Rationale for Surgery:

Nearly all patients with documented SDB are candidates for surgical intervention. This mandates that the patients are medically and psychologically stable and wish to undergo a surgical procedure. They should be informed of the various medical and surgical treatments, along with current treatment philosophies. Surgical indications should include the two major pathophysiologic parameters of SDB: neurobehavioral and cardiopulmonary derangements caused by nocturnal obstructions during sleep. Patients with the diagnosis of UARS usually present with marked excessive daytime sleepiness (EDS). Since there are numerous other causes of EDS such as narcolepsy, insomnia and sleep deprivation, a nasal CPAP trial, in this group, can be diagnostic and therapeutic thus helping to establish that EDS is secondary to upper airway resistance syndrome and sleep fragmentation (SDB). The cardiopulmonary risks of OSAS have been documented when the respiratory disturbance index is greater than 20 and their lowest oxygen saturation level is below 90%.4 This severity necessitates treatment to lower the risk of cardiopulmonary sequelae and the increased mortality rate.

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