Big difference between sleep apnea (CPAP) and radiofrequency ablation (RFA) treatments in fighting sleep apnea

But now that many people know that there is a new procedure called RFA (Radio Frequency Ablation), many are asking "What's the difference?"

simply put:

• CPAP = Managing Sleep Apnea
• RFA = Cure Sleep Apnea

The difference between CPAP and RFA is basically the difference between having a strategy to get better sleep every night (CPAP) or a treatment to get better sleep permanently (RFA).

As mentioned above, CPAP machines became popular in the 1980s as a solution for getting more air into the lungs while sleeping at night. A mask, a hose and a machine that forces air into the patient's mouth and nose are a convenient way for many people to "kick the surgical can" on the road. However, the convenience of these devices is not without its problems, including the fact that up to half of the people who should be using a CPAP machine every night actually don't. This low compliance rate is an ongoing concern for physicians and patients.

Enter RFA, a new non-surgical option for treating sleep apnea. It is intended for individuals who cannot tolerate a CPAP mask or for whom CPAP is ineffective.

How RFA works

Radiofrequency ablation (RFA), also known as electrocautery, is a medical procedure in which part of the heart's electrical conduction system, tumors or other abnormal tissue are ablated using alternating current (in the range of 350–500) generated from a thermal medium. kHz). RFA is usually performed on an outpatient basis using local anesthetic or conscious sedation. When it is delivered through a catheter, it is called radiofrequency catheter ablation. .

Two important advantages of radiofrequency current (compared to the low-frequency alternating current or direct current pulses used previously) are that it does not directly stimulate nerves or myocardium, so it can often be used without general anesthesia, and it treats the desired tissue without significant of collateral damage.

The documented benefits have led to widespread use of RFA in the 21st century. RFA procedures are performed by an interventional pain specialist (such as an anesthesiologist), interventional radiologist, otolaryngologist, gastrointestinal or surgical endoscopist under image guidance (such as X-ray screening, CT scan or ultrasound), or cardiac electrophysiologist, a subspecialty of cardiologist .

The tongue base area is a common site of airway obstruction in patients with apnea, and RFA is a technique to prevent the tongue base from blocking the airway. A small amount of radiofrequency heat energy is applied to the base of the tongue, causing a reduction in the volume of that part of the tongue and reducing the softness of the tongue. The RFA procedure prevents the tongue from falling back and blocking the airway.

The advantages of RFA over surgery include:

• RFA is a non-surgical, outpatient procedure (similar to completing dental surgery.)
• The patient drives to the office.
• The tongue area is anesthetized while the patient is awake.
• Radiofrequency heat is applied to the base of the tongue, painlessly.
• The patient drives himself home.
• Patients typically return to work the next day and resume their daily diet and exercise regimen.

Please note that RFA does not cure everyone. But since sleep apnea can lead to serious health-related problems if left untreated, and having a CPAP machine that you ultimately don't use isn't the answer, RFA deserves a closer look.

Prospective patients should first see a doctor and undergo a sleep study. If you need help getting started with the process, please contact us for a no-obligation consultation. We are sleep specialists at Chevy Chase ENT located in Virginia, Maryland, and the Washington, D.C., metro area, treating sleep apnea and sleep-related issues. We can help diagnose your condition, recommend whether a sleep study would be beneficial, and provide you with a variety of treatment options, including CPAP, radiofrequency ablation (RFA), and more.

This lead article reviews the clinical use of RFA in obstructive sleep apnea, including controversies and potential advantages in specific medical situations. Unlike other electrosurgical devices, RFA allows very specific treatment to target the required tissue with precise demarcation lines, avoiding collateral damage, which is critical in the head and neck region due to the high density of major nerves and blood vessels. RFA also does not require high temperatures. However, overheating due to misuse of RFA can lead to harmful effects such as condensation on the electrode surface, boiling within the tissue that may leave “big holes,” tearing, and even charring .