Surgery for obstructive sleep apnea reduces drowsiness during daytime

WASHINGTON - A new study from Henry Ford Hospital in Detroit has found that patients with obstructive sleep apnea who undergo surgery to improve their breathing get a better night’s sleep and therefore are less drowsy during the day.

The study finds surgery greatly reduces daytime sleepiness - a common side effect from this disorder in which the upper airway is partially or completely blocked during sleep - when compared to other non-surgical treatments for obstructive sleep apnea.

The retrospective study looked at 40 patients who underwent one of three surgical interventions - uvulopalatopharyngoplasty, tonsillectomy or radiofrequency ablation of the base of tongue - between January 2007 and December 2009.

All patients in the study had at least mild obstructive sleep apnea, defined as five or more apnea/hypopnea events per hour of sleep and excessive daytime sleepiness. Many patients prior to surgery reported experiencing fatigue, snoring and failure to successfully use continuous positive airway pressure (CPAP).

Both prior to and following surgery, patients were asked to complete the Epworth Sleepiness Score (ESS) questionnaire, which measures patients’ general level of daytime sleepiness by rating their level of sleepiness (0 = never doze/sleep; 3 = high chance of dozing/sleeping) during eight common daytime activities such as watching TV, reading or driving. The ratings for each activity are then added together for a total Epworth Score.

Before surgery, all patients in the study reported having an ESS score of 10 or more, which is considered “very sleepy” during the day.

Following surgery, 38 patients’ scores were significantly reduced, with a postoperative average score of 5.5. One patient in the study had no change in his score, while two experienced an increase.

Patients in the study also experienced a 50 percent reduction in apnea/hypopnea events during sleep following surgery.

“While this is not a prospective study, the results show an improvement in Epworth Sleepiness Score after surgery that is greater than typically reported with continuous positive airway pressure therapy,” notes co-author Brandy Tacia.

Results from the study will be presented Jan. 29 at the Triological Society’s Combined Sections Meeting in Scottsdale, Ariz. (ANI)