TABLE II.D.
Risks, side effects and adverse effects of common obstructive sleep apnea interventionsa
| Intervention | Possible side effects and adverse effects |
|---|---|
| Home sleep study testing | False negative result, diagnosis delay, sensor discomfort or failure, skin irritation (from adhesives). |
| In-laboratory sleep study testing | Discomfort, skin irritation (from adhesives), sensor discomfort, or failure. |
| Continuous positive airway pressure therapy or automatic positive airway pressure therapy | Discomfort, nasal complaints, oral dryness, skin irritation, allergy to mask materials, poor sleep quality, aerophagia, claustrophobia, mask leak, epistaxis, dizziness. |
| Bilevel positive airway pressure therapy | Discomfort, nasal dryness, oral dryness, skin irritation, poor sleep quality, aerophagia, claustrophobia, mask leak, epistaxis, dizziness. |
| Oral appliance | Discomfort, occlusal changes, jaw or temporomandibular joint pain, tongue irritation, excessive salivation, mouth dryness, damage to teeth. |
| Drug-induced sleep endoscopy | Excessive sedation, desaturation, laryngospasm, risk of anesthesia,b loss of airway, need for intubation, epistaxis. |
| Tonsillectomy | Acute postoperative pain and swelling, severe pain, temporary dysphagia, postoperative bleeding, infection, risk of anesthesia.b |
| Soft palate surgery (i.e., UPPP, ESP,LP) | Acute postoperative pain and swelling, dysphagia, taste change, postoperative bleeding, infection, temporary or permanent velopharyngeal insufficiency, long term globus sensation, pharyngeal dryness, oronasal fistula, risk of anesthesiab, death. UPPP surgery associated with 1.6% major complication rate and 0.09% mortality rate. |
| Genioglossus advancement | Acute postoperative pain and swelling, mandibular fracture, neurosensory changes, mandibular fracture, dental injury or dental pulp necrosis, postoperative bleeding or floor of mouth hematoma, infection, risk of anesthesia.b |
| Hyoid suspension | Acute postoperative pain and swelling, temporary dysphagia, infection, postoperative bleeding, infection, risk of anesthesia.b |
| Base of tongue surgery or lingual tonsillectomy | Acute postoperative pain, postoperative bleeding, infection, dysphagia, globus sensation, taste loss or change, tongue numbness, pharyngeal scarring, risk of anesthesia.b |
| Epiglottis surgery | Acute postoperative pain, postoperative bleeding, infection, dysphagia, changes in speech, taste change aspiration, globus, risk of anesthesia.b |
| Nasal and sinus surgery | Acute postoperative pain, postoperative bleeding, infection, orbital injury, septal perforation, cosmetic changes, lacrimal system injury, hyposmia/anosmia, vision changes or blindness, intracranial injury, cerebrospinal fluid leak, risk of anesthesia.b |
| Jaw surgery | Occlusal changes, facial neurosensory deficits, cosmetic changes in facial profile and structure, infection, bleeding, subcutaneous emphysema, malunion or nonhealing of the mandible, temporomandibular related pain, risk of anesthesia.b |
| Hypoglossal nerve stimulation surgery | Acute postoperative pain, postoperative bleeding, infection, tongue stiffness, tongue abrasion, transient tongue hemiparesis, lip weakness, device malfunction requiring revision surgery, device migration, pneumothorax, discomfort with use, risk of anesthesia.b |
| Tracheostomy | Acute postoperative pain, postoperative bleeding, infection, tube obstruction, tube displacement, tracheoesophageal fistula, pneumothorax, tracheal stenosis, trachea-innominate fistula, thyroid injury, voice changes, risk of anesthesia.b |
| Bariatric surgery | Acute postoperative pain, postoperative bleeding, infection, nausea, vomiting, gastroesophageal reflux, mucosal ulcers, gallstones, anastomotic leak, chronic malnutrition, dumping syndrome, hernia, need for revision surgery, risk of anesthesia.b |
a
May not include all possible risks of listed interventions. Surgical risks include common expected postoperative symptoms and rare long-term risks. All interventions have the risk for insufficient improvement in snoring and OSA.
b
Includes risk of sore throat, nausea, vomiting, damage to teeth, laryngospasm, aspiration, anaphylaxis, hypoxia, respiratory failure, cardiovascular collapse, or death.