Snoring/Sleep Apnea - Pillar Procedure

Health consequences of untreated sleep breathing disorders adds an estimated $15 billion annually to American health care costs. Over 75 million people in the US either snore or have a sleep disorder called Obstructive Sleep Apnea (OSA). Snoring is the sound created by the vibrating tissues in the back of the throat and nose. These vibrating tissues can include the nasal airway, soft palate, uvula, tonsils or adenoids. In 80% of cases, the soft palate is the primary contributor to the snoring problem.

There are many health consequences to snoring, including daytime sleepiness, poor mental and emotional health, decreased productivity, and slower reaction times leading to vehicle accidents. However, snoring not only affects the individual doing the snoring, but the people they sleep with. Bedmates of snorers generally lose an average of one hour of sleep per night, and a growing number of snoring couples sleep apart, which can result in strained relationships and reduced intimacy.

Snoring can be an early warning sign of a more serious underlying medical condition called Obstructive Sleep Apnea (OSA). The Greek word “apnea” literally means “without breath.” People with untreated OSA stop breathing repeatedly during sleep, sometimes hundreds of times per night, and often for periods of time exceeding one minute for each stoppage. Health consequences of untreated OSA include sleep deprivation, headaches, weight gain, cognitive dysfunction, sexual dysfunction, depression, Type II diabetes, high blood pressure, heart attack and stroke.

Diagnosing OSA requires a test called “Polysomnography”. This test measures how long the patient slept, and counts “apnea events”, defined as pauses in breathing that are followed by drops in blood oxygen and increases in blood carbon dioxide, and “hyponea events,” defined as a 50% reduction in air flow for more than 10 s, followed by a 4% desaturation, and/or waking up. These numbers are then used to calculate the Apnea-Hypopnea Index (AHI), which is expressed as the number of apneas and hypopneas per hour of sleep. An AHI of less than 5 is considered normal, 5 to 15 is considered mild OSA, 15 to 30 is considered moderate OSA, and any AHI score over 30 is considered severe OSA.

There are many treatment options available for patients with OSA, which have varying degrees of success. Some of them involve lifestyle changes, such as weight loss, avoidance of alcohol and smoking, and nasal sprays strips. Physicians may prescript a CPAP (Continuous Positive Airway Pressure) machine which is a mask worn every night for the rest of the patient’s life that forces air into the nasal passages during sleep. However, many patients find using the CPAP machine inconvenient and uncomfortable and there is well over a 50 % drop out rate for this treatment option.

For many patients, especially the 80 % who have a significant soft palate problem contributing to their apnea, surgery is the best option to provide a long-term reduction or cure of OSA symptoms. The Pillar Procedure is an FDA approved surgery, performed more than 25,000 times world-wide. Three tiny Pillar implants are placed into the muscle of the soft palate in a procedure which can be performed in the office. These implants provided internal structural support to the soft palate to prevent it from collapsing during sleep. While some OSA procedures can be quite invasive and have high rates of relapse, the Pillar Procedure is:

• Minimally invasive treatment
  
• Requires only a single, brief in-office visit
  
• Relatively painless with no prescription narcotics required
  
• Resume normal diet the same day
  
• Requires minimal follow-up
  
• Low complication rate
  
• A long-term solution

The Pillar Procedure has demonstrated both patient and partner satisfaction in many clinical trials. It not only reduces snoring and improves the sleep of the patient’s bed partner, many patients see a decrease in over 50 % of their AHI scores. The Pillar Procedure can be performed either alone or as part of a treatment plan for patients who have multilevel obstruction, and does not prevent the patient from other future treatment options.

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