Influence of modified uvulopalatopharyngoplasty on body weight and quality of night sleep in patients with low compliance to CPAP therapy

Abstract

Topicality: Obstructive sleep apnea syndrome (OSAS) is one of most wide-spread sleep disorders worldwide leading to the strong decrease in the quality of life, occupational and social efficiency of the patients. Golden standard for the management of OSA included CPAP therapy. However, it creates significant inconvenience for patient and has low compliance. Surgical treatment is considered as an alternative but still lucks unified approaches and quality scientific data. Methodology: Study involved 37 patients with II stage OSA caused by defects of soft palatine and uvula previously incompliance to CPAP that underwent uvulopalatopharyngoplasty (UPPP) by advanced low traumatic technic. Respiratory polygraphy (RP) was performed before (b) and after (a) operation to estimate the efficacy of procedure. Statistical analysis included body weight (BW), BMI, tital number of apnea episodes (NAE), total number of hypopnea episodes (NHE), percentage of normal sleep (NS) with average for indicators with normal distribution, median values, difference between the groups was evaluated by Wilcoxon signed-rank test with p-value=0.05. Results: Average age of the patients was 45(SD=13) years. The results were next: BMI(b)=30,2 (SD=2,7); BMI(a)=28,83 (SD=2,96); BW(b)=91,35 (SD=10,21); BW(a)=86,59 (SD=9,86); median NAE(b)=39, median NHE(b)=15; NS(b)=85,32% (SD=10,02); median NAE(a)=18, median NHE(a)=7; NS(a)=96,39% (SD=3,98). Advanced low traumatic UPPP led to the positive changes in of all indicators with high statistical significance (p<0,01). Conclusions: Advanced UPPP has shown positive effects on the quality of night sleep and respiration in patients incompliant to CPAP therapy. In addition UPPP had led to decrease in bode weight but this point should be followed up longer.