Radiofrequency tissue reduction of the palate in patients with moderate sleep-disordered breathing

Objective: Radiofrequency volumetric reduction of the palate has been advocated as a treatment for mild sleep-disordered breathing (SDB). Our study examines the efficacy of this procedure on patients with mostly moderate SDB. Design: Prospective, nonrandomized, consecutive series. Setting: St. Boniface Hospital, Sleep Disorders Centre, University of Manitoba, Winnipeg. Method: Twelve patients with polysomnographically proven moderate SDB were given a total of 2400 to 3600 joules of radiofrequency energy to their soft palate over two to three treatments. Follow-up examined the effect of treatment on subjective and objective parameters including the Epworth Sleepiness Scale, loudness of snoring, Apnea-Hypopnea Index (AHI), and Arousal Index. Results: Two of 12 patients had a good objective response to treatment in that their AHI dropped by more than 50% and to a value of less than 20. However, none of the patients claimed to have a satisfactory subjective response. There was a slight reduction in the mean AHI from 31.2 +/- 5.1 to 25.3 +/- 4.2 (p < .05), but no clinically significant difference was found between pre-and post-treatment groups with respect to other sleep parameters. There was no improvement in daytime sleepiness or snoring. Conclusions: Radiofrequency tissue ablation of redundant soft palate tissues lacks clinical efficacy in patients with moderate SDB.