Sleep Surgery

A good night's sleep is essential to your health — but if you suffer from sleep-disordered breathing, you're not getting restorative sleep.

Sleep-disordered breathing refers to a wide spectrum of sleep disturbances, including snoring and obstructive sleep apnea, that are caused by collapse or blockage of your airway during sleep. Sleep surgery encompasses a range of procedures that correct these issues.

Left untreated, sleep-disordered breathing can lead to a number of health problems — including heart disease, high blood pressure, diabetes and stroke — and can even affect your immune system.

Who is a Good Candidate for Sleep Surgery?

You might be a good candidate for sleep surgery if you meet the following criteria:

• You've been diagnosed with an obstruction in the nose or mouth that affects your ability to breathe while you're asleep.
• You can't tolerate nonsurgical treatments like continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) therapy.
• You don't have any major medical problems that would make surgery high-risk.

What Sleep Surgery Procedures are Available at RUSH?

RUSH was one of the first systems in the country to offer Inspire therapy, or upper airway stimulation therapy. This innovative treatment involves a small implant that stimulates muscles to keep the airway open. The procedure is covered by most major insurance plans for people who have moderate to severe obstructive sleep apnea and can't tolerate a CPAP machine. Our sleep surgery team has performed Inspire surgeries since the treatment's debut in 2014, making him one of the most experienced in the Chicago area.

 

 

 

 

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Other procedures we offer include a wide range of surgeries on the nose, sinuses, soft palate (the tissue toward the back of the roof of the mouth) and throat. No matter what your issue may be, from mild snoring to nasal or tonsil obstructions to severe obstructive sleep apnea, we're dedicated to finding the solution that helps you return to restful sleep.

And if you've been told that sleep surgery isn't an option for you — or if you had ineffective sleep surgery elsewhere that needs correcting — the experts at Rush can help.

Underlying Conditions Treated

Sleep surgery refers to a range of procedures used to treat a variety of conditions that affect your breathing and your ability to sleep, including the following:

• Adenoid hypertrophy (enlarged adenoids)
• Allergic rhinitis
• Gastroesophageal reflux disease (GERD). Many people with obstructive sleep apnea also have GERD. Some studies have shown that treating obstructive sleep apnea can improve GERD symptoms.
• Nasal obstruction, such as a deviated septum or nasal valve collapse
• Obstructive sleep apnea (OSA)
• Sinusitis
• Snoring
• Tonsillitis (infected tonsils) or tonsil hypertrophy (enlarged tonsil tissue)

Sleep surgeons at RUSH offer advanced surgical treatments, including minimally invasive options, for people with obstructive sleep apnea and other disorders who can't tolerate nonsurgical therapies, such as continuous positive airway pressure (CPAP). These procedures can help you safely breathe when you go to sleep at night, dramatically improving the quality of your sleep.

How are Sleep Disorders Diagnosed?

If a sleep study reveals that you have an anatomical cause of your sleep problems (such as obstructive sleep apnea), we recommend that you have a full upper airway evaluation with specialists in the Section of Sleep Surgery at RUSH. More advanced tests, including the following, will help us pinpoint the exact type and severity of the problem.

• Drug induced sleep endoscopy: an outpatient procedure that enables doctors to evaluate your airway while you sleep. This study shows why and where your breathing is being blocked, which helps the sleep surgeon choose the best treatment options.
• Drug induced sleep endoscopy during positive airway pressure (DISE-PAP): Like drug induced sleep endoscopy, this outpatient procedure allows doctors to evaluate your airway while you sleep. However, this test adds positive airway pressure to simulate CPAP. If you’ve tried CPAP and it hasn’t worked, this test can help determine why — and whether a surgical procedure may offer more relief. Rush is one of just a few hospitals in the U.S. to offer DISE-PAP.
• Nasal endoscopy: a procedure that is performed in the doctor's office to examine your nasal cavity. This test helps doctors diagnose conditions such as sinusitis, deviated septum, turbinate hypertrophy and nasal polyps.
• Awake flexible laryngoscopy: also performed in the doctor's office, this procedure helps doctors examine your nasal cavity, throat and larynx (voice box).  It helps diagnose conditions such as sinusitis, deviated septum, turbinate hypertrophy, GERD, obstructive sleep apnea, throat cancer, difficulty swallowing (dysphagia) and hoarseness.

Types of Sleep Surgery

Breathing problems occur in three main areas:

• Nose/nostrils
• Soft palate (the soft tissue toward the back of the roof of the mouth)
• Throat

Sleep surgeons at RUSH are dedicated to helping you find the right procedure to address your individual needs. They offer a variety of surgical procedures to treat both common and complex problems, including the following:

Nasal surgery

• Adenoidectomy
  • Used to treat adenoid hypertrophy, a condition in which the adenoids (glands in the back of the nose) are enlarged, causing difficulty breathing, obstructive sleep apnea or chronic sinus disease
  • Most commonly performed in children, but some young adults may need to have their adenoids removed
• Endoscopic sinus surgery
  • May be recommended for people with sinusitis who do not respond to medical therapy
  • A minimally invasive procedure used to open blocked sinus drainage pathways and allow mucus to flow more freely
  • Also used to treat nasal polyps or inflammation in the nose, which can affect the quality of a person's sleep
  • Usually done under general anesthesia as an outpatient procedure
• Nasal turbinate surgery
  • Used to treat turbinate hypertrophy, a condition where the tissue lining the large bones in the nose becomes enlarged, causing nasal airway obstruction and difficulty breathing
  • May be recommended to reduce the size of the nasal bones
• Nasal valve surgery
  • Used to treat severe nasal obstruction due to nasal valve collapse, a common cause of airway obstruction. Many people who feel relief with Breath-Right strips have this problem.
  • A variety of techniques are available; your surgeon will work with you to determine which one is right for you
• Septoplasty
  • Used to treat a deviated septum, when the wall (nasal septum) that separates the nostrils is off-center, causing difficulty breathing through the nose

