People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs, the tongue or other soft tissue obstruct the throat. This blocks the upper airway and airflow stops. When the oxygen level in the brain becomes low enough, the sleeper partially awakens to clear the obstruction (coughing or gasping), and the flow of air starts again. The patient then falls asleep again and the process repeats itself leading to disrupted or fragmented sleep.
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.
Sleep Apnea Treatment
The first step in treatment for sleep apnea resides in recognition of the symptoms and seeking appropriate consultation. Sleep physicians are an important member of the treatment team as they diagnose the presence and severity of sleep apnea and monitor progress over time. If your sleep physician feels that surgery is an option or you cannot tolerate CPAP or other devices, surgical treatment may be for you.
Board Certified Oral Surgeon, Dr. Michael Wasson can 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. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight.
Treatment Options for Sleep Apnea
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. Often patients do not tolerate these devices well, have severe OSA, or have schedules that do not allow for consistent use. In these cases surgery is recommended.
Many surgeries such as tongue reduction, uvulopalatopharyngoplasty (UPP), Tonsillectomy, and others have been performed in the past with mixed results leading to them falling out of favor.
Today, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (orthognathic surgery). This is often referred to as Maxillomandibular Advancement (or MMA). This procedure is done in the hospital under general anesthesia and requires a one night 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.