Sleep Apnea: Thinking Beyond CPAP

Sleep apnea is a common condition among American adults, especially those who are also overweight. For most people, CPAP machines are the first line of defense. CPAP, which stands for Continuous Positive Airway Pressure, provides breathing support and can help prevent airway collapse during the night, a characteristic of obstructive sleep apnea. But what if there was an alternative to CPAP that could help improve your overall health rather than just correcting breathing issues? For some patients, weight loss surgery is that solution.

The Consequences Of Sleep Apnea

Sleep apnea is characterized by a cessation of breathing while asleep, and while in rare cases it can stem from a neurological condition, in most cases the condition is obstructive, meaning that something blocks the airways. In children and teens, this kind of sleep apnea may be caused by overly large tonsils or adenoids or excessive tissue in the soft palate, but in adults, it’s often due to being overweight. The airway collapses under excessive weight in the neck.

Long-term, sleep apnea can cause a further increase in weight due to sleep disruption and daytime tiredness. It can also increase the risk of heart disease, already the leading killer of Americans. On its own, sleep apnea may not be deadly – when breathing stops, it’s typically only for a few seconds, far less than you could hold your breath for – but it can exacerbate and cause much more severe health problems.

Surgical Options

Many patients are resistant to using CPAP machines for sleep apnea because it requires them to wear a complex mask while sleeping. It’s inconvenient and sometimes uncomfortable and it corrects the problem without addressing the root cause. This is the key benefit of weight loss surgery – it gets to the source of obstructive sleep apnea.

Patients who are interested in weight loss surgery for sleep apnea have several options, starting with traditional gastric bypass surgery. Gastric bypass is generally only indicated for those with more mild cases of sleep apnea, as more severe cases – as well as patients who are more seriously overweight – can suffer surgical complications. For those patients, starting with CPAP, as well as possibly deviated septum repair or jaw reconstruction, can be a better option.

One of the negative aspects of gastric bypass surgery is that it permanently reduces the size your stomach, something many individuals want to avoid since that can lead to long-term nutritional deficiencies. Luckily, there are several other less drastic surgical options that can help people with sleep apnea lose weight and improve their condition.

Gastric sleeve surgery is an alternative to gastric bypass that uses a similar process – reduction of stomach capacity – without skipping a section of the intestinal tract, as is common in traditional gastric bypass. That means that there’s a much lower risk of nutritional malabsorption. The reduction is also somewhat less drastic, reducing the stomach to the size of a banana and stomach function is comparably better maintained.

Finally, there’s a new weight loss procedure available that could prove a valuable alternative once mainstreamed. Known as a gastric balloon, the procedure involves inserting and inflating a silicone balloon in the stomach, reducing the volume available for food. The procedure is meant to be short-term, with the balloons remaining in the stomach for 6 months at a time. Unfortunately, 5 people recently died after receiving the procedure for reasons that remain unclear. This is, of course, a risk with any surgery, but gastric balloons are still new on the weight loss surgery scene.

The ultimate goal of weight loss surgery for sleep apnea is to reduce neck circumference and take pressure off the airways so that it doesn’t collapse during the night. Though it’s not a primary option for all patients, for those who qualify, weight loss surgery is an ideal solution as it reduces a variety of health risks, rather than exclusively treating sleep apnea – certainly something worth considering.