Sleep Apnea

Sleep apnea has effective, individualized treatment that can restore restorative sleep, reduce daytime sleepiness, and improve quality of life. Proper care also lowers associated cardiovascular risks such as high blood pressure, arrhythmias, and cerebrovascular events.

Sleep apnea

The obstructive form occurs when, during sleep, the throat muscles relax and narrow the airway, leading to loud snoring, breathing pauses, and micro-arousals that fragment rest. Untreated, it increases the risk of high blood pressure, heart rhythm disorders, stroke, insulin resistance, and decline in attention and performance.

Accurate diagnosis

Confirmation is made through a sleep study — in-lab polysomnography or, in selected cases, home sleep testing — always combined with a specialized clinical evaluation. This mapping establishes severity and guides individualized treatment.

Non-surgical treatments

Positive airway pressure is considered the first-line treatment for most patients, with different mask interfaces and modes such as CPAP, auto-titrating, and bilevel, adjusted to comfort and need. Features like humidification, careful mask selection, and educational support improve adherence and enhance clinical outcomes. For mild to moderate cases, or when CPAP is not tolerated, oral appliances fitted by a sleep dentist advance the jaw or stabilize the tongue, widening the airway during sleep.

Lifestyle changes and complementary measures

Weight control, regular physical activity, reduced evening alcohol intake, and optimized nasal breathing form the foundation of any treatment plan. In cases with significant overweight, structured weight-loss programs — including pharmacological support when indicated — can ease symptoms and reduce severity. In positional apnea, technologies that prompt the patient to change position help maintain side-sleeping and can be used alone or combined with other therapies.

Surgery and advanced technologies

When conservative approaches do not deliver the desired result, surgical options are considered to correct anatomical obstructions of the nose, palate, tonsils, base of tongue, and facial skeleton. Options include next-generation palatal procedures, lateral pharyngoplasties, expansion sphincter pharyngoplasty, and maxillomandibular advancement in specific cases. Barbed reposition pharyngoplasty (BRP) repositions and supports the palate and lateral pharyngeal walls, distributing tension more evenly with less tissue trauma and generally faster recovery — especially useful in retropalatal collapse. Transoral robotic surgery of the pharynx and base of tongue, known as TORS, allows precise resection under magnified vision to address retrolingual collapse and epiglottic changes in suitable anatomical profiles, integrating into highly predictable airway surgical plans.

Patient selection and personalization

Drug-induced sleep endoscopy (DISE) is a valuable tool to precisely identify levels and patterns of airway collapse, distinguishing palatal, retrolingual, and laryngeal obstruction, including multilevel cases. These findings guide oral appliance use, define the role of surgery, and help safely select techniques such as barbed reposition pharyngoplasty and TORS. This coordinated diagnostic and therapeutic journey prioritizes effectiveness, comfort, and safety, with care plans tailored to each patient.

Follow-up and outcomes

Structured follow-up in the first weeks is decisive for consolidating adherence, resolving discomfort, and monitoring outcomes such as daytime sleepiness, blood pressure control, and sleep quality. Educational interventions and technical support encourage consistent device use and postoperative recovery, leading to fewer respiratory events and sustained functional improvement. With an individualized plan and ongoing monitoring, most patients experience meaningful gains in well-being and cardiovascular protection.

When to seek evaluation

Warning signs include loud snoring, witnessed breathing pauses, nighttime choking, morning headaches, and excessive daytime sleepiness — especially while driving or in meetings. The recommendation is to seek evaluation with a sleep specialist to confirm the diagnosis and define the best therapeutic combination for your profile. The earlier the care, the greater the potential to regain energy, productivity, and quality of life.

Where we see patients

At Dr. José Eduardo Marcondes’s practice — a reference in otolaryngology, with extensive experience — care for sleep apnea is comprehensive, precise, and human, from advanced diagnosis to personalized treatment. Patients are seen at premium locations in São Paulo and Alphaville, with the infrastructure and team prepared to welcome a discerning audience, with a focus on safety, comfort, and results.