Not all patients with obstructive sleep apnea will benefit from an operation; long-term, sleep apnea surgeries have only about a 25% success rate. But those with physical abnormalities like nasal polyps, large tonsils, or a very small chin, for example, may choose going under the knife over living with a continuous positive airway pressure (CPAP)) machine.
In 1998, after a decade of his snoring and sleepiness, Steve Watson's wife, Sally, finally convinced him to consult an ear, nose, and throat doctor (ENT) and visit a sleep clinic. An overnight sleep study showed he had obstructive sleep apnea, a condition that caused Watson, now 55, to routinely stop breathing in his sleep.
For most sleep apnea patients, doctors suggest treatment with a CPAP machine, which blows air continuously through the nose all night long. But Watson's ENT explained that his condition was caused by nasal obstruction, meaning that a one-time surgery to correct his narrow sinus passages should help him breathe easier.
Nasal surgery and excruciating pain
After careful consideration, Watson, a graphic designer in North Vernon, Ind., had surgery to straighten out his deviated septum, grind down his enlarged turbinates (bony and soft-tissue structures lining his nasal cavity), and remove his uvula (a procedure called uvulopalatopharyngoplasty, or U3P). It was excruciating.
"When I came out, it was just intense pain around the clock," he says. "I had one of those self-administered painkillers and I was hitting that baby every chance I could for the first 24 hours. Seemed like three days before I could go without them."
When he was coherent enough to speak, he confronted his wife, Sally, a nurse who was familiar with the procedure. "I looked at her and said, 'You didn't tell me it would be like this.' She just laughed and said, 'I know, but I was afraid you'd back out.'"
As if he weren't in enough pain, Watson had to return to the doctor a week later to have sterile packing removed from his nasal cavity. "It felt like someone was reaching into my brain," he says.
To make matters worse, the uvula plays a big role in swallowing, so the first time he took a big drink of water, he blew it out his nose. It took a while to retrain his throat muscles, but eventually he was able to drink without a problem.
A second surgery, and long-term results
One year later, Watson's snoring had decreased but hadn't disappeared, and signs of his sleep apnea were still around too. So Watson opted to have another operation, this time an overnight stay to remove some excess tissue in his pharynx. It was a much easier surgery in terms of pain and recovery. On a scale of one to 10, Watson put it at a 1.5, compared with a 9.5 for the nasal surgery.
After the surgery, Watson had the best night of sleep he'd had in years.
Since that operation more than five years ago, Watson has not had a trace of sleep apnea. "As painful as it was, surgery was the best thing I ever did. I'd do it again because it was so worth it," he says. And he doesn't hold anything against his wife for not warning him about the pain: "I knew she was just looking out for me."