Effectiveness of Treating Obstructive Sleep Apnea by Surgeries and Continuous Positive Airway Pressure: Evaluation Using Objective Sleep Parameters and Patient-Reported Outcomes

Background/Objectives: Uvulopalatopharyngoplasty (UPPP), palatal plus nasal surgery (PNS), and continuous positive airway pressure (CPAP) are widely implemented treatments for obstructive sleep apnea (OSA). This study aims to explore the long-term effects on objective sleep parameters and patient-reported outcomes (PROs) following different therapeutic interventions for OSA. Methods: Data from patients with moderate-to-severe OSA were retrospectively collected from a medical center and a regional hospital, spanning from December 2011 to August 2018. Objective evaluations included the Apnea–Hypopnea Index (AHI), minimum O₂ saturation, and sleep efficiency. The PROs consisted of the Snore Outcomes Survey and Epworth Sleepiness Scale. Using mixed-effects models, we evaluated longitudinal changes in sleep parameters and PROs, accounting for repeated measures and variations within individuals over time. Results: Among 448 patients with moderate-to-severe OSA, follow-up data were collected for 42 patients undergoing UPPP surgery, 171 undergoing PNS, 127 using CPAP, and 108 in the non-treated group. The mean follow-up was 16.7 months (SD = 11.9, range: 1.6–77.3). Significant improvements were observed in AHI, minimum O₂ saturation, and hypersomnia immediately following interventions with UPPP, PNS, and CPAP therapy (p < 0.05). Moreover, the analysis revealed no significant rate of change in these parameters over time, suggesting that the benefits of these treatments were sustained in the long term. Furthermore, all interventions exhibited a significant short-term effect on self-reported snoring when compared to the control group, with a p-value of less than 0.001. However, the magnitude of this improvement gradually decreased over time. The snore scores seemed to return to pre-treatment levels among the UPPP, PNS, and CPAP groups after averages of 46.4, 63.5, and 74.4 months, respectively (all p < 0.05). Conclusions: Surgical interventions and CPAP therapy showed potential long-term effectiveness in managing OSA. Snoring symptoms reappeared about 3.9–5.3 years after surgical treatments, which seemed earlier than the average of 6.2 years in patients receiving CPAP and should be considered in patient-participatory decision-making processes.