Frequently Asked Questions

It is a disease where the throat closes totally or partially while you sleep. This blocks airflow for 10 seconds or more, causing choking and critical drops in blood oxygen levels.

Snoring is just the noise of air vibrating against the relaxed tissues of the throat. Apnea occurs when those tissues collapse completely and prevent you from breathing, causing real suffocation.

Loud snoring, breathing pauses detected by your partner, frequent nighttime urination (nocturia), morning headaches, and feeling extremely sleepy or fatigued during the day.

It is a diagnostic test performed in the operating room by inducing light sleep with medication. We use a flexible camera through the nose to see in real time which area of your throat closes when you snore or have apneas.

The sleep study (polysomnography) confirms you have apnea, but it doesn't tell us where the obstruction is. DISE shows at which level of the throat the airway closes while you sleep, and that helps to choose the right surgery for your case.

Both specialties are qualified to operate on the nose. Modern rhinoplasty unites both fields within facial plastic surgery: aesthetic refinements must not compromise breathing (the most common reason for secondary surgery), nor should functional surgery disregard facial harmony. Dr. Méndez-Benegassi combines both areas: an ENT specialist (SEORL-CCC), member of the European Academy of Facial Plastic Surgery (EAFPS) and the Spanish Society of Aesthetic Medicine (SEME), with a Master’s Degree in Facial Aesthetics with Honors (UCM). Consultations and free simulations are held at HM Madrid, HM Valdebebas, and HM Tres Cantos.

In ultrasonic rhinoplasty, bone is cut and sculpted using a high-precision piezoelectric instrument. Unlike traditional osteotomes and hammers, ultrasound selectively acts on bone tissue while preserving blood vessels, cartilage, and soft mucosa, which in clinical trials resulted in significantly less swelling and bruising during the first week.

Yes. This is known as functional septorhinoplasty: a deviated nasal septum is straightened and the nasal valve or turbinates are corrected to optimize airflow, while the nasal dorsum and tip are cosmetically reshaped during the same single surgery.

During the in-person consultation at HM Madrid, HM Valdebebas, or HM Tres Cantos, Dr. Méndez-Benegassi performs a prior computer simulation on your facial photographs at no extra cost. This allows you to jointly evaluate your expectations and the realistic anatomical possibilities before making any decision.

It is a modern, minimally invasive technique to open the palate. We use special barbed sutures (knotless) to reposition the sagging tissues to the sides, widening the throat without cutting muscle.

No. Unlike older surgeries, BRP is a reconstructive technique that reshapes and tightens muscles without removing them. We preserve your anatomy to avoid swallowing problems or voice changes.

It is a technique where the surgeon uses the arms of a robot (Da Vinci) and 3D vision to operate deep areas like the tongue base or epiglottis through the mouth, without external scars.

The throat is a very narrow space. The robot gives us magnified 3D vision and its instruments rotate 360°, allowing us to remove the tissue that suffocates you while protecting vessels and nerves with extreme precision.

Absolutely not. Thanks to the robotic technology available at HM Hospitals, we reach the deepest areas of the throat without the need for external incisions or bone fractures.

No. Although it is the standard treatment, if you can't tolerate it there are effective alternatives such as Mandibular Advancement Devices (MAD) or personalized airway surgery (BRP/TORS).

It is a custom-made dental splint that gently advances the lower jaw. This movement stretches the throat muscles and pushes the tongue forward, opening the airway.

At ronquidoyapneas.com we perform a DISE where we test an advancement simulator in your mouth while you sleep. If we see on screen that your airway opens, the MAD is more likely to work for you; if it does not open, we tell you before you order it. The final effectiveness is confirmed at follow-up.

They are intimately linked. When air is lacking, the brain commands the jaw to clench and grind teeth in a desperate attempt to move the tongue forward and open the throat.

Yes. Every time you stop breathing, your heart suffers extreme stress and adrenaline spikes. This narrows your blood vessels and multiplies the risk of heart attacks, strokes, and serious arrhythmias.

Apnea alters hunger hormones (leptin and ghrelin). Without rest, your metabolism slows down and your body craves more caloric foods, creating a vicious cycle of weight gain and shortness of breath.

Yes. Peak testosterone production occurs during deep sleep. Since apnea fragments rest, levels drop, causing low libido, erectile dysfunction, and fatigue.

We see patients at: Hospital HM Valdebebas, Hospital Universitario HM Madrid (Plaza del Conde de Valle de Súchil), and Hospital Universitario HM Tres Cantos.

Yes. We have a video consultation service for an initial assessment. It is ideal for patients who don't live in Madrid to review their tests and plan an initial treatment.

You can do it through our website, choosing HM Valdebebas, HM Madrid, or HM Tres Cantos, or requesting a video consultation.

It is a cartilage shaped like a "lid" above the vocal cords. If it is too soft (floppy epiglottis), when you inhale while sleeping it gets sucked backward and seals your breathing. Often, the CPAP machine pressure worsens this closure, so robotic surgery may be indicated.

They are lymphoid tissues hidden at the very base of the tongue. If they grow too large, they push the tongue against the throat wall and block airflow. With the Da Vinci Robot (TORS) we can reduce them without external cuts.

It is a small bone in the neck where the tongue muscles are anchored. If it is positioned too low, the tongue falls and blocks the airway. The "hyoid suspension" technique fixes it forward to open the lower respiratory tract.

It means your throat closes in a circle, like the diaphragm of a camera. This is vital information: if you have this pattern, a sleep pacemaker will fail. In these cases, we apply Barbed Reposition Pharyngoplasty (BRP) to tighten the walls outward.

