How To Beat Sleep Apnea? Cut It Out (Surgically) Sleep apnea is a chronic and common sleep disorder that makes it hard to breathe while sleeping. When all else fails, doctors are turning to a surgery currently used to remove cancerous tumors at the back of the throat. It relies on robots to do the delicate task of removing tissue in the throat.
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How To Beat Sleep Apnea? Cut It Out (Surgically)

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How To Beat Sleep Apnea? Cut It Out (Surgically)

How To Beat Sleep Apnea? Cut It Out (Surgically)

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This is MORNING EDITION, from NPR News. I'm Renee Montagne.


Steve Inskeep is on assignment in Cairo. I'm Linda Wertheimer.

In "Your Health" today, nighttime breathing problems for kids and adults. Millions of Americans don't get a good night's sleep. Sleep apnea causes them to stop breathing, and wake up repeatedly, throughout the night.

As NPR's Patti Neighmond reports, some patients can be helped by surgery.

PATTI NEIGHMOND: About a year ago, Daniel Sheiner knew something was wrong. He was only 32, but he was exhausted from the moment he woke up.

Mr. DANIEL SHEINER: I had absolutely no concentration.

NEIGHMOND: His job as a computer programmer suffered. So did social relationships.

Mr. SHEINER: I would interject something into a conversation that had already been said, or ask a question that had already been answered. When I was done with the carton of milk, I'd put it in the pantry - and I'd put trash in the fridge.

NEIGHMOND: Sheiner suspected sleep apnea, and it turned out he had one of the most severe cases of apnea doctors had ever seen. A sleep study revealed he woke up 112 times every hour.

Dr. ERICA THALER (Ear, Nose and Throat Surgeon, University of Pennsylvania Hospital): If you translate that to minutes, it's about twice a minute that he stopped, for a significant amount of time, breathing.

NEIGHMOND: Dr. Erica Thaler is an ear, nose and throat surgeon at the University of Pennsylvania Hospital in Philadelphia. Sheiner was put on a nighttime breathing machine. He wore a face mask in bed, connected to a device that pumped air into his nose and mouth. It didn't work.

Mr. SHEINER: My sleep apnea was still severe. And it was very difficult to sleep because the rhythm of the machine didn't match my natural breathing patterns.

NEIGHMOND: In fact, many patients who try the breathing machine can't tolerate it. It turned out that Sheiner was a good candidate for surgery because his apnea was not caused by extra weight; it was caused by an obstruction. Dr. Nisha Aurora, a sleep specialist at Mount Sinai Medical Center in New York, says this is often the cause of sleep apnea among people who are thin.

Dr. NISHA AURORA (Sleep Specialist, Mount Sinai Medical Center): If their tonsils are big, if they've got a lot of redundant tissue in the back of the throat, a lot of soft-palate tissue - all those things are something that can be taken care of surgically.

NEIGHMOND: And this was Sheiner's problem. His tonsils were large, and he had extra tissue at the back of his throat. So he went to see surgeon Erica Thaler, who was perfecting a new technique using robotic arms to perform surgery through the mouth.

Dr. THALER: What the robot allows you to do is to get into a small, confined space without your hands. So you know, human hands are huge, and the robot's hands are tiny. And yet they can do the exact, same thing if you control them remotely.

NEIGHMOND: And this meant Sheiner could have both his tonsils and excess tissue removed at the same time. This is such new surgery that Sheiner's one of about a half a dozen patients to undergo it. Without the robot technology, Sheiner's doctors would've had to make an incision in his face or neck to do the operation.

Sheiner says after surgery, it was a whole new life.

Mr. SHEINER: I'm alert. I'm energetic. I'm able to focus, get things done. I find myself solving problems much more quickly and more confidently.

NEIGHMOND: This isn't the only surgery available for apnea. Everyone's anatomy is different. For some people, wires can be inserted into the palate to keep the airway open, or a screw can be anchored in the jaw to pull it forward. But these surgeries are successful only 20 to 30 percent of the time. Dr. Aurora says only one surgery has proved effective more than 90 percent of the time.

Dr. AURORA: People that have cranial facial abnormalities or, you know, small jaws, or chins that are very far back - people with these kind of abnormalities often do well with surgery, and surgery would be preferable.

NEIGHMOND: But this is structural surgery that literally, repositions the bones in your face. It takes hours in the OR and months to recover, so most patients don't want to do it - which brings us back to the non-invasive nighttime breathing machine - which has greatly improved, according to Dr. Nisha Aurora.

Dr. AURORA: Many of them can sense when the patient's having a respiratory event and give the pressure accordingly. There's been significant improvement over the last 10 years in these machines.

NEIGHMOND: So now, around half the patients who try breathing machines get relief without surgery.

Patti Neighmond, NPR News.

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