Effect of Isolated Uvulopalatopharyngoplasty on Subjective Obstructive Sleep Apnea Symptoms

Abstract

ObjectivesThe aims of this study were 1) to evaluate the effect of isolated uvulopalatopharyngoplasty (UPPP) on subjective obstructive sleep apnea (OSA) symptoms in adult patients regardless of the response to surgery, and ultimately 2) to investigate the differences in changes in subjective OSA symptoms between successful and unsuccessful surgery groups.MethodsTwenty consecutive adult patients who underwent isolated UPPP were enrolled. Pre- and postoperative subjective OSA symptoms (snoring, witnessed apnea, daytime sleepiness, morning headache, daytime fatigue, restless sleep, difficulty with morning arousal) and polysomnographic data were evaluated in all subjects. Changes in subjective OSA symptoms before and after surgery were investigated in the successful (n=11) and unsuccessful (n=9) groups. Surgical success was defined as a reduction of at least 50% in the preoperative apnea-hypopnea index (AHI) and a postoperative AHI less than 20 per hour.ResultsAfter isolated UPPP, all subjective OSA symptoms changed significantly in the patients, especially in the successful group. In the unsuccessful group, snoring, witnessed apnea and daytime fatigue changed significantly, while other symptoms did not change significantly after surgery.ConclusionIsolated UPPP may improve subjective OSA symptoms in adult patients whom surgery was successful or unsuccessful. However, after isolated UPPP, the improvements in subjective OSA symptoms in the unsuccessful group may be different from those in the successful group.

Survey of Knowledge and Attitudes about Obstructive Sleep Apnoea Among Italian Anaesthetists

“…In agreement with Wang (19), the lower median knowledge score regarded the treatment of OSA. Only 15.7% of the anaesthetists knew that OSAs is an indication for LAUP, despite the fact that it is a common office-based procedure; less than 50% knew that uvulopalatopharyngoplasty (UPPP) is an OSA-effective treatment (24). Similarly, 70% of the responding physicians were not aware that CPAP may cause nasal congestion (25); one of the most important factors limiting the adherence to this effective therapy, and the lack of familiarity with this therapy by anaesthetists can represent a barrier to its application in the perioperative period (26).…”

Nocturia Improvement With Surgical Correction of Sleep Apnea

“…Furthermore, CPAP treatment has several adverse effects including nasal obstruction, mask leak, skin breakdown, pressure intolerance, and claustrophobia [11,12]. Therefore, some patients select surgical therapy [13]. Among numerous OSA surgical procedures according to the obstructive level, uvulopalatopharyngoplasty (UPPP) is one of the most popular for treating oropharyngeal obstruction [14].…”

Obstructive Sleep Apnea and Surgery: Quality Improvement Imperatives and Opportunities

“…Other measures, such as general quality of life, OSA-specific quality of life, measurements of sleepiness, and performance, are being considered as reportable metrics [68, 69•]. Studies attest to the efficacy of uvulopalatopharyngoplasty (UPPP) on subjective symptoms with appropriate patient selection, in some cases even where polysomnographic improvement was not apparent [70]. Outcomes for sleepiness and snoring were shown to improve significantly across reviews, although the level and quality of evidence were not as robust as desired [71].…”