Having a deviated septum or enlarged turbinates forces you to breathe through your mouth, which causes the jaw and tongue to fall backward. Nasal surgery helps you breathe better, but it's usually just the "first piece" of a puzzle that often requires acting on the throat as well.

Estrogen and progesterone keep the throat muscles firm. With menopause, muscle tone drops, tissues become flaccid, and the risk of apnea in women equals that of men.

Because women often have atypical symptoms: chronic fatigue, lack of energy, or headaches, instead of the explosive snoring typical of men. At HM Valdebebas, we perform specific studies to avoid misdiagnoses of anxiety or depression.

It is apnea that appears due to weight gain and hormonal changes during pregnancy. If you stop breathing, your baby's oxygen drops and the risk of preeclampsia (high blood pressure) increases. If you start snoring loudly while pregnant, you should consult us.

Yes, if the pre-operative assessment allows it. Minimally invasive techniques such as BRP or a MAD are usually well tolerated by older people and can improve their daily vitality.

Childhood bruxism is often a sign of suffocation. When air is lacking, the brain commands clenching teeth to try to move the jaw forward and open the throat. It is an "alarm" that your child is not breathing well.

Yes, untreated moderate or severe apnea is legal grounds for not renewing your license due to accident risk. However, if you prove you are successfully under treatment (surgery, MAD, or CPAP), you can drive normally.

Yes, the risk of occupational accidents doubles. In truck drivers, apnea is a maximum-risk disease. We seek the most comfortable treatment (such as MAD or surgery) so they can continue working safely and legally.

For office work, 7 to 10 days is enough. If your job requires intense physical effort, we recommend 2 to 3 weeks to support good healing before returning to heavy lifting.

It is a delicate legal matter: if negligence is proven for not treating diagnosed sleepiness, insurers could challenge coverage. Treating your apnea lowers accident risk and also protects you in that situation.

They do not cure apnea. They only lubricate the throat to reduce simple snoring noise, but they don't prevent the throat from collapsing. They are a cosmetic "patch" that masks a real medical problem.

They can open the nose slightly, but apnea occurs much lower (palate or tongue). A nose clip has no physical force to prevent internal suffocation when muscles relax.

These are electronic devices that vibrate gently when they detect you sleeping on your back (a position that worsens apnea). They force you to turn on your side without waking up, being very effective for positional apnea.

No. "Boil and bite" ones are bulky, fall out, and can damage your jaw joint. A professional MAD is millimetric, custom-made, and its effectiveness is verified beforehand with a DISE.

Yes, it is the Hypoglossal Nerve Stimulator. It is a small implantable device that automatically moves the tongue forward with each breath. It is an option for those who can't tolerate CPAP.

Alcohol is a powerful muscle relaxant. When you drink, the muscles that keep the throat open become excessively flaccid and collapse much faster, worsening apneas and oxygen drops.

You will feel discomfort similar to a bad sore throat for the first 7 to 10 days. Since no muscle is cut, the pain is much less than with older techniques. We will prescribe strong painkillers to make this process as comfortable as possible.

During the first week we recommend a soft, cold diet (ice cream, yogurt, cold soups, smoothies). The cold helps reduce inflammation. Avoid hot, crunchy, acidic, or spicy foods until healing progresses.

No. Being reconstructive techniques that respect anatomy, your voice will not change. You will notice discomfort swallowing the first few days due to inflammation, but once recovered, your throat function will be completely normal.

You should avoid intense physical exercise for the first month to prevent blood pressure spikes that could cause bleeding. You can start walking gently after a few days, but wait at least 3 to 4 weeks for the gym or running.

It is normal to see some blood streaks in saliva the first few days. However, if bleeding is heavy or doesn't stop, you must go to the emergency department at our HM hospitals immediately. For safety, we will always give you clear written instructions.

Leaks usually occur because the straps have loosened or because you open your mouth while sleeping. Try adjusting the harnesses (without over-tightening) or use a chin strap to keep your mouth closed. If it persists, you may need an oronasal mask.

The pressurized airflow dries out the mucous membranes. A heated humidifier connected to your machine usually helps. It warms the air and adds moisture, eliminating dryness and morning congestion.

Always use distilled water. Tap or mineral water contains lime and minerals that damage the machine and can promote the growth of bacteria harmful to your lungs.

This happens when the machine's air diverts to the stomach instead of the lungs. It is solved by adjusting the machine's pressure or activating the expiratory pressure relief mode. If it doesn't improve, a Mandibular Advancement Device (MAD) can be considered.

It is a medical device and you can carry it in the cabin. However, for frequent travelers, many patients prefer a custom MAD: no plugs needed, fits in a pocket, and is more convenient in hotels or planes.

Unfortunately, yes. Snoring is a frequent cause of bed separation. Treating your apnea not only improves your health but also restores cohabitation and allows your partner to recover their rest and vitality.

Always trust your partner. During apneas you are unconscious and your brain usually "erases" the awakenings. Your bed partner's testimony is the most reliable tool we have for suspecting severe apnea.

Yes. Partners of snorers lose up to one hour of sleep per night, causing chronic fatigue and irritability. By getting surgery or treatment, you are directly caring for the health of the person sleeping next to you.

It is a common psychological barrier. If your apnea is mild or moderate, a MAD is an aesthetic and silent option. If it is severe, surgery (BRP/TORS) may allow you to sleep without wires or masks.

Chronic lack of rest and the fear that your partner might die from nighttime choking generate great stress in the relationship. Solving the problem usually brings immediate improvement in mood and harmony.

