of your throat to determine the cause of any throat obstruction. This brief endoscopic procedure helps us develop a road map of the many available sleep surgeries that will most benefit you.

Broad Range of Non-Surgical Treatments for Sleep Disorders

In many cases, non-surgical treatments for obstructive sleep apnea will resolve any sleep disruptions. These treatments, often involving sleep apnea devices, are much improved with easier, less restrictive devices. Some of the non-surgical treatment options include:

  • Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BiPAP): This is the most common treatment for obstructive sleep apnea. It consists of continuous, but mild, air pressure delivered through a face or nasal CPAP mask while asleep. If used as instructed, this therapy is very effective. Newer CPAP devices are wireless and adjust air pressure automatically through the night.
  • Oral appliance: For patients with mild or moderate obstructive sleep apnea, an oral appliance can be an effective therapy option. This custom-made appliance helps keep the lower jaw in a more forward position, which stabilizes the attached soft tissue of the throat.
  • Adjunct therapy: Other treatment alternatives in the management of obstructive sleep apnea include weight loss and positional therapy with special pillows and body positional devices, which can sometimes lead to significant improvement of OSA.

Lifestyle changes that can help with sleep apnea include improving sleep habits and avoiding alcohol and smoking. Correction of nasal obstruction, such as decongesting sprays, nasal strips or nasal surgery can sometimes make sleeping or using CPAP devices easier.

Advanced Sleep Apnea Surgery

If your sleep apnea is more severe, or you have been unable to resolve your sleep problems with non-surgical treatments, our team has a range of surgical treatments for obstructive sleep apnea that may help, including:

  • Base of tongue resection: Patients with either a large base of tongue, which is the very back part of your tongue, or a large lingual tonsil area, which are small areas of lymphatic tissue at the base of your tongue, can benefit from resection or ablation of the excess tissue. This procedure is done through the mouth.
  • Hyoid suspension: This procedure addresses lower throat obstruction by advancing a small neck bone, called the hyoid bone, forward - suspending it to the front of the lower jaw. The hyoid suspension expands and stabilizes the airway during sleep, making obstruction less likely to occur.
  • Palatal surgery: Depending on the type of soft palate obstruction, such as front to back or side to side of the roof of your mouth, a specific procedure will be chosen to open the obstruction in the appropriate direction. Different palatal surgeries with modifications are available.
  • Inspire therapy stabilizes tongue and throat tissue via breathing synchronized stimulation of the hypoglossal nerve, or tongue nerve. Implantation of this device is less invasive than other surgical options and the stimulation is tolerated very well by most patients. Studies have shown that two out of three patients with this therapy experienced significant improvement of their obstructive sleep apnea and snoring.

Sleep Problems Impact Many Areas of Health

Sleep disorders can be a symptom of issues such as obesity, and lack of restful sleep can cause significant issues with your health or daily functions, including:

  • Decreased function, including less energy and less interest in activities you used to enjoy
  • Increased accidents or lack of focus due to sleep deprivation
  • Increased depression and aging
  • Increased risk of heart disease, high blood pressure, stroke or diabetes