Severe OSA Treatments


 

1. Which surgical treatments for severe sleep apnea are covered by insurance?

A: UPPP (Uvulopalatopharyngoplasty) is a procedure performed under general anesthesia in a hospital setting to remove tissue at the back of the throat (tonsils, uvula, and part of the soft palate) and thus enlarge the oral airway. UPPP surgery is extremely invasive, involving significant pain, high risk of complications, and recovery time of two weeks or more with only ~40% success rate.

Tonsillectomy is another major dissection surgery, somewhat less invasive in that it involves only removal of the tonsils, which are typically overly large.

Although the majority cost of either of these surgeries is covered by insurance, the patient out-of-pocket cost is typically as high as the total cost of receiving the Pillar® Procedure treatment.


2. Are there any non-surgical treatments that are covered by most insurance plans?

A: Yes, the CPAP (continuous positive airway pressure) device is considered the “gold standard" of non-surgical care for OSA. These devices have been around for a long time and they do work, but CPAP treatment often fails for the following reasons - 

• Lack of patient compliance/tolerance, with reported compliance often as low as 40-50%
• The machine noise is often as disturbing to patients and bed partners as snoring/gasps of breath
• Patient must transport machine with them when traveling

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Michael Macdonald, M.D.
500 Sutter Street
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San Francisco, CA 94102