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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.
  • This blocks the upper airway and airflow stops.
  • When the oxygen level in the brain becomes low enough, the sleeper partially awakens, the obstruction in the throat clears, and the flow of air starts again, usually with a loud gasp.

  • 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 x-ray) 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 recommended to monitor an individual overnight.

  • There are several treatment options available.
  • 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 an 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 (LAUPP).
  • In other cases, a radio-frequency probe is utilized to tighten the soft palate. These procedures are usually performed under light IV 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 a one to two day 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 treatment.