At the American Society of Plastic Surgeons and American Society of Maxillofacial Surgeons Plastic Surgery 2007 conference in Baltimore, plastic surgeons discussed the latest surgical advances for the treatment of sleep apnea.

Men over the age of 40 are the most common sufferers of sleep apnea due to their heavier build and shorter necks. "Women, children, and overweight people are not immune,” says Stephen Schendel, MD, ASPS member surgeon and lecture presenter. “Many men are extremely embarrassed to get help for sleep apnea even though it can lead to serious health issues.”

Sleep apnea is a temporary inability to breathe during sleep. Although someone may not be aware they have the condition, it can significantly disrupt their quality of sleep. According to the National Institutes of Health, sleep apnea is as common as adult diabetes and affects more than 12 million Americans.

“Left untreated, sleep apnea can cause high blood pressure and other heart disease, memory problems, mood swings, impotency, and headaches,” says Andrew Wexler, MD, ASMS president. “The condition can also lead to serious work injuries and car accidents because sufferers are drowsy and fall asleep.”

Sleep apnea can occur when soft tissues of the nose and mouth relax—which may restrict air flow. Plastic surgeons open the airway by removing excess tissue in the nose. The tongue is also shortened and pulled forward preventing it from slipping into the throat while sleeping. The disorder is also seen in patients with less pronounced facial features, such as a small chin, because they often have smaller airways. Plastic surgeons move the upper and lower jaws forward, creating a larger airway for these patients. Being overweight can also restrict the airway. However, physicians say that the best treatment for these patients is weight loss.

Nonsurgical options may not be as effective or as long-term as surgery. The most common nonsurgical treatment is a Continuous Positive Airway Pressure (CPAP) machine, which patients equate to sleeping with a scuba mask on, which can often fall off during the night and forces the user to sleep on his back. Radiotherapy is another option that has moderate success. However, it may be only appropriate for people with minor conditions and requires multiple treatments.

“Treating sleep apnea is one of the less talked about ways plastic surgeons are helping to restore health and proper function to patients,” says Richard D’Amico, MD, ASPS president. “After all, quality sleep is an integral part of how we function properly.”

[ASPS, October 30, 2007]