Your brain will wake you up before that happens, but the real risk is the accumulated damage: that daily stress on the heart multiplies the chances of suffering a heart attack or stroke while sleeping.

It is a sign that you breathe through your mouth because your nose doesn't work well or your throat is closing. By opening your mouth, saliva escapes. Correcting your airway will give you drier, more hygienic sleep.

When you run out of air during REM sleep (deep sleep), your brain integrates that real physical suffocation into your dreams, turning them into distressing nightmares. It is your body screaming for oxygen.

It is called gasping. It is the survival sound you make at the end of an apnea. Your brain sends an adrenaline burst so you break through the throat blockage and gasp for air. It is a maximum alarm signal.

We don't rely on impressions. At 6 months we repeat the sleep study and compare it with the pre-operative one (AHI and oxygen). This shows objectively how much the apnea has improved.

TORS stands for Transoral Robotic Surgery. We use special retractors that safely keep the mouth open. Through that space, we introduce a 3D camera and miniaturized robotic arms. No incision is made on the face or neck.

Three arms are used: one central with the 3D camera and two lateral with millimetric instruments. The robot is not autonomous; it is controlled at all times by the surgeon from a console, translating movements using articulated instruments and magnified 3D vision.

It is a small implantable device that detects your breathing and sends a gentle electrical impulse to the tongue nerve, automatically moving it forward so you don't choke. It is an alternative for those who can't tolerate CPAP.

It means we no longer treat everyone the same. We investigate whether your problem is anatomical, muscular reflexes, or a low sleep threshold. Identifying your "phenotype" allows us to tailor the treatment to your case.

No. We use a very superficial and controlled sedation to mimic your natural sleep. There is no intubation. The moment the anesthesiologist stops the medication, you wake up within minutes as if you had taken a nap.

Not at all. You will be completely relaxed. The level of suffocation we observe is the same you experience every night at home, but here you are monitored second by second. You won't feel or remember anything about the process.

Because we don't want to operate "blindly." Operating on the palate when the real obstruction is at the tongue base is the main cause of surgical failure. DISE shows, before surgery, at which level of the throat the airway closes while you sleep.

No. Although you will wake up quickly, residual sedative reduces your reflexes. You must come with an adult companion who can drive you home. You can resume normal activities and driving the next day.

You must come fasting (6-8 hours without eating or drinking). Bring comfortable clothing and all your previous reports. The procedure is outpatient: you will arrive, we will perform the test, and you will go home the same day.

Almost always it is the first option. Oversized tonsils and adenoids are the number one cause of childhood apnea. Removing them restores the child's normal growth and immediately improves school performance.

It is called "persistent apnea." It occurs when the blockage is in areas that were not addressed, such as the tongue base or a floppy larynx. In these cases, we perform a pediatric DISE to locate the new obstruction point.

Yes. A short lingual frenulum prevents the tongue from resting on the palate. This causes the palate to grow narrow and the jaw to be small, reducing the space for breathing and promoting snoring.

Complications are uncommon when it is properly indicated. If the child is very young or has obesity, our protocol at HM Valdebebas or Tres Cantos includes one night of monitored observation to watch breathing closely.

Intense bruxism in children is often a sign of suffocation. When air is lacking, the brain commands clenching teeth to try to move the jaw forward and open the throat. It is an "alarm" that your child is not breathing well.

Yes. We have a protocol for out-of-town patients. We start with an online video consultation to assess your case. We coordinate tests and surgery so your stay in Madrid is minimal and efficient.

Generally, we recommend staying 3 to 5 days after hospital discharge. This allows us to perform an in-person check-up at our clinic to check healing is on track before your return trip.

Yes, we receive patients from various countries. The patient care team will help you with the necessary logistics so you can be treated at our HM Hospitals centres.

Bring them on the day of your in-person consultation, on paper or on your phone. If it is a video consultation, keep them to hand so you can show or share them during the call. Do not send them by email: it is not end-to-end encrypted and can be read on the servers it passes through.

Pharmacy ones are standard, bulky, and can damage your jaw joint. A professional MAD (like SomnoDent or TALI) is manufactured with millimetric precision for your mouth, is much more comfortable, durable, and its effectiveness is verified beforehand with a DISE.

ResMed (AirSense 10 and 11) is one of the best brands for its quietness, reliability and auto-adjustment; after problems with some older Philips models, it is the one we usually recommend.

We almost always recommend AutoCPAP (APAP). Unlike fixed, which blows at the same force constantly, AutoCPAP adjusts pressure second by second based on what you need at each sleep stage, being much more natural and easier to tolerate.

iNAP is a mask-free system that uses gentle suction to hold the tongue forward. It is ideal for travel and patients who can't tolerate pressurized air. We evaluate whether you are a candidate through a Sleep Endoscopy at our HM centers.

Be careful: many cheap chin straps push the jaw backward, which closes the throat more. If you need one, we use designs like Knightsbridge, which pull the jaw upward, keeping the airway open.

The AHI (Apnea-Hypopnea Index) is the number of times you stop breathing per hour. 5 to 15 is mild, 15 to 30 is moderate, and over 30 is severe. A high AHI without treatment multiplies the risk of heart attack.

It is a key metric that measures not only how many times you stop breathing, but how much total time you spend without oxygen each night. It is the best indicator of how much damage your heart is really suffering.

It is the lowest oxygen level your blood reached during the night. Normal is above 94%. If your saturation drops below 80% or 70% during apneas, your organs are suffering very dangerous oxidative stress.

It means your apneas occur mainly (or only) when you sleep on your back, because the tongue falls by gravity. This type of apnea has a very good prognosis with smart positional therapy or surgery.

