Bengaluru: A 35-year-old man suffering from obstructive sleep apnea (OSA), who experienced symptoms such as breathing difficulties, choking during sleep, disturbed sleep patterns, excessive daytime tiredness, and fatigue, recently underwent a complex corrective surgery in Bengaluru. The procedure involved upper and lower jaw osteotomies, anticlockwise rotational correction, and maxillomandibular advancement (MMA), following which the jawbones were stabilised using mini-plates and screws. Doctors said the patient, who had relied on continuous positive airway pressure (CPAP) therapy for years, has now regained the quality of his sleep without needing CPAP support.With growing awareness around the importance of quality sleep and its impact on physical and mental health, city doctors say more OSA patients are now exploring surgical options instead of depending solely on CPAP therapy.“The number of surgeries for OSA has gradually increased in recent years, especially among patients who are unable to tolerate long-term CPAP usage or have structural airway problems. With better awareness, improved diagnosis, and advancements in digital surgical planning technologies such as CAD-CAM and virtual surgical simulation, more patients are now opting for definitive surgical correction,” said Dr Sathish MS Vasishta, consultant, craniomaxillofacial surgery, Aster CMI Hospital.According to him, surgical treatment is usually preferred by patients in the 30–50 age group who are unable to tolerate CPAP therapy or have structural airway obstruction that can be corrected through advanced jaw or airway surgeries.Doctors said common surgeries performed for OSA include uvulopalatopharyngoplasty (UPPP), tonsillectomy, nasal septoplasty with turbinate reduction, and maxillomandibular advancement, which involves moving the upper and lower jaws forward to widen the airway.“Many patients with sleep apnea are usually looking for a one-time solution. They would rather go in for a corrective surgery to remove or improve their airway obstruction rather than using a CPAP machine,” said Dr Soumya M S, senior consultant, ENT surgeon, Narayana Health City.She added that many patients find CPAP uncomfortable because the masks are tight-fitting, must be worn every night for life, and can become inconvenient while travelling. Some patients also feel self-conscious wearing what she described as a “fighter pilot mask” in bed with a partner.“About 40-50% of patients eventually stop using their CPAP regularly because of these issues. For these CPAP-intolerant patients, surgery is a life-saving alternative,” she said.However, doctors cautioned that surgery may not work for every patient with sleep apnea. “There is no conclusive clinical trial demonstrating which patient phenotype benefits most from surgery,” said Dr Satyanarayana Mysore, chairman, HOD & consultant – pulmonology, sleep medicine & lung transplant physician, Manipal Hospital, Old Airport Road.He added that despite the best surgical techniques and expertise, outcomes can vary significantly between patients with similar characteristics. “One patient may benefit significantly while another may not respond to surgery. In that sense, the outcome can sometimes feel like tossing a coin,” he said.Doctors also pointed out that despite increased awareness around sleep apnea in recent years, many patients continue to remain undiagnosed because symptoms are often ignored or mistaken for other health conditions. They advised people experiencing symptoms such as loud snoring, choking or gasping during sleep, breathing difficulties, disturbed sleep patterns, excessive daytime sleepiness, morning headaches, fatigue, poor concentration, and irritability to seek medical consultation for sleep apnea.Inset: What is OSA?Obstructive sleep apnea (OSA) is a sleep disorder in which the airway repeatedly gets partially or completely blocked during sleep, causing interruptions in breathing. This can lead to loud snoring, choking or gasping during sleep, poor sleep quality, excessive daytime sleepiness, fatigue, and other health complications.
