Sleep
Apnea

Sleep Apnea

People with obstructive sleep apnea (OSA) experience disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs, the tongue is sucked against the back of the throat, blocking the upper airway and stopping airflow. When the oxygen level in the brain becomes low enough, the sleeper partially awakens, clearing the obstruction in the throat, and airflow resumes, usually with a loud gasp.

Health Implications

Repeated cycles of decreased oxygenation can lead to very serious cardiovascular problems. Additionally, individuals with OSA often suffer from excessive daytime sleepiness, depression, and loss of concentration. Some patients have less severe obstructions, known as Upper Airway Resistance Syndrome (UARS), but they experience many of the same symptoms.

Diagnosis and Consultation

The first step in treatment is recognizing the symptoms and seeking appropriate consultation. Oral and maxillofacial surgeons offer consultation and treatment options.

A thorough evaluation includes a detailed medical history and assessment of the anatomical relationships in the maxillofacial region. Cephalometric (skull x-ray) analysis helps determine the level of obstruction. Sometimes, a naso-pharyngeal exam with a flexible fiber-optic camera is performed. To confirm the degree of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor the individual overnight.

Treatment Options

Several treatment options are available for OSA:

Nasal CPAP Machine: This initial treatment involves using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction during sleep.

Surgical Options:

Uvulo-palato-pharyngoplasty (UPPP): Performed on the back of the soft palate and throat.

Laser-Assisted Uvulo-palato-plasty (LAUPP): A similar procedure performed with a laser.

Radio-Frequency Probe: Utilized to tighten the soft palate. These procedures are usually performed under light IV sedation in the office.

In more complex cases, orthognathic surgery may be necessary. This involves repositioning the bones of the upper and lower jaw to increase the size of the airway. This procedure is performed in a hospital under general anesthesia and typically requires a one to two-day overnight stay.

Importance of Treatment

OSA is a very serious condition that requires careful attention and treatment. Most major medical plans offer coverage for the diagnosis and treatment of OSA.

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