Soft palate procedures

• Palatopharyngoplasty (originally known as uvulopalatopharyngoplasty, or UPPP)
  • May be recommended if the palate is a major source of airway obstruction
  • Involves repositioning muscles in the throat and/or removing excess palate tissue to open the space in the back of the throat for improved breathing at night
  • There are different ways to do the procedure, and your sleep surgeon will work with you to determine which one is right for you. Sleep surgeons at RUSH offer the most current techniques, including expansion sphincter pharyngoplasty and lateral pharyngoplasty.
• Radiofrequency ablation of the palate
  • Used to treat snoring caused by issues with the palate
  • An outpatient procedure performed under local anesthesia in the doctor's office
  • May need to be repeated to achieve desired results

Throat surgery and procedures

• Lingual tonsillectomy
  • Used to treat obstructive sleep apnea caused by enlarged tonsil tissue at the back of the tongue
  • Surgeons either reduce the size of the tissue or remove part of it to help open the airway and allow for better breathing at night
• Radiofrequency ablation of the tongue base
  • Used to treat obstructive sleep apnea caused by an enlarged tongue
  • Under general anesthesia, a small probe is inserted into the tongue and used to heat the tissues, reducing the size of the tongue
  • May need to be repeated to achieve desired results
• Tonsillectomy
  • Used to treat tonsillitis (infection) or tonsil hypertrophy (enlarged tonsils)
  • Tonsils are removed through the mouth using a heated energy device that minimizes bleeding
  • Although it is an outpatient procedure, if you have obstructive sleep apnea or other serious health conditions, you may have to stay overnight for observation
• Tracheostomy
  • Used in very rare circumstances to treat OSA when all other treatments have failed and your sleep apnea is causing severe medical complications
  • Used to create an opening in the windpipe (trachea) and place a plastic tube to help you breathe
  • Most often used for people with severe respiratory disease who need a ventilator to breathe, as well as those with head and neck tumors that are blocking the airway
• Inspire Therapy (upper airway stimulation)
  • An innovative treatment for patients with moderate to severe obstructive sleep apnea who cannot tolerate CPAP therapy
  • Involves implanting a small stimulator under the skin that stimulates the throat muscles while you sleep to prevent them from collapsing
  • Rush was one of the first sites in the U.S. to offer Inspire and continues to be a leader in its use. 
  • Get the answers to some frequently asked questions about Inspire.

Skeletal Surgery Procedures

• Minimally Invasive Surgically-assisted Rapid Palatal Expansion
  • Used to treat a narrow, high-arched palate that can contribute to nasal obstruction and obstructive sleep apnea
  • Your surgeon will work together with an orthodontist using a palate expander to widen your upper jaw and nasal cavity to help maximize nasal breathing
  • This is an outpatient surgery
• Maxillomandibular Advancement Surgery
  • May be used to treat obstructive sleep apnea related to a narrowed airway, often associated with small or underdeveloped jaws
  • This procedure makes cuts in both the upper and lower jaws and moves the jaws forward to significantly enlarge your airway
  • This is an inpatient surgery requiring overnight hospital stay
• Genioglossus Advancement
  • May be recommended if you have a recessed chin contributing to a narrowed airway
  • Often used in conjunction with other sleep apnea surgeries to help optimize your airway

RUSH Excellence in Sleep Surgery

• Unmatched expertise: With a practice focused exclusively on sleep surgery — and hundreds of successful procedures performed — RUSH's sleep surgeons are experts in pinpointing the procedure that will help you. We offer DISE-PAP (drug induced sleep endoscopy during positive airway pressure application). This test can help determine precisely what’s causing your sleep apnea — and which surgical procedures are most likely to help. 
• Coordinated care for multiple symptoms: Patients with sleep apnea often have other sleep issues or ear, nose and throat problems. Our sleep surgeons partner with ENT doctors and other RUSH specialists to treat all of your interrelated health issues and coordinate all your care so you get the relief you need.
• Dedicated sleep team: Our sleep disorders care team includes experts in behavioral health, neurology and pulmonary medicine. Whatever your sleep issue, we'll work with you to find the right solution and get you back to healthy sleep.
• Customized approach: RUSH's sleep surgeons use the most up-to-date techniques for every procedure, and tailors their approach to your unique situation. Whenever possible, they use a minimally invasive surgical approach that results in less pain and a faster recovery time for you. And they'll see you personally at your post-procedure appointments to ensure that you're getting great sleep.
• When it's more than sleep apnea: If you are suffering from a combination of symptoms, including sleep disturbances, persistent sinus pain and pressure, breathing problems and/or coughing, you may benefit from the one-stop approach at the RUSH Sinus, Allergy and Asthma Center.
• Nationally ranked: RUSH's ear, nose and throat program is ranked among the nation's best by U.S. News & World Report.