Guide. Treatment. RFASleep Apnea. Non-Surgical Treatment Proven Effective in Treating Mild to Moderate Obstructive Sleep Apnea (OSA)

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1 Get Rid of Your CPAP and Get a Better Night s Rest RFASleep Apnea Treatment Guide Non-Surgical Treatment Proven Effective in Treating Mild to Moderate Obstructive Sleep Apnea (OSA) RFA Sleep Apnea Treatment Center of Chevy ChaseENT 1

2 Tired of Your CPAP Device? RFA Sleep Apnea Treatment May Be Right For You As an Obstructive Sleep Apnea (OSA) sufferer, you know the risks of OSA, and if you re using a CPAP device you also know how clumsy, uncomfortable, and irritating they are to wear every night while you re trying to sleep. Fortunately, there s a non-surgical treatment option that has been proven effective in treating mild to moderate sleep apnea. Radio Frequency Ablation (RFA) is a simple, painless, non-surgical treatment procedure that uses radio wave energy to cure your sleep apnea and help you get rid of your CPAP mask and machine. RFA treatment relieves the potential for airway blockage that causes the snoring, breathing disruption, and lack of a good night s sleep that are the symptoms of untreated OSA. RFA is a painless, non-surgical procedure, performed during a regular office visit, that can free you from the discomfort of wearing your CPAP mask With RFA treatment, patients suffering from mild to moderate OSA can often get rid of their CPAP masks. In some cases with severe OSA, RFA treatment can make using a CPAP mask more tolerable, by lowering the air pressure required after the RFA procedure. MySleepApneaMD.com 2

3 RFA Sleep Apnea Treatment A Painless, in-office Treatment to Cure Mild to Moderate OSA The RFA procedure is performed in our office as an outpatient procedure with local anesthesia. RFA treatment consists of an initial, one-hour visit, followed by five monthly, half-hour visits to our office. A local anesthetic is administered to the base of the tongue, and a small probe delivers a mild pulse of radio frequency energy to the base of the tongue in the back of the throat. After the procedure is finished, usually in less than 30 minutes, you can drive yourself home and resume your usual routine. 1.) Airway obstruction occurring at the base of the tongue 2.) Radio frequency energy delivered to the tongue base 3.) Improved airway with resolution of tongue base obstruction Sleep Apnea: It s Not Just About the Snoring We know that if you or a family member has sleep apnea, the most common complaint is the disruptive snoring that keeps your partner awake. But aside from snoring, you need to know about the significant risks associated with untreated sleep apnea. Sleep Apnea Often Means Sleep Deprivation and Other Potential Health Problems A good nights s sleep requires effortless and continuous breathing to bring oxygen to the brain to facilitate our body s restorative processes during sleep. Sleep apnea, a common RFA Sleep Apnea Treatment Center Of Chevy ChaseENT 3

4 A poor night s rest due to OSA causes fatigue, depression, and lack of alertness during the day condition that affects over 22 million Americans, interferes with breathing and often causes sleep disruption, with 80 percent of moderate to severe sleep apnea cases going undiagnosed each year. What is Sleep Apnea? Obstructive sleep apnea (OSA) occurs when the tissue at the base of your tongue relaxes too much and drops back into your airway while sleeping. When this happens, it results in abnormal breathing patterns, loud, disruptive snoring, and repetitive episodes of obstructed breathing which results in sleeplessness and gasping for breath. In its mildest form, the airway blockage caused by OSA permits some air to move through the airway, but this air must pass by your tongue that is partly obstructing the airway, and this partial blockage is what causes snoring. However, in more significant airway obstruction caused by OSA, the tissue at the back of the tongue prolapses and moves further back into the base of the throat, completely obstructing the airway. When airway obstruction occurs during sleep apnea, breathing stops and so does the delivery of fresh oxygen to the brain. Breathing interruptions caused by sleep apnea can occur for a few seconds or even as long as 60 seconds or more. In severe sleep apnea cases, these interruptions can occur hundreds of times a night, often causing disruption during the rapid-eyemovement (REM) sleep stage, the deepest and highest-quality stage of sleep. When this sleep disruption occurs, you are not getting the full night s sleep that is necessary for full alertness during the day, and lack of good sleep leads to daytime fatigue, poor alertness, depression, and adverse effects on the heart and brain. Poor sleep quality due to sleep apnea means you re not generally at your best during the day: You re fatigued and fall asleep during the day, resulting in decreased energy, slowed cognition, and lack of motivation. The effect of sleep MySleepApneaMD.com 4

5 deprivation on your body due to sleep apnea is similar to a camera battery that s lost its charging capacity: It can be charged, and will work for a time, but soon loses its energy and ability to function because it lacks the staying power of a battery that is fully charged. Lack of alertness during the day caused by sleep apnea can also lead to accidents while driving or operating heavy machinery. Also, any condition which deprives us of the proper amount of oxygen has a negative effect on daily life and long-term health. Because of this, the longer-term effects of sleep apnea can lead to high blood pressure, heart failure, heart attacks, stroke, and diabetes. Untreated OSA can lead to: High blood pressure Heart disease Stroke Diabetes For high-risk patients those who are obese, who smoke, or who suffer from high blood pressure, elevated cholesterol, or heart conditions sleep apnea can have even more dangerous effects. For example, an overweight patient with a heart condition may not be able to tolerate the constant, stop-and-go blockage to their breathing process that occurs during more severe sleep apnea. Aside from the health problems of poor sleep, for these patients, the stress of constantly interrupted breathing can sometimes lead to a fatal heart attack or stroke during sleep. The Continuous Positive Airway Pressure (CPAP) mask, the most commonly prescribed treatment for sleep apnea, uses continuous air pressure to keep the airway open during sleep, and can be an effective treatment for sleep apnea. However, there are many common complaints we hear from patients who use CPAP masks: They re uncomfortable, difficult to tolerate, cause claustrophobia, and can interfere with falling asleep. For these patients, RFA treatment can be a good option. What Can I Do To Treat Sleep Apnea? There are a wide variety of treatments available for OSA relief from dental mouthpieces worn at night, to implants for the soft palate, and more invasive surgical procedures involving hospital stays and long recovery periods. RFA Sleep Apnea Treatment Center Of Chevy ChaseENT 5

