Obstructive Sleep Apnea

• Enlarged tonsils and adenoids in the upper airway, especially in children
• Poor muscle tone in head and neck that keep the airway open
• Obesity
• Tumor or growth in airway (rare)
• Skeletal abnormalities (e.g., small jawbone)

The most common symptoms of sleep apnea are:

• Periods of not breathing during sleep, measured in seconds
• Loud snoring or noisy breathing during sleep
• Mouth breathing
• Restlessness during sleep
• Excessive daytime sleepiness or irritability

Consult a Brigham and Women’s otolaryngologist for an evaluation of noisy breathing during sleep or snoring, or if periods of not breathing become noticeable or problematic. In addition to a complete medical history and physical examination, diagnostic procedures for obstructive sleep apnea may include:

• Sleep history
• Evaluation of the upper airway
• Sleep study (polysomnography) to evaluate:
  • Brain activity
  • Electrical activity of the heart
  • Oxygen content in the blood
  • Chest and abdominal wall movement
  • Muscle activity
  • Amount of air flowing through the nose and mouth

Symptoms of obstructive sleep apnea may resemble other conditions or medical problems. Consult a BWH otolaryngologist for more information.

Learn more about obstructive sleep apnea.

Treatment for obstructive sleep apnea is based on the age and condition of the patient as well as the cause. Non-surgical treatments are always tried first.

Non-Surgical Treatment

Wearing a continuous positive airway pressure mask (CPAP) while sleeping can help to keep the airway open. Weight loss is also helpful to counter obstructive sleep apnea.

Uvulopalatopharyngoplasty is the most common surgical procedure for sleep apnea. It trims the soft palate and uvula, and removes the tonsils and other tissue. It is a major surgery performed in a hospital. Most patients go home within 24 hours.

Surgical Treatment

An uvulopalatopharyngoplasty to correct sleep apnea removes or shrinks excess tissue where the mouth meets the throat. The decision to perform this surgery is based on the anatomy of the back of the throat and is not recommended for every patient.

Treatment for Children

In children, enlarged tonsils and adenoids are the most common cause. In this case treatment is surgery and removal of the tonsils (tonsillectomy) and/or adenoids (adenoidectomy).

You will receive a thorough diagnostic examination to evaluate if you have obstructive sleep apnea and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced otolaryngologist are important to the successful outcome for patients with ear, nose and throat disorders and conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by otolaryngologist, anesthesiologists and nurses who specialize in surgery for patients with obstructive sleep apnea. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by experienced surgical and nursing staff.

Brigham and Women’s Faulkner Hospital provides a multidisciplinary approach to patient care by collaborating with colleagues who have extensive experience in diagnosing and treating ear, nose and throat disorders and conditions. In addition, patients have full access to Brigham and Women's Hospital's world-renowned academic medical community, with its diverse specialists, and state-of-the-art facilities.