UPPP and LAUP are commonly performed throat surgeries which surgically remove the uvula and parts of the soft palate. These surgeries are promoted by many healthcare professionals as being able to cure snoring or sleep apnea (stoppages of breathing in sleep), both of which are common sleep disorders. In the past, scientific research in sleep has reported that the success rate for these popular throat surgeries is generally 40%. Unfortunately, most of these studies used very liberal definitions of "success," and have ignored the more subtle effects of breathing problems in sleep that are similarly destructive to sleep quality. These more subtle effects of breathing problems and their importance are only beginning to be widely recognized by the sleep community.

At the Ohio Sleep Medicine Institute in Columbus, Ohio, Dr. Helmut Schmidt has begun using an extremely sensitive measurement of these subtle breathing problems called a Respiratory Arousal Index (RAI). The RAI measures brief awakenings that occur during the night in response to increased breathing effort from a partially closed airway or from snoring. A normal RAI is fewer than 10 arousal events per hour of sleep that are attributable to increased breathing effort. This new measurement shows that throat surgeries, specifically UPPP and LAUP, successfully cures only a very small number and specific types of patients.

Dr. Schmidt and colleagues performed overnight sleep studies on 14 patients (13 men and I woman), average age of 46.7 years, who had either UPPP or LAUP by other physicians in the central Ohio area. By the traditional measurement of a 50% reduction in the number of times a person experiences impaired breathing events (apneas) of 10 seconds or longer during the night, 50% of the patients in this particular study achieved "success." However, use of the more sensitive Respiratory Arousal Index (RAI) shows that only I patient out of 14 (7%) achieved success by showing a RAI of less than 10. This was also the only patient who no longer complained of daytime sleepiness or snoring 4 years after his surgery. The difference for this single patient was all of the following characteristics: (1) he was not overweight; (2) before his surgery he had a very mild breathing problem in his sleep (RAI = 13.7 per hour); and (3) a special x-ray of his head and neck revealed that he also had normal airway anatomy, specifically the area in the lower part of the throat behind his tongue which was of normal width (greater than 10 mm.). 11 of the 14 patients had abnormal narrowing of the airway space in the lower part of the throat and were thus not appropriate candidates for upper throat (UPPP or LAUP) surgeries alone.

The use of the RAI shows that only I patient out of 14, or only 7% of the patients having UPPP or LAUP throat surgeries were successfully treated.