The ODI is the Oxygen Desaturation Index. It measures how many times per hour your oxygen drops more than 3% or 4%. It is essential for understanding the severity of nighttime suffocation beyond the noise of snoring.

Today we know it is not. Although it was popular in the 90s, laser is very aggressive, causes many rigid scars, and has a low long-term success rate. Modern medicine has evolved toward reconstructive techniques like BRP.

Because laser burns and removes tissue (amputation). In contrast, Barbed Reposition Pharyngoplasty (BRP) does not cut anything; it simply uses barbed sutures to reposition muscles. It is more effective, much less painful, and respects your anatomy.

Yes. The laser failure was usually because it only treated the palate. Through a DISE at HM Madrid, we will locate whether the current problem is at the tongue base or the epiglottis. If so, it can be treated with transoral robotic surgery (TORS), performed by the doctor himself with an HM Hospitales Da Vinci Xi robot.

No. Radiofrequency uses low temperature to "shrink" tissue from the inside without burning the surface. It is excellent for turbinates or the soft palate in mild cases, being much less painful than laser.

Generally, BRP. By using barbed sutures, we widen the throat functionally. Laser only shortens the palate, which often doesn't solve the lateral collapse of the throat walls, which is where true apnea occurs.

It is due to CO2 accumulation in the blood from not breathing properly. This excess gas dilates brain blood vessels. Treating apnea usually makes these headaches disappear from the first week.

Yes, it is one of the main causes. The lack of deep sleep generates "microsleeps" at the wheel. A snorer with apnea has up to 6 times more risk of suffering a serious accident due to sleepiness.

Because your brain cannot "clean itself" or consolidate memories without deep sleep. Fragmentation from apneas generates a mental fog that many patients confuse with aging or work stress.

Yes, it indicates you breathe through your mouth all night because your nose is blocked. The constant airflow dries out saliva, promotes bad breath, and indicates your jaw is falling backward, worsening apnea.

Because apnea prevents proper lymphatic drainage and tissue oxygenation. Although you spend 8 hours in bed, your body is in constant struggle, which accelerates skin aging and tired-looking eyes.

Because women often present atypical symptoms: chronic fatigue, lack of energy, headaches, or insomnia, instead of the typical explosive male snoring. At HM Valdebebas, we perform differential diagnoses to avoid treating a respiratory problem with psychotropic drugs.

It is known as Gestational Apnea. The lack of nighttime oxygen increases the risk of preeclampsia (high blood pressure), gestational diabetes, and can affect the baby's birth weight. If you notice loud new-onset snoring during pregnancy, it is vital to evaluate it.

Uncontrolled hypothyroidism promotes apnea by causing weight gain and greater flaccidity in neck muscles. Treating the thyroid is an essential step to improve your rest prognosis.

Yes. Lack of deep sleep prevents cell regeneration and collagen production. Women with apnea often notice more pronounced dark circles, dull skin, and morning facial puffiness due to poor oxygenation.

By eliminating breathing stops, your blood oxygen normalizes and your body enters deep muscle recovery phases. Athletes notice immediate improvement in endurance, faster recovery after exertion, and greater mental clarity in competition.

Absolutely yes. In athletes, the cause is usually anatomical: a narrow palate, a small jaw, or a large tongue base. Sleep Endoscopy (DISE) is key to locating the fault and correcting it without affecting your physical capacity.

If the anatomy allows it, surgery (BRP or TORS) avoids depending on the machine, filters and plugs when travelling. Whether it is suitable depends on the DISE and the severity of the apnea.

Enormously. Growth hormone and testosterone are released primarily during deep sleep. If apnea fragments your rest, your hormone levels drop, making it difficult for muscles to grow and recover after training.

Because you didn't rest. Even though you spent 8 hours in bed, if you have apnea, your body has been fighting not to suffocate. Your heart has been working at maximum capacity and your muscles haven't received the oxygen needed to regenerate.

Our sites at HM Hospitals offer modern private rooms with all amenities for you and your companion. The environment is designed so your recovery after surgery (for example, a pharyngoplasty) is peaceful and safe.

General anesthesia is used. You will be monitored at all times by a specialized anesthesiologist from the HM group. The robot's precision allows surgery to be quick, reducing anesthesia time and facilitating a faster awakening.

No. You will wake up in the Post-Anesthesia Recovery Unit (PACU), watched by specialized nursing staff. Once you are fully alert and pain is controlled, we will transfer you to your room with your family.

Yes. Clinics and non-robotic surgery can be at HM Madrid, HM Valdebebas or HM Tres Cantos, by proximity or preference. Robotic surgery is performed by Dr. Méndez-Benegassi himself with an HM Hospitales Da Vinci Xi robot; appointments are made at his clinics at HM Madrid, HM Valdebebas or HM Tres Cantos (or by video consultation), where the case is assessed and you are told where the operation takes place.

Generally, the stay is just 24 hours. If surgery is done in the morning and everything progresses well, most patients are discharged the next day after confirming they tolerate soft food well.

We offer a video consultation service. We can perform the initial assessment online, review your sleep tests, and explain treatment options. It is an efficient way to start your path to restful sleep without travel.

Yes, we work with major insurers at HM centers. We will help you with the necessary documentation so your insurer authorizes both diagnostic tests (DISE) and surgical procedures.

Any previous sleep study, reports from your cardiologist, and if you use CPAP, the data log from your machine. All this information helps us save time and be more precise in your initial diagnosis.

Upon waking from the test, the surgeon will explain the preliminary findings. Subsequently, in a follow-up appointment, we will review your throat video together so you can see exactly what happens when you sleep and understand the proposed treatment plan.

