Surgical Vs Conservative Treatment of Obstructive Sleep Apnea. Literature Review

Abstract

Obstructive sleep apnea (OSA) is common sleep disorder where there are either a partial or complete blockage of the upper airways, imposing a thoughtful evaluation of treatment options for the disease. Conservative treatment for OSA focuses primarily on lifestyle and behavior changes. Lifestyle changes such as weight loss, cessation of alcohol and changing of sleep habit has important roles. Often is Continuous Positive Airway Pressure (CPAP) thought of as it first line treatment option. The usage of oral appliance in patients that either cannot tolerate CPAP or in patients with mild-to-moderate OSA could perhaps have a benefit. These conservative options aim to change the habit of sleeping, reduction of obesity and supine sleeping which contributes to the collapse of the airway and thus causes symptoms of OSA. Surgical treatment options for OSA have a more direct approach towards the problem of collapsibility of the airway, where one assesses the anatomical abnormality that is the cause of OSA. Surgical treatments of OSA rearrange the anatomy of the upper airway to which it creates a long-term solution in the treatment of OSA. Surgical treatment is often the last resort in severe cases. When comparing conservative and surgical treatment approaches in regards of OSA, the conservative treatments are less invasive, but they might be limited in efficacy, thus not giving the wanted result. Surgical interventions often are more definitive solutions to the problem, but there is no guarantee that the result is adequate, and thus not giving the result wanted. The management of OSA needs a tailored approach for each individual patient. This literature review highlight the differences between conservative and surgical approach when treating OSA. Further in this review of literature, each conservative and surgical treatment options will be investigated, and its advantages and disadvantages will be discussed.