Research & Publications

Sinus Surgery May Also Ease Sleep Apnea: Response by Dr. Sesso

Date Posted: Tuesday, October 13th, 2015 by Alan Berger

Chronic sinus infections may be affecting your sleep. According to a recent study published last month in JAMA-Otolaryngology Head and Neck Surgery, sinus surgery can improve sleep quality. This study supports what we commonly observe in our practice every day. Think about the last time you had a "head cold, sinus infection or stuffy nose." Most likely you didn’t have a very good night’s sleep when your nose was congested. Patients suffering with chronic sinusitis may experience nasal congestion and poor sleep every night.

Researchers found that patients who underwent sinus surgery reported breathing easier, better quality sleep and an improved quality of life. This study adds to the growing body of evidence that the nose plays a role in obstructive sleep apnea (OSA). The exact mechanism of how the nose influences OSA is not known; however, it is thought that nasal obstruction causes mouth breathing and, in turn, mouth breathing may cause a narrowing of the airway at the back of the tongue. This may seem counter-intuitive (that mouth breathing obstructs the airway) yet, in some patients, the act of mouth breathing can cause the tongue to "fall back" into the airway and cause obstruction.

In my daily practice, I discuss nasal obstruction with all of my sleep apnea patients. It has long been my belief that improving the nasal airway has a benefit for both daytime and night-time breathing. Unfortunately, this is often overlooked and many of my patients with OSA tell me that no one has ever examined their nose. I believe that OSA, to a certain extent, is an anatomical problem and warrants an anatomical exam. During a patients initial visit, I will examine their entire upper airway, including the nose, to determine if we can find complementary or alternative treatments for snoring, sleep apnea or fatigue. For example, if patients with nasal obstruction are struggling with continuous positive airway pressure (CPAP) therapy, we may discuss a minor surgical procedure to enlarge their nasal airway in the hopes of making CPAP more tolerable. Surgery may not be warranted in all patients. In fact, medical therapy may be the treatment of choice.

If surgery is indicated, these procedures can be performed on an outpatient basis (and sometimes in the office). Today’s surgical techniques do not require nasal packing. Most patients experience mild discomfort and can go back to work or school within 2 days.

If you struggle with congestion, sinus infections, snoring, fatigue or sleep apnea, treatment and relief are available. The first step is seeing your doctor.