We perform periodic check-ups to monitor healing. The most important milestone is at 6 months, where we repeat the sleep study to objectively confirm that apnea has disappeared and your health is protected.

The lack of oxygen and sudden pressure changes in the chest during apneas "stretch" the heart walls. This damages its electrical system and causes arrhythmias like atrial fibrillation. Treating apnea is vital for the cardiologist's treatments to succeed.

It is very likely. It is called ventricular hypertrophy. When you suffocate, your heart has to pump much harder against a closed airway. Like any muscle that overworks, it thickens, but in the heart this makes it rigid and less efficient.

Although the brain usually wakes us up, extreme stress can trigger a fatal arrhythmia or heart attack in people with already weakened hearts. The risk is greatest in the early morning hours, when REM sleep is most intense and apneas are longest.

In most patients with "resistant hypertension" (the kind that doesn't respond to medication), yes. By eliminating apneas, the nighttime adrenaline spikes disappear, allowing arteries to relax and blood pressure to normalize.

The lack of oxygen generates chronic inflammation and oxidative stress. This alters fat metabolism and damages artery walls (endothelium), which makes it easier for cholesterol to stick and form plaques, increasing stroke risk.

Not necessarily. The uvula is just one part of the problem. If the obstruction is at the tongue base or lateral walls, removing the uvula will only make the snoring less noisy, but you will still have dangerous apneas.

It helps seal the passage to the nose when we swallow and participates in the articulation of some sounds. That is why at ronquidoyapneas.com we prefer techniques like BRP, which preserve it and only reposition it so it doesn't obstruct.

Because older surgeries (UPPP) were very painful and left rigid scars that sometimes made swallowing difficult. Current techniques are "functional": we seek to widen the space while respecting the patient's natural tissues.

It doesn't grow back per se, but if the patient gains a lot of weight or tissues become very flaccid with age, the palate can sag again. That is why weight stability is key after any sleep surgery.

A very long or thick uvula vibrates more easily, generating more snoring. However, the risk of apnea depends more on the total throat space than on the shape of the uvula alone.

Because clenching teeth is often a survival reflex. When the throat closes, the jaw tenses to try to advance and open the airway. Your dental wear is the "fingerprint" of your nightly struggle to breathe.

If in addition to clenching you also snore or have apneas, a regular occlusal splint may be insufficient or even worsen apnea. The MAD (Mandibular Advancement Device) protects teeth and also helps you breathe.

It is due to the constant effort of the chewing muscles during the night to prevent the tongue from falling backward. It is muscle fatigue from trying to keep the airway open.

Yes, it is very common. If the child doesn't breathe well through the nose due to adenoids, they will clench their teeth to try to open the oral airway. Treating the respiratory cause usually makes childhood bruxism disappear.

It doesn't indicate severity by itself, but it is a warning sign that prompts us to ask about snoring or fatigue. Many patients discover their apnea thanks to their dentist noticing this unusual wear.

You can speak from the very first moment, although you will notice a somewhat "nasal" or heavy voice the first few days due to inflammation. In 2 weeks, your voice will be practically the same, though it may take longer depending on pain (which usually lasts about 5 days and can be intense).

Yes, it is part of the healing process and the mucosa's reaction to the procedure. It is resolved by staying well hydrated and following the rinses we will prescribe at the clinic.

Nothing serious, but it can be uncomfortable. The barbed sutures in the Pharyngoplasty are designed to withstand tension. We try to control coughing with medication so the area rests as much as possible.

You must avoid it completely for at least the first 3 weeks. Smoke irritates the wound, increases the risk of infection, and can cause tissues to swell more, compromising the final result.

It is a temporary side effect of healing and antiseptic rinses. It usually disappears once you start eating a more varied diet and the inflammation subsides.

Yes. Chronic oxygen deprivation and sleep fragmentation prevent nighttime cell regeneration. This translates to duller skin, loss of elasticity, and premature appearance of wrinkles and bags under the eyes.

Apneas hinder lymphatic drainage and increase venous pressure in the head during the night. When apnea is treated, some patients notice less facial puffiness in the morning.

Narrow, elongated faces, or retruded jaws (retrognathia), usually have narrower airways. It is a matter of space: if the "container" (your face) is small, the "contents" (tongue and palate) collapse more easily.

Although our goal is functional (breathing), some techniques like mandibular advancement or orthognathic surgery can change the profile, eliminating the appearance of a "receding chin" and tightening neck tissues.

It is not just lack of sleep; it is lack of oxygen. Oxygen-poor blood is darker, and since the skin around the eyes is so thin, that bluish or violet tone characteristic of those who don't breathe well during sleep shows through.

Sometimes the tongue isn't large by itself, but the jaw is small and doesn't leave it space. We check this at the HM Valdebebas consultation by measuring the oropharyngeal space; if the tongue blocks the view of the palate, it is a clear risk factor.

When entering deep sleep, muscles lose their tone (atonia). The tongue, being a large heavy muscle, shifts by gravity toward the back wall of the throat, acting as a plug that blocks airflow.

Yes. With robotic surgery (TORS), performed by the doctor himself, we work on the tongue base (the deepest part). This area has no taste buds, so we can safely reduce its volume without you losing the flavor of food.

It's like going to the gym for your mouth. The tongue is trained to maintain a forward and elevated position. It is an excellent complement after surgery to help the muscle not relax excessively again.

There is only one way to be sure: Sleep Endoscopy (DISE). By watching you sleep with the camera, the surgeon observes whether it is the tongue that retracts and blocks the air or if the problem is higher up, in the palate.

