The Downside of Sleep Apnea Surgery: What 2 Patients Wish They Had Known

To many patients with obstructive sleep apnea, surgery is an appealing option: It's a one-time procedure versus night after night of wearing a clunky continuous positive air pressure (CPAP) contraption to bed.

"But you have to remember, CPAP always works," says David Rapoport, MD, medical director of the New York University Sleep Disorders Center. "You may not like it, but it always works."

Surgery, on the other hand, has about a 25% to 30% success rate, and patients with the most severe cases of sleep apnea traditionally are the least likely to eliminate their symptoms.

"We ask our patients, 'Which is better? Are you willing to settle for a small chance of success?'" says Rapoport. "Some of them are; it's like people who buy lottery tickets all the time. The important thing is that they need to be making an informed decision."

It's true that better surgeons probably have better success rates or may be able to pick out people who are likely to have good results. And for some lucky patients, one operation will cure their sleep apnea. But the bottom line is, a doctor should never promise you permanent results from a surgery.

Jim's operation reduced his snoring to a quieter whistling.
"No matter what, it keeps coming back"
When Jim Latza was diagnosed with sleep apnea in his early 30s, his ear, nose, and throat doctor suggested an operation. "He told me I had a classic case in which my soft palate was too large, and was sagging down to cover my airways," says the 55-year-old salesman from Lakewood, Ohio. "He explained that surgery wouldn't cure it completely but would make it so I'd live a normal life, to a ripe old age."

So Latza got the works: soft palate cut back, tonsils and uvula removed, and a deviated septum repaired. The surgery was intense, with a long recovery: "When they take your uvula, they warn you that you're going to choke for a while because the throat has to learn to close on its own," he remembers. "There were several times—and it still happens even to this day—when I eat something with a lot of crumbs, like shredded wheat cereal, and a little piece gets loose in the back of my throat where Im not expecting it. Then it's a 20-minute coughing spell until I get that little piece out of there."

A Chronic Snorer's Surgery Success
Steve had 2 operations to eliminate his sleep apnea  Read more
Thankfully, Latza also noticed an immediate improvement in his sleep. "I couldn't believe how well I slept right after the surgery, even with the pain and the stitches. The doctor told me that was normal: He'd had people sleep for three days straight after the operation because they'd been so deprived for so long."

The deep sleep lasted a few months, but soon enough Latza was snoring again—a quieter whistling this time. Now it was his large tongue, his doctors told him, that blocked his throat while he slept. "It seems like no matter what we do, the apnea always manages to work its way around and pop back up," he says.

Latza knows now that no surgery can cure his apnea (aside from a tracheostomy, which is out of the question for him). But thanks to his earlier operation, his apnea is mild enough that he can keep it under control with lifestyle habits such as weight loss and sleeping on his side.

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Last Updated: April 16, 2008

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