A three-centre prospective pilot study to elucidate the effect of uvulopalatopharyngoplasty on patients with mild obstructive sleep apnoea due to velopharyngeal obstruction

In this paper we describe the outcome of a prospective study designed to in vestigate the role of uvulopalatopharyngoplasty in the management of mild o bstructive sleep apnoea. A group of 21 patients fulfilling strict inclusion and exclusion criteria underwent uvulopalatopharyngoplasty performed by a single surgeon using a modified technique. Specifically designed daily pain questionnaires were completed by the patients for 2 weeks after surgery an d the morbidity associated with the procedure was assessed at 2, 6 and 12 w eeks after operation. Thirteen of the 21 patients underwent a postoperative sleep study at 3 months after operation. The outcome measures used were th e apnoea/hypopnoea index, the minimum O-2 saturation, the sleep arousal ind ex, the sleep architecture, the Epworth Sleepiness Scale score, the subject ive improvement in both the patient's and their partner's sleep and the mor bidity associated with uvulopalatopharyngoplasty. We conclude that the pati ents with mild obstructive sleep apnoea mo st likely to obtain significant benefit from uvulopalatopharyngoplasty are those with a body mass index of between 27 and 30 with no cephalometric disproportion, those with frequent arousals not associated with periodic limb movements, those whose sleep rel ated breathing disorder is not positional and most importantly those with s ymptomatic day time sleepiness.