It is very common at first. Your brain interprets pressurized air as something foreign and removes it while you sleep. Don't despair; keep trying every night. Over time, your brain will get used to it and stop seeing CPAP as a threat.

Modern machines (like ResMed's) are extremely quiet (less than 30 decibels). If yours is very noisy, check that the filter isn't dirty or that there isn't a leak in the tube or mask itself.

No. It indicates there is an air leak in the upper part of the mask going directly to your eyes. This can cause conjunctivitis or dry eyes. You need to better adjust the nasal bridge or try a different size mask.

Hygiene is vital. You should wash the mask daily with warm water and neutral soap. The tube and humidifier reservoir should be thoroughly cleaned once a week to prevent mold or bacteria growth.

If you have significant nasal congestion, using a nasal mask will be difficult. In those cases, it is useful to have a spare oronasal mask. Using the heated humidifier with CPAP helps greatly in thinning mucus during a cold.

It is agile and personalized. Once the date is scheduled, the admissions team will contact you to confirm the arrival time. Being a high-resolution hospital, the paperwork is quick so you can focus solely on your health.

Yes, at our HM Hospitals sites, rooms are prepared so a family member can stay overnight comfortably, ensuring your peace of mind during the 24-hour admission.

We have integrated operating rooms and diagnostic imaging equipment that allow us to perform DISE and sleep surgery.

Of course. If you live far from Madrid or have a specific question after discharge, we can conduct a follow-up by video call to review your progress, check healing, and adjust your medication without you having to travel.

Request an appointment for an initial assessment. Whether in central Madrid, Valdebebas, or Tres Cantos, we will evaluate your case comprehensively and decide whether the first step is a home sleep study or directly an operating room sleep test.

Yes. Chronic lack of deep sleep depletes the neurotransmitters of well-being (serotonin, dopamine). Some patients diagnosed with treatment-resistant depression improve when their apnea is treated.

Because your brain hasn't rested. Each night with apnea is a night of constant fight-or-flight response. Your nervous system is permanently on high alert, which translates into explosiveness, impatience, and interpersonal conflicts.

No. Apnea insomnia is caused by your body unconsciously waking up to avoid suffocation. You may feel like you "can't sleep" when in reality you do sleep, but apneas wake you so quickly that you don't perceive it.

Absolutely. A child who doesn't breathe at night doesn't consolidate what they learned during the day. Their memory, attention, and behavior deteriorate. We always recommend ruling out respiratory problems in any child with academic difficulties.

This is more common than you think. Chronic fatigue from apnea leads many people to stop socializing, exercising, and enjoying leisure. Recovering your night's rest means recovering your social life and your zest for life.

It means operating on several points of your airway in the same session: for example, the nose, palate, and tongue base. Instead of separate operations, several levels can be treated in a single surgery, which can shorten the overall recovery.

It can be done in selected patients; combining it with palate surgery under a single anaesthesia is assessed case by case. Robotic surgery is performed by Dr. Méndez-Benegassi himself with an HM Hospitales Da Vinci Xi robot; appointments are made at his clinics at HM Madrid, HM Valdebebas or HM Tres Cantos (or by video consultation), where the case is assessed and you are told where the operation takes place.

It is a technique that "pins" the hyoid bone (where the tongue is anchored) forward and upward. By elevating this bone, the tongue base lifts and clears the lower respiratory tract.

Yes, we receive international patients. We coordinate an initial video call and organize the entire protocol so that their stay in Madrid is as short and successful as possible.

It is ideal for your throat health. By opening the airway, your body will naturally tend to close the mouth because it can now breathe well through the nose. Sometimes we use chin straps the first few days to retrain this habit.

It depends on your policy. Your clinic will give you the medical codes and the details of the operating centre so you can check coverage with your insurer.

The next step is an in-person or online assessment to study your case and explain your options.

Yes, recent research suggests that sleep fragmentation and oxygen deprivation prevent the brain from "cleaning" beta-amyloid protein, whose accumulation is key in Alzheimer's. Treating apnea in older patients is a vital form of neuroprotection.

At that age we prioritize minimally invasive techniques. A Mandibular Advancement Device (MAD) or gentle radiofrequency can greatly improve his oxygen without the risks of major surgery. We evaluate each case at HM Tres Cantos with a safe geriatric approach.

Absolutely. Many elderly patients present confusion, memory lapses, and disorientation diagnosed as dementia, when in reality it is a brain exhausted from not breathing. By treating apnea, mental clarity often returns surprisingly.

Oxygen deprivation affects balance, and nocturia (getting up to urinate) forces them to wander in the dark half-asleep. Treating apnea reduces bathroom trips and improves stability, preventing hip fractures.

It is a scientific reality. Growth hormone is released primarily during deep sleep. If your child has apnea and doesn't reach that phase, their physical growth and cognitive development can be seriously delayed.

Yes. Unlike adults (who feel sleepy), children with apnea often react to fatigue with hyperactivity, irritability, and lack of concentration. Many cases diagnosed as ADHD are actually nocturnal respiratory problems.

It is not advisable to wait for it to go away. Untreated childhood apnea can affect sleep, behaviour, learning and facial growth; early assessment allows timely treatment.

Excessive sweating in children is a sign of respiratory effort. Their body is working double to push air through a narrow airway. It is a warning sign that should make us suspect enlarged tonsils or adenoids.

Yes. At HM Madrid, Valdebebas, or Tres Cantos, we coordinate your blood tests, electrocardiogram, and chest X-rays so you don't have to run around. The entire process is centralized for your convenience.

We will give it absolute priority. If we detect signs of imminent cardiovascular risk or very severe apneas, we will expedite the in-person appointment and sleep study to start treatment as soon as possible.

