Perception of surgical treatments for obstructive sleep apnea among sleep medicine physicians: A cross-sectional study

BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disorder associated with significant morbidities and mortality if untreated. Continuous positive airway pressure is the gold standard treatment for OSA, but poor adherence significantly limits its use. However, there is evidence to support the effectiveness of surgical treatments for OSA. OBJECTIVES: This study aimed to assess the experience of sleep physicians in Saudi Arabia in treating OSA using surgical options. MATERIALS AND METHODS: This cross-sectional study featured an electronic survey that was sent to all sleep physicians across the Kingdom of Saudi Arabia between January 2018 and March 2018. The questionnaire contained questions on the demographics of the physicians and the types of surgical referral for patients with OSA. RESULTS: Twenty-six physicians completed the questionnaire. More than two-thirds of the physicians preferred to refer their patients to otolaryngologists (69.23%), while the remainder preferred to refer their patients to oral and maxillofacial surgeons (23.07%). More than half of the physicians indicated that maxillomandibular advancement (MMA) was the most effective surgical procedure (53.8%), followed by adenotonsillectomy (19.2%), then uvulopalatopharyngoplasty (UPPP) (11.5%). Four physicians (15.4%) chose “none” as the best answer. More participants indicated that the benefits outweighed the risks for MMA (53.84%) than for UPPP (19.23%). CONCLUSION: Based on the opinions of sleep physicians in Saudi Arabia, MMA is the best surgical option for the treatment of moderate to severe OSA. Otolaryngologists are the preferred surgeons because they are more available than oral and maxillofacial surgeons physicians, who are scarce in Saudi Arabia.