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Treatment Options for Sleep Disorders
By Laurie Bailey


Dr. Ryan Soose


Dr. Andrea Lewis

Snoring and sleep apnea are very common, but potentially dangerous conditions, affecting millions of Americans. The symptoms and health effects can vary greatly from one person to another as well as across the lifespan – that’s why a ‘cookie-cutter’ approach just doesn’t work said Dr. Ryan Soose, Director of the Division of Sleep Surgery at UPMC, with offices at UPMC Mercy and a new location in Monroeville. He and Dr. Andrea Lewis take a comprehensive individualized approach to treating sleep disorders both medically and surgically.
In fact, they are two physicians – out of only three in the country – who are ENT (ear nose and throat) surgeons and are fellowship trained in sleep medicine.
“Training in both upper airway surgery and sleep medicine allows us to employ a variety of medical and surgical options and customize a treatment plan to each individual” said Dr. Soose.
Today’s surgical options for treating snoring and sleep apnea are less invasive, with improved effectiveness and faster recovery, and can be used as stand-alone treatments. They can also be performed in conjunction with non-surgical methods that include weight loss, oral appliances, or continuous positive airway pressure (CPAP). Most commonly used to treat sleep apnea, CPAP involves a mask that fits over the nose and /or mouth. It blows air into the patient’s airway to keep it open during sleep.
“CPAP can be highly effective with long-term adherence,” explained Dr. Lewis. But two-thirds of people who need them don’t do so consistently, she added. Other patients having issues with nasal congestion sometimes experience trouble with the CPAP as well.
Studies show that patients who have nasal surgery to correct chronic nasal obstruction are able to lower the air pressure of their CPAP, ultimately becoming more comfortable with its use.
Surgical options to treat sleep disorders primarily involve three areas of the anatomy: the nose, the upper throat, including the tonsils and palate; the lower throat, including the tongue and voice box area.
“The specific surgical procedures vary from patient to patient and depend on each individual’s unique anatomy and pattern of obstruction.” said Dr. Soose.
Every patient who visits the Sleep Center receives a comprehensive sleep history and physical examination during their initial visit, said Dr. Soose. Many also have an upper airway endoscopy as part of that exam.
“The endoscopy allows us to better characterize the airway anatomy and to predict proper procedure selection and treatment success. It’s a quick comfortable look at the nose and throat performed right in the office during the visit” said Dr. Soose, adding that it only takes about one minute.
For some patients, a new procedure known as sleep endoscopy may be recommended. In sleep endoscopy, sedation is used to recreated conditions that mimic sleep, allowing the surgeon to better assess how and where the breathing obstruction is occurring.
One common sleep disorder – snoring – is keeping approximately 90 million adults from having a good night’s sleep, according to the National Sleep Foundation.
“Many patients undergo a sleep study and are told they don’t have sleep apnea, but have loud snoring that may lead to other medical and psychosocial problems,” said Dr. Soose.
Snoring causes many couples to sleep in separate bedrooms and can put a big strain on marriages and relationships. Snoring also has been linked directly to carotid vascular disease and stroke risk.
At the UPMC Division of Sleep Surgery, Drs. Soose and Lewis offer a variety of treatment options for snoring, including nasal procedures, Pillar palatal implants, and radiofrequency tissue reduction. Pillar palatal implants, made of a thin fibrous material, are placed in the palate to stiffen it, subsequently reducing palatal flutter and the noise of snoring. This minimally invasive procedure is done under a local anesthetic in the office and many patients go back to work the day of the procedure.
Dr. Ryan Soose and Dr. Andrea Lewis are located at the UPMC Mercy Division of Sleep Surgery 1400 Locust Street Bldg. D, Suite 2100 in Pittsburgh, (412) 232-3687 and UPMC at Daugherty Drive, 125 Daugherty Drive, Suite 400, Monroeville, PA, (412) 374-1260.

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