Sleep apnea is a chronic condition that interrupts your sleep multiple times a night so that you wake up feeling groggy, unrested, and irritable. “Apnea” comes from the Greek word “apnos,” which means “without breathing.” If you have sleep apnea, you’re literally sleeping without breathing for some portion of the night.
The most common form of sleep apnea is referred to as obstructive sleep apnea (OSA). When you have OSA, part of your anatomy prevents oxygen from flowing freely through your airway while you sleep. In some cases, you might have a large tongue or tonsils that block your airway. Sometimes, though, the obstruction lies in your nasal passages and sinuses.
Robert A. Guida, MD, a plastic and rhinoplasty surgeon in Manhattan and Staten Island, New York, recommends sinus surgery for some sleep apnea patients who haven’t responded to other therapies. If you’re frustrated by OSA treatments that don’t work, sinus surgery might finally get you the rest you need.
Your sinuses are a series of eight air-filled chambers that run in four right-left pairs from your forehead to your cheeks. While nobody is sure why we have developed sinuses, we do know they make our skulls lighter and affect the sound of our voices.
Sinuses are lined with tissues that can become infected, inflamed, and swollen, causing a condition called sinusitis. Women, men, and children with sinusitis often develop sleep apnea, too. When your sinuses are congested and infected, it’s hard to breathe freely, especially when you’re lying down at night.
You can also develop nasal polyps in your sinuses. Polyps are benign tumors, but they block the flow of mucus and air, leading to congestion and, possibly, apneas.
If you’ve tried an oral appliance or continuous positive airway pressure (CPAP) machine for your sleep apnea, and you’re still waking up from not breathing, your sinuses may be the reason why. An oral appliance moves your jaw and tongue forward so that your throat stays open while you sleep. However, if your sinuses are congested or have polyps, your airway is still obstructed.
A CPAP machine forces air into a mask that fits over your nose — or over both your nose and mouth — so that you breathe throughout the night. However, if the air’s being forced into nasal passages and sinuses that aren’t completely clear, you’re not getting the oxygen you need.
Studies have shown that sinus surgery reduces the severity of OSA symptoms by 56%. Patients are also more likely to use their oral appliances and CPAP after surgery because their improved airflow makes those devices more effective.
Dr. Guida performs sinus surgery while you’re under anesthesia. He uses minimally invasive endoscopy, which makes the surgery less traumatic and shortens your recovery. An endoscope is a tiny camera that he places in your nasal passages so that he can watch a magnified version of your sinuses on a computer screen. He doesn’t make any incisions in your skin, which means you can go home the same day as your procedure.
Using tiny instruments that he threads through your nostrils and into your sinuses, Dr. Guida removes obstructions such as polyps and scar tissue. During endoscopy, he can also use special instruments to straighten your nasal cartilage, which might be deviating into one of your nasal passages, blocking air. Finally, he may reduce the size of the turbinates, which are passages that cleanse and humidify inhaled air, but which may become swollen or inflamed.
To find out if sinus surgery is the right treatment for your sleep apnea, contact our nearest office today by calling or booking an appointment online.