6 Dental mouthpieces must be worn at night during sleep, just like a CPAP mask. Patients who use dental mouthpieces complain of excessive salivation and drooling, jaw discomfort, and difficulty sleeping. RFA sleep apnea treatment has been proven effective in clinical studies for treating mild to moderate OSA Implants are available, which are inserted into the soft palate, reducing the potential for airway blockage and associated breathing disruption during sleep. While these options can provide effective relief in some individuals, this involves a minor surgical procedure placing synthetic material into the body, with associated risks of infection, implant failure, or other complications from these procedures. There are other major surgical interventions to treat the tongue base, such as Maxillary-Mandibular Advancement (MMA) surgery and Trans Oral Robotic Surgery (TORS). These surgical options require general anesthesia in a hospital, prolonged recovery of up to one month, and significant risks. RFA Sleep Apnea Treatment: An Effective, Non-Surgical Alternative to Using a CPAP Machine RFA sleep apnea treatment has been widely recognized as being an effective treatment for relief of OSA, providing substantial reductions to the snoring and breathing disruption that are the major problems associated with OSA. These studies have shown that RFA treatment is an effective alternative for patients who either cannot or will not tolerate using a CPAP device. For many patients who suffer from mild to moderate OSA, RFA treatment has been proven as an effective alternative to wearing a CPAP mask every night. The RFA procedure has been proven highly successful in treatment of mild to moderate sleep apnea. According to clinical studies, RFA treatment has been successful in treating 75% of sleep apnea cases (Fibbi et al., 2009), resulting in a 45% long-term reduction in sleep disturbance based on (continued on page 8) MySleepApneaMD.com 6

7 Answers to Common Questions About RFA Sleep Apnea Treatment What is RFA? Radio frequency ablation (RFA) of the tongue base uses small bursts of radio frequency energy to reduce the volume and stiffen the tissue at the base of the tongue. RFA therapy results in preventing the obstruction which occurs during sleep with obstructive sleep apnea (OSA). How Does it Work? With the RFA procedure, a local anesthetic is applied to the back of the throat. A short burst of radio frequency energy is applied to the tongue base in a painless fashion. Over the ensuing weeks of RFA treatment, that area of the tongue reduces in volume and stiffens. This results in preventing the obstruction that occurs with sleep apnea. Is it Painful? Because it s performed with a local anesthetic, RFA is a painless procedure. There are no dietary restrictions or other preparations necessary and patients can drive themselves home after each treatment. How Long Does it Take? An initial consultation is required to determine if a patient is a good candidate for the RFA procedure. The initial treatment takes about one hour, and subsequent treatments take about minutes. How Many Treatments are Required? After the initial one hour treatment, five additional treatments, spaced out over a six-month time period, are usually required to complete the RFA treatment. What Can I Expect During Treatment? The RFA procedure is performed in our office while you are sitting upright in a chair. A local anesthetic is applied to the back of the throat. After your oral area is completely numb, a probe is used to apply the radio frequency energy to the back of the tongue in a painless fashion. Patients drive themselves home shortly after the procedure. Are There Any Risks or After-Effects? There are risks to everything in life, including medical interventions. There is a very low risk of infection with the RFA procedure; however, each patient is usually covered with antibiotics and monitored very closely. There is usually a small amount of throat swelling which does not interfere with speaking, swallowing, or breathing. There is also a mildly sore throat for 1-2 days which is usually treated with over-the-counter pain medications such as Tylenol or Aleve. Overall, RFA is a very safe procedure with an excellent safety track record. Is the RFA Treatment Right for Everyone? Each patient must be individually assessed to evaluate whether or not RFA treatment is right for them. The assessment consists of obtaining a patient history, a review of medications and past medical history, a complete examination of the upper airway, and a review of the sleep study. Based on this review and evaluation, candidacy for RFA is determined. Is RFA Treatment Covered by Insurance? Medicare and United Healthcare currently cover the RFA treatment. Many insurance carriers follow the guidance of Medicare and we anticipate other insurance carriers to follow. RFA Sleep Apnea Treatment Center Of Chevy ChaseENT 7

8 Contact us and speak to a doctor to determine if RFA can treat your Obstructive Sleep Apnea respiratory disturbance index (RDI) measurements (2008 analysis by Farrar et al.). Over 70% of patients with mild OSA (RDI between 5-15) can be cured, and over 50% of patients with moderate OSA (RDI between 16-30) can be cured and cured patients no longer require CPAP. Although patients with severe OSA may not be cured, RFA treatment should be considered as this can lower their RDI, lessen the apnea severity, and decrease the adverse consequences on their health. Sleep Apnea and RFA Insurance Considerations RFA treatment is covered by many health insurance plans, including Medicare and United Healthcare. For Further Information, Contact Us Is RFA treatment right for you? Contact us to schedule an appointment and examination to determine if and how well the RFA procedure will help alleviate your sleep apnea symptoms, free you from your CPAP mask, and give you the good night s sleep you deserve. Chevy ChaseENT RFA Sleep Apnea Treatment Center 5530 Wisconsin Avenue Suite 1500 Chevy Chase, MD (301) Fax: (301) RFAinfo@mysleepapneamd.com MySleepApneaMD.com 8