Sleep Apnea

People with Obstructive Sleep Apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs, the tongue is sucked against the back of the throat which temporarily shuts off air flow. Oxygen levels drop in the brain, causing partially awakening. The obstruction clears and oxygen flows again. The end of the cycle is usually marked by a loud gasp. The course of repeated cycles have serious consequences for affectied individuals and their sleep partners.

Repeated cycles of decreased oxygenation lead to very serious cardiovascular problems. Additionally, these individuals suffer from excessive daytime sleepiness, depression, and loss of concentration.

Some patients have obstructions that are less severe called Upper Airway Resistance Syndrome (UARS). In either case, the individuals suffer many of the same symptoms.

The first step in treatment resides in recognition of the symptoms and seeking appropriate consultation. Oral and Maxillofacial Surgeons offer consultation and treatment options.

In addition to a detailed history, the Doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (skull xray) analysis, the Doctors can ascertain the level of obstruction. Sometimes a naso-pharyngeal exam is done with a flexible fiber-optic camera. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommend to monitor individuals overnight.

An initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. One of the surgical options is a uvulo-palato-pharyngo-plasty (UPPP) which is performed in the back of the soft palate and throat. A similar procedure is sometimes done with the assistance of a laser and is called a Laser Assisted uvulo-palato-plasty (LAUP). In other cases, a radio-frequensy probe is utilized to tighten the soft palate. These are procedures usually performed under light intravenous sedation in the office.

In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (Orthognathic Surgery). This procedure is done in the hospital under general anesthesia and requires 1 to 2 days overnight stay in the hospital.

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