When Dean Nakanishi’s wife, Staci, was suffering from insomnia at the end of her pregnancy, she discovered for the first time that her husband would regularly stop breathing during sleep.

“She got scared and woke me up again and again,” he said. “My wife spent the last trimester of her pregnancy thinking not only about our baby, but also worrying about me.”

Nakanishi decided to talk to his primary care provider, who referred him to the UW Medicine Sleep Disorder Center at Harborview for help. He was diagnosed with obstructive sleep apnea, a serious sleep disorder in which soft tissue in the nose and throat collapses during sleep. The airway becomes blocked and causes a person to stop breathing during sleep, often for a minute or longer. The National Institutes of Health estimates that 12 million Americans are affected by the disorder.

Left untreated, sleep apnea can lead to sleep impairment, which could affect job performance and increase the chances for a motor vehicle crash. The disorder can also cause high blood pressure and other cardiovascular problems, weight gain and headaches.

Nakanishi received a prescription for CPAP, or continuous positive airway pressure. CPAP is a machine used during sleep that delivers air through a specially designed nasal mask. It is the most effective, nonsurgical treatment for alleviating snoring and obstructive sleep apnea, and it’s the first-choice treatment by sleep specialists because it safely controls breathing.

“Like many people, I don’t want to be confined to the Darth Vader-like equipment, but I know I need it for my family and not just me, so I was willing to give it a try,” said Nakanishi of Everett. “You need to be able to breathe through your nose. I was having some pretty significant congestion over a long period of time, and using the CPAP wasn’t easy.”

About a third of all patients who are prescribed CPAP have trouble using it, and like Nakanishi, many of those people can’t use the machine because nasal tissue is too big and blocks the airway. Fortunately, a new minimally invasive surgery can make using CPAP easier by shrinking the turbinate, or nasal, tissue with radiofrequency waves.

“With radiofrequency turbinate reduction, I am able to very precisely heat tissue in the nose. The heat causes mild scarring that shrinks the turbinate tissue gently and makes more room in the airway,” said Dr. Ed Weaver, chief of sleep surgery and director of the sleep apnea research group at Harborview and a UW associate professor of Otolaryngology-Head and Neck Surgery. “It’s a quick procedure that takes just minutes once the tissues are numbed with nasal anesthetic. It can be done in clinic and most patients are back to their regular daily activities immediately. Plus, it can help patients avoid other, more invasive surgeries for sleep apnea.”

While the procedure can’t cure sleep apnea, the procedure generally allows people to use their CPAP successfully, resulting in a much better night’s sleep – for both the patient and their bed partner.

“It’s one of the few operations I can do to take care of two people at once,” Weaver said.

The sleep center team and the sleep apnea research group have received a National Institutes of Health grant to be the lead study site researching the procedure further. Weaver, the study’s principal investigator, has plenty of anecdotal evidence of happy patients, including Nakanishi, but his team would like to quantify the effects of the treatment on nasal airway functionality.

The team also hopes to assess what effect radiofrequency turbinate reduction has on CPAP use and how that usage translates to clinical outcomes, particularly in regard to quality of life and cardiovascular health.

“We know that people with obstructive sleep apnea are more at risk for cardiovascular problems, such as high blood pressure and heart disease, presumably because they are not able to get enough air during sleep,” Weaver said. “Our assumption is that the more a patient can use CPAP, the better their overall cardiovascular health will be. Likewise, we believe the treatment will improve sleep quality and quality of life, which we will also test.”

This trial is one of several major clinical studies being conducted by the sleep apnea research group.

Nakanishi, a middle school teacher, father of two young sons and a runner, has noticed a difference in his health since he has had the turbinate nasal reduction – his quality of sleep has improved and breathing through his nose is easier with much less congestion.

“I really appreciate Dr. Weaver’s bedside manner, rapport and his ability to give a good evaluation and give options,” Nakanishi said. “Dr. Weaver was very professional and very friendly. I would definitely recommend this surgery to people who are experiencing turbinate issues. It has improved my – and my wife’s – quality of sleep tremendously.”