News

Health Canada has approved a new treatment for obstructive sleep apnea, an implant designed to stiffen the palate and prevent snoring and breathing problems that are at the root of the common disorder.

The treatment, known formally as the Pillar palatal implant system, can be done in a doctor's office under local anesthetic. The procedure is expected to cost between $1,500 and $2,000.

Paul Younan, a Chicago software designer, received a Pillar implant in June, 2004.

"It didn't do anything immediately, but about 60 days later, I started feeling significantly better," he said.

Mr. Younan said that after the treatment, the interruptions in his sleep -- where he would stop breathing and wake up -- fell by about half.

"Essentially, this took care of the palatal part of my problem," he said.

There are many factors that contribute to sleep apnea, including breathing being compromised by the palate or the tongue. Mr. Younan suffered from both of those problems so, in addition to the implant, he wears a dental device that prevents his tongue from interfering with breathing.

The most common treatment for sleep apnea is a CPAP (continuous positive airway pressure) device; at bedtime, sufferers don a small mask and a machine pumps air into the mouth and nose to prevent involuntary lapses in breathing.

"The CPAP machine worked well, but I hated it," Mr. Younan said. "It was clunky and it gave the feeling of being on life support, which was creepy."

The other alternative for him was surgery, the removal of part of the uvula. "I looked into that and it seemed pretty barbaric and really painful," he said.

"The implant was a better idea." The implants, which are made of polyester, measure only 18 millimetres and "you don't feel them," Mr. Younan said.

Jeffrey Lipsitz, medical director of the Sleep Disorders Centre of Metropolitan Toronto, said there are a multitude of treatments for sleep apnea "because there is no one thing that works."

He said the Pillar procedure, now that it has been approved, is a welcome addition and probably something the clinic will offer. "Patients read about this stuff on the Internet, so we've had inquiries," he said.

Dr. Lipsitz said the key for him is to find the treatment that will work best for an individual patient. "This isn't for everyone. Patients should be selected appropriately," he said.

Sleep-apnea sufferers who are interested in the Pillar procedure will almost certainly have to pay out of pocket, Dr. Lipsitz said. "I don't expect it will be covered by OHIP" or other provincial health plans, he said.

The sleep specialist said that one of the major underlying causes of sleep apnea is obesity and before patients start shopping around for different procedures and equipment -- be it CPAP, the Pillar procedure, dental devices or surgery -- they should lose weight.

By some estimates, as many as two million Canadians suffer from obstructive sleep apnea. However, the condition is often undiagnosed and only a fraction of sufferers are treated.

While the snoring and breathing problems associated with sleep apnea are problematic, research is showing the condition can also have severe health consequences, including a sharp increase in the risk of heart attack and stroke.

The Pillar implant is a product of Restore Medical of St. Paul, Minn. About 16,000 patients in two dozen countries have received the implants, according to the company.