Obstructive sleep apnea (OSA) is a condition where a person’s sleep is disrupted by obstruction at the back of their throat. When OSA occurs, the tongue is sucked against the back of the throat. The tongue blocks the upper airway and airflow is impeded. As the oxygen level in the brain decreases, the sleeper gets woken up. The tongue assumes its normal position, and the flow of air returns. This many times happens with a loud gasp.
When OSA occurs repeatedly, there is decreased oxygenation in the person’s system. This can cause serious cardiovascular issues, daytime sleepiness, depression, and problems with concentration. A less severe form of the condition is called Upper Airway Resistance Syndrome (UARS). The symptoms of this condition are very similar to those of OSA.
How Is OSA Diagnosed?
Diagnosis of sleep apnea is based upon the confirmation of the doctor of the trademark symptoms. The doctor will take a detailed history of the patient and assess the anatomic relationships in the maxillofacial region. By taking a skull x-ray, the doctor can determine the extent of the obstruction. Sometimes, the doctor will conduct a naso-pharyngeal exam with a fiber-optic camera. The doctor might also order a sleep study to determine the patient’s oxygen levels during their sleep.
How Is OSA Treated Non-Surgically?
Obesity can many times increase the severity of sleep apnea. It is found that losing weight can many times reduce the severity of the condition or eliminate it altogether. Weight loss should be a priority for all people have sleep apnea. Eating a better diet and exercising are not only important for overall health. They will also help you get better sleep. For extremely obese people, weight loss surgery may be an option. This technique is used when a patient has failed to lose weight by other methods.
Positive Airway Pressure
Positive airway pressure is a treatment where the patient places a small mask or nose tubes over the nose or the nose and mouth, and compressed air is delivered to the lungs. The air pressure helps keep the airway from collapsing. PAP therapy is considered to be highly successful in treating the condition. It is also the most common treatment for the condition. However, a person must use the device whenever they sleep. Some people are unable to go through with this treatment because the device makes them feel uncomfortable or claustrophobic.
Dental devices can relieve sleep apnea by positioning the lower jaw forward. This in turn moves the tongue forward, preventing it from blocking the back of the throat. There are dentists who are expert in treating sleep apnea, and they should be consulted for this treatment. Oral appliances are most helpful for people who have mild or moderate sleep apnea. If you wear dentures or your teeth are in poor condition, then this treatment may be