Nasal Surgery to Improve Sleep

There is no better feeling than waking up in the morning feeling refreshed after a good night’s sleep.  Some patients rarely achieve this feat and therefore feel tired and sleepy during the day.  There are many causes of daytime sleepiness, but today I want to focus on abnormal breathing during sleep.  This is referred to as obstructive sleep apnea or sleep disorder breathing, and there are nasal surgical options to improve it.

What is obstructive sleep apnea?

Obstructive sleep apnea or OSA occurs when there is blockage in the airway during sleep.  This blockage prevents normal breathing and triggers the body to react.  The body reacts in 4 ways:

1)  You stop breathing for few seconds (apnea)

2)  Your breathing slows down (hypopnea)

3)  Your mind wakes up (arousal)

4)  The oxygen content in your blood goes down

These reactions significantly decrease the quality of sleep, and can result in daytime sleepiness.

What can you do to improve breathing while asleep and feel more awake during the day?

There has been a vast amount of research and many books that solely pertain to this topic.  If a patient has OSA, the best treatment may be using a CPAP or BiPAP machine that helps you breath while you sleep.  Some patients cannot tolerate CPAP or have mild obstructive sleep apnea.  In these patients, septoplasty may be the best option for improvement.

What are the nasal surgeries to improve OSA?

The nose should be evaluated by a nasal specialist to identify the location of the blockage in the nose.  The most common areas of blockage in the nose are:

1)  Deviated septum

2)  Turbinate hypertrophy

The deviated septum is the cartilage and bone that separates the right and left nasal passageways.  If the septum is off center, part of it can be removed to open the airway.  This is called a septoplasty.  The surgeon must leave enough of the septum to support the nose and prevent it from collapsing.

Inside of the nose, there are 3-4 long cylinders of tissue that help control airflow, humidify the air, and clean inspired air (turbinates).  Sometimes one of these cylinders can become enlarged.  These cylinders can be made smaller to help improve a patient’s breathing.  This procedure is call a turbinate reduction.



Can nasal surgery help me feel more rested?

Nasal surgery can significantly improve sleep quality and daytime sleepiness in patients with nasal breathing problems.  In regards to treating obstructive sleep apnea, these procedures may be beneficial for patients with mild cases.  It is unlikely that these procedures will significantly improve severe sleep apnea.  In patients that have to use high settings on the machine to help them sleep, these procedures may allow a patient to turn down the high settings.  A lower setting is typically more comfortable.

Why is this information important?

The nose is a complex anatomical structure.  Many structures interact to provide the proper passageway that may enable a patient to breathe normally.  Disruption of breathing can greatly affect a patient’s quality of life by making them feel tired and sleepy, but luckily, the opposite is also true.  If a patient has structural components making breathing difficult, this can be fixed with surgery, which may greatly enhance their life.  Patients seeking breathing improvement or aesthetic improvement of the nose should see a nasal specialist that understands both aspects of the nose.

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