Woman with CPAP

Treatment Options

Though there are many options for treating sleep apnea, snoring, and other sleep disorders, each one has a common goal—preventing airway constriction during sleep. Recommended treatment courses will depend on a number of factors, including severity of the sleep apnea/snoring, physical and anatomical causes, and history. Our sleep specialists work with you to develop a treatment plan that best fits your needs. To make an appointment, request one online or call 617-573-3954.

Minimally invasive/office-based treatments

Radiofrequency palatal stiffening procedures
This procedure is designed to stiffen the soft tissues of one’s palate and uvula. An individual may return to usual activities the same day; however, many chose to go home and rest. Subsequent discomfort is mild and can typically be controlled with over-the-counter medications. Results are generally appreciated within weeks. This procedure can be repeated if an individual desires further reduction in snoring. 

Pillar implant
This procedure is designed to stiffen the tissues of the soft palate to minimize snoring by decreasing the tissue vibration that causes snoring. An individual may return to usual activities the same day and pain is mild. Results are generally appreciated within days to weeks. 

Turbinate reduction
Turbinates are tubular structures in the lateral walls of your nose. In many instances, they are enlarged and can result in nasal obstruction/snoring. By reducing their size, breathing becomes easier, both during the day and throughout the night. Results are generally appreciated within days to weeks. The discomfort from this procedure is mild and easily controlled with over-the-counter medications.   

Outpatient/surgical procedures

Tonsillectomy and/or adenoidectomy
This surgical procedure is a treatment option for individuals who are found to have enlarged tonsils and/or adenoids, which narrow the upper airway. Removal of the enlarged tissue will allow for better, easier breathing. This procedure requires a general anesthetic and the patient is generally able to go home the same day. Full recovery from a tonsillectomy can take up to two weeks. Removal of tonsils and adenoids is considered first line therapy for obstructive sleep apnea in children.

Septal deviation repair
This procedure is performed to help an individual breathe better through the nose. The septum is a partition between the two sides of the nose, which is commonly deflected, resulting in nasal obstruction. In addition to simply breathing better, many patients find an improvement in their snoring after this procedure. In many instances, the surgeon will also reduce the turbinates at the time of septal deviation repair. When the turbinates are enlarged, they also contribute to nasal obstruction.

Inpatient/surgical procedures

Uvulo-palatpharyngoplasty (UPPP)
This procedure is designed to remove and reduce tissue in the back of the throat. The tissue addressed with a UPPP includes the soft palate, uvula, and tonsils. A patient will generally be observed in the hospital overnight and can return to usual activities after two weeks.

Maxillo-mandibular advancement
This is a fairly aggressive surgical procedure, most commonly performed on patients with moderate to severe obstructive sleep apnea who are not good candidates for UPPP and are not able to tolerate CPAP. It addresses the boney structures of the face including the mandible and maxilla (mid-face). In this procedure, cuts are made through the mandible and the maxilla and tissues are brought forward. By bringing the tissues forward, the airways are expanded. This procedure generally requires multiple days of inpatient hospitalization and several weeks of recovery. The results from this procedure are excellent.

Genioglossal advancement
This procedure involves creating a small window of bone in the jaw where the tongue attaches. This bone segment is brought forward and stabilized to help prevent the tongue from prolapsing back and obstructing the airway. This procedure is most appropriate for individuals who have a prominent tongue base, an overbite, and/or are not able to tolerate CPAP therapy. This procedure requires general anesthesia and an individual will stay overnight for airway monitoring. Return to typical activities is anticipated in one to two weeks. 

Tongue reduction
Since the tongue is a prominent contributor to airway narrowing, multiple procedures have been described to help reduce the volume of this structure. These procedures are most appropriate for individuals with a markedly enlarged tongue base and are not able to tolerate CPAP therapy. 

Hypoglossal nerve stimulator
This is a surgically implanted device that delivers electrical impulses to the nerve, which innervates to the tongue. The electrical impulses lead to gentle muscle contractions and improvement in airway patency. This procedure is most appropriate for patients with moderate to severe obstructive sleep apnea who are not able to tolerate CPAP.  

Non-procedural treatments

CPAP
CPAP stands for continuous positive airway pressure. It is the most commonly prescribed treatment for obstructive sleep apnea. It works by delivering pressured air to your upper airway to help maintain patency. It delivers air pressure through a mask, which is worn overnight. Prior to starting CPAP therapy, you will have a CPAP titration study performed in our sleep lab. During this study, an optimal pressure setting and mask are identified for therapy. There are other types of similar devices such as BIPAP, Auto-PAP, and ASV (adaptive servoventilation) that may be applied in various circumstances.

Oral appliance therapy
This is a device that's worn on the teeth and designed to bring the lower jaw forward. In doing so, the upper airway caliber is increased and you'll see an improvement in the severity of your sleep apnea and/or snoring. These devices are fabricated by dentists who will work with our specialists. They work best in individuals with mild to moderate sleep apnea and good teeth.

Provent
Provent is the trade name of a disposable device that's worn over the nostrils at night. It works by creating increased air pressure in the upper airway during expiration. When wearing Provent, you are able to inhale freely but will encounter mild resistance on exhalation. This resistance results in positive airway pressure and improved airway patency. It tends to work better in patients with mild to moderate obstructive sleep apnea who are able to breathe well through their nose.