Yes. We perform a sleep endoscopy (DISE) to see whether your anatomy makes surgery or a MAD a reasonable alternative to CPAP.

We alternate in-person check-ups with video call follow-ups. Additionally, we can monitor your follow-up sleep study results remotely, saving you unnecessary trips.

Lack of sleep alters the hormone ghrelin. Your brain, lacking energy from nighttime hypoxia, asks for "quick" sugar to survive the day, which makes you gain weight and worsens your apnea.

It has been observed that chronic throat inflammation can affect the Eustachian tube and middle ear. Additionally, the constant snoring noise (which can exceed 80-90 decibels) can cause mild acoustic trauma to the snorer themselves.

It can be from tissue inflammation after a night of intense vibration or from acid reflux that apnea itself causes. Treating the airway usually eliminates this very annoying sensation.

It helps tissues not dry out and vibrate less, but it doesn't prevent throat collapse if there is a physical obstruction. It is a complement, not a cure for apnea.

These are habits like avoiding screens before bed or keeping the room dark. After surgery, these habits ensure you make the most of your new airway and achieve truly deep rest.

Yes, as long as there are enough healthy teeth to anchor the device. At our clinic, we evaluate your dental health to design a device that is safe and effective for you.

Yes, it is called uvular edema. The vibration has been so violent that the tissue swells with fluid. It is a clear sign that your throat is suffering physical trauma every night.

It is not just about stopping the noise; it is about recovering years of life. We protect your heart, brain, and relationship. It is, literally, being born again every morning with energy.

Yes, but you must be under treatment and demonstrate it is effective. Untreated apnea is cause for medical exclusion in aviation due to fatigue risk. Many pilots prefer robotic surgery or BRP to avoid depending on CPAP during layovers and to pass their medical exams successfully.

Enormously. Sleep apnea increases the risk of arrhythmias and cardiovascular events underwater. Additionally, chronic throat inflammation from snoring can make ear equalization (Valsalva maneuver) difficult.

On the contrary. We use the BRP technique (Barbed Reposition Pharyngoplasty), which is reconstructive and does not cut the soft palate muscles. By opening the airway, you reduce vocal effort and acid reflux, which usually results in a more rested voice with better resonance.

It's not just fat; it's muscle. A very muscular, wide neck presses the airway from outside. Additionally, these athletes usually have large tongues. If the DISE confirms the obstruction is at the tongue base, robotic surgery (TORS) may be an option.

Constant travel makes CPAP use a burden (customs, plugs, distilled water). Most of our executive patients at HM Valdebebas opt for definitive surgery or a custom MAD for the freedom and discretion it offers.

They are suture threads with tiny millimetric "barbs" or spicules. These barbs allow anchoring and tensioning tissue without knots, distributing tension evenly and preventing the palate from sagging again.

It is extremely rare. The sutures are designed to integrate with your throat tissue. We use multiple suture lines so tension remains stable. We only ask for caution with very hard foods or violent efforts in the first two weeks.

We use sutures that dissolve slowly. The suture's purpose is to hold the palate in its new "open" position while the body creates its own natural scarring (controlled fibrosis). Once your body has fixed the new throat shape, the suture is no longer needed.

Because conventional surgery (UPPP) cut tissue and left rigid scars that caused chronic pain. BRP is a "repositioning" surgery: we don't remove anything, we just move muscles to a place where they don't obstruct breathing.

Yes, it is its greatest advantage. While other techniques only treat the palate front to back, BRP pulls the lateral walls outward and widens the pharynx in that direction.

It should be washed every morning with a soft brush and warm water. Once a week, we recommend using specific disinfecting tablets (like those for dentures) to eliminate bacteria and prevent the material from developing bad odor or yellowing.

Being a custom-made device fitted to your current teeth, if there is a significant change in your mouth (like a new implant or tooth loss), the MAD might stop fitting. In that case, bring it to the clinic to see if we can readjust it or if a new impression is needed.

First we need to control your gum health. If teeth have mobility, they cannot support the device's tension. Once your gingival health is stabilized at HM Hospitals, we will evaluate whether the MAD is safe for you.

Most patients notice they stop snoring from the first night. However, the full benefit on daytime fatigue is usually appreciated at 2 to 3 weeks, when the brain starts recovering from months or years of poor sleep.

By keeping the jaw and hyoid bone advanced during the night, the neck tissues tighten. Although it is not cosmetic neck surgery, many patients see a somewhat more defined profile while using the device.

No. Each apnea is different. One may obstruct at the palate and the other at the tongue. Each person needs their own diagnosis through DISE for the treatment to be effective. That said, if you both get treated, your bedroom will be an oasis of peace!

Tobacco is the number one enemy of healing. Smoke irritates the throat mucosa and causes more inflammation than normal after surgery. We recommend quitting at least 2 weeks before and 3 after surgery to support healing and the result.

Yes, but you must be very rigorous with cleaning. In humid climates, fungi and bacteria grow faster in the tube and mask. Make sure to dry all pieces well every morning.

The stress of the change in environment and, especially, a pillow that doesn't have the right height for your neck can cause your airway to close more than usual.

You will feel that your throat is occupied and swollen (as if you had something to swallow) and a sense of relief knowing you are already in the healing process. You will be well medicated so you don't feel sharp pain, just tolerable discomfort.

Science has observed a relationship: chronic oxygen deprivation (hypoxia) and systemic inflammation can promote the progression of some tumors. Treating apnea not only protects your heart but helps your immune system be more efficient in cellular surveillance.

