Med Center offers new procedure for snoring and mild sleep apnea

  • Published
  • By Mike Frangipane
  • 88th Air Base Wing Public Affairs
WRIGHT-PATTERSON AIR FORCE BASE, Ohio --  Wright-Patterson Medical Center Ear Nose and Throat Department introduces Somnoplasty or knifeless surgery to correct snoring and mild obstructive sleep apnea.

"This new device replaces some of the more severe and painful surgeries used to correct these problems. This procedure and recovery are far less uncomfortable," said Dr. (Maj) Peter G. Michaelson, Chief Otolaryngologist. "There are multiple procedures that can accomplish relief but this one is backed by ample research and my own professional experience." 

Snoring occurs when the muscles relax during sleep allowing the soft palate (at the back roof of the mouth) and the uvula (the dangling structure at the back of the mouth) to fall back into the airway and vibrate as the air passes over them creating the snoring sound. 

Chronic snoring can, however, signal a more serious medical condition called obstructive sleep apnea. OSA occurs when these soft-tissue structures (the soft palate, uvula, tonsils, and tongue) fall back sufficiently during sleep to block the airway, cutting off airflow entirely for 20 seconds or more. The brain, sensing a decrease in oxygen, sends a nerve impulse that awakens the individual from sleep, usually with a gasp or snort, opening the airway. These awakening episodes can occur hundreds of times in a single night. The sufferer, prevented from attaining a restful and refreshing sleep, awakes in the morning still tired and without energy to meet the day. 

"Those with OSA may have less energy so they don't work out as much," Dr. Michaelson said, "they gain additional weight, which makes the apnea worse. It is vicious domino effect that we want to get in and break." 

Snoring will have its negative effect mostly on others within earshot of the sleeper, but OSA can produce serious medical results. During each episode blood oxygen falls to dangerous levels causing the heart to work harder raising the blood pressure and putting a great deal of stress on the cardiovascular system. Left uncorrected, OSA can cause long-term health problems such as heart disease, hypertension (high blood pressure), and stroke. OSA affects approximately 18 million Americans. It is estimated that 95 percent of Americans with OSA have neither been diagnosed nor treated. 

In addition to snoring, some of the symptoms of OSA include dry mouth upon awakening, protracted physical exhaustion, difficulty concentrating, morning headaches, even falling asleep at a stop light, and a constant battle to stay awake at the computer or during work meetings. 

The gold-standard for treating OSA has been CPAP or Continuous Positive Airway Pressure which involves the use of an air pump and headgear mounted mask covering the nose and mouth or a cushioned nose piece that mounts against the nostrils. It is an effective treatment but requires getting accustomed to sleeping with the device on one's face. 

The unit must be taken with you on overnight or extended trips. "Although the gold standard therapy, CPAP has some compliance issues," reports Dr. Michaelson, "meaning that, over time, the number of patients continuing to use it may decrease. For those with snoring and mild OSA, we can offer an in-office procedure that may make CPAP unnecessary." 

Somnoplasty (Somn - sleep. Plasty -surgical repair) Temperature Controlled Radiofrequency is a welcomed alternative to CPAP. It uses low-power, low temperature radio frequency energy applied by a needle-like probe just below the tissue surface to shrink the tissue and make it less susceptible to blocking the airway during sleep. 

"It does not remove the tissue, it just scars the sub-surface tissue, shrinking it and stiffening it," said Dr, Michaelson. 

In contrast to former surgical procedures Somnoplasty is performed on an outpatient basis with local anesthesia and has only a mild level of patient discomfort. 

"It wasn't bad at all," said Capt. Michael Basler, an Operating Room Nurse and one of the first group to be treated with Somnoplasty TCRF at the Med Center. In for his second and final treatment, Capt Basler described his experience. "Dr Michaelson puts numbing spray in my mouth and he injects local anesthetic before the procedure so I didn't feel the probe going in. ... You feel a little warmth at the probe site for about the last three minutes of each 5 minute application (usually three applications are given in each sitting) and in a few minutes, he said 'time is up' and it was over that quickly. Although there was some post-procedure swelling, requiring me to sleep in a recliner for two or three days following, still I was back to work in two days and feeling fine." 

In regard to the effectiveness of the treatment, Dr. Michaelson reports, "the success rate has been good using the TCRF device, often curing snoring or mild OSA in as little as two treatments." 

Perhaps the most important testimonial comes from Capt. Basler's wife. Following his first procedure, and before the one witnessed here, he tells us , "My wife has already noticed an improvement in my snoring." A snoreless home is a happy home.