Every time you stop breathing, your body releases inflammatory markers (like C-Reactive Protein). It is as if you had constant internal inflammation that damages your arteries and organs. By getting surgery or using the MAD, you "put out" that internal fire.

It is plausible, because deep sleep helps regulate the immune system and apnea fragments it. What treating apnea does achieve is less interrupted sleep.

Yes. A patient with untreated apnea has more risk of postoperative complications in any procedure. That is why many surgeons recommend treating apnea before undergoing other important operations.

The epiglottis is the "lid" that protects your vocal cords when swallowing. If it is too soft or flaccid, the very suction of air while sleeping causes it to bend backward and cover the lung entrance. It is a very common cause of CPAP failure.

It can only be seen through Sleep Endoscopy (DISE). When you fall asleep in the operating room, we insert the camera and see how that "lid" falls and suffocates you. It is a diagnosis that often goes unnoticed in conventional consultations.

It is a very rewarding technique that we perform with Robotic Surgery (TORS) or laser. It consists of removing a small portion of the epiglottis edge to give it rigidity or fixing it forward, preventing it from being sucked back when breathing.

No. The surgery is millimetric and only removes excess or lax tissue. The protective function of the epiglottis remains intact. Usually, after a few days of swelling, you will be able to swallow and speak normally.

To make the most of the consultation, have your sleep study (polysomnography) and any previous reports from your ENT or cardiologist at hand, and show them during the call. Do not send them by email. If you have nothing, do not worry: the doctor will tell you what you need.

We can establish a very strong suspicion and an action plan. The final anatomical diagnosis will always require a physical examination or DISE, but the video consultation allows us to rule out useless treatments and save a lot of time.

After the video consultation, the doctor will email you the report as a password-protected PDF. If he considers it necessary, he will also issue a prescription, which arrives the same way, by email as a password-protected PDF. We cannot guarantee that a prescription or a report will be accepted outside Spain: that depends on the regulations of your country.

Of course. Many patients who haven't had success with their CPAP or with surgeries at other centers contact us to analyze their case and offer them the ronquidoyapneas.com perspective.

It is the space just behind the tongue. It is the narrowest point of the airway in many patients. If this space is small, any minimal tongue relaxation will cause severe apnea.

Sometimes it's not that the tongue is big, but that the palate is narrow or the jaw is short. It is a lack of architectural space. Multilevel surgery can gain space by acting on several areas; whether it is indicated is decided after the DISE.

Yes. Nasal congestion inflames the turbinates and forces you to breathe through the mouth. This generates negative pressure in the throat that makes tissues vibrate and collapse more easily.

Yes, it is due to the accessory muscular effort you make during the night to try to "pull" the trachea and open the throat while you suffocate. It is real muscle soreness from the effort of breathing.

Yes, all rooms at HM Valdebebas, Madrid, and Tres Cantos are equipped with all modern amenities so you or your companion can stay connected if needed during the 24-hour admission.

Comfortable, loose clothing. We recommend shoes without laces (like house slippers) and pajamas or shirts that open in the front to make check-ups and wound care easier without moving the neck too much.

If you are very nervous, the anesthesiologist may prescribe a mild anxiolytic. However, the ideal is to rest naturally so you arrive at the operating room in the best possible condition.

Our commitment is safety and follow-up. There is no standard treatment: the plan is based on each person's anatomy, from the first video consultation to the control sleep study at 6 months.

It is the number of times you stop breathing or breathe very shallowly per hour of sleep. It is the main "thermometer" for diagnosing apnea. Normal: less than 5 events/hour. Mild: 5-15. Moderate: 15-30. Severe: more than 30.

It measures how many times per hour your blood oxygen level drops by 3% or 4% from your normal level. It is considered concerning when ODI exceeds 5. If your ODI is much higher than your AHI, it means your apneas are especially aggressive on your blood.

It is the cumulative time (in minutes or percentage) you spend with oxygen levels below 90% during the night. Ideally it should be 0%. Spending more than 1% of the night below 90% is already associated with increased cardiovascular risk and chronic fatigue.

It is the "pulse wave": the pattern blood makes when passing through your finger illuminated by the ring or pulse oximeter sensor. It is not just a number; the shape of that wave tells us how rigid your arteries are and if your heart is overworking to pump blood when you lack air.

It measures the strength of the pulse signal at the sensor location. Normal is between 2% and 20%. If your PI drops sharply (for example from 5% to 1%), it means your body has panicked and closed peripheral blood vessels due to an apnea.

It is the exact time in milliseconds between one heartbeat and the next. High HRV indicates good health, recovery, and deep rest. Low HRV signals stress, inflammation, or that your nervous system is exhausted from not being able to breathe properly.

It is our master metric. It combines AHI, CT90, and PI drops to calculate the real damage your heart suffers. Two people can have the same AHI, but one can have a much higher Hypoxic Risk if their desaturations are longer or if their heart is more stressed during the event.

It is the Pediatric Sleep Questionnaire (PSQ), a scientifically validated tool for detecting Obstructive Sleep Apnea (OSA) in children aged 2 to 18 without the need for initial invasive tests.

It consists of 22 questions about snoring, daytime sleepiness, and behavior (such as hyperactivity). The score is calculated by dividing the number of "YES" answers by the total number of questions answered.

A score greater than 0.33 (i.e., answering "YES" to more than one-third of the questions) indicates a high risk of apnea and suggests the child should be evaluated by a specialist to prevent growth or learning problems.

It is validated for children aged 2 to 18. It is especially useful as an initial screening tool when parents suspect their child snores, sleeps poorly, or exhibits hyperactivity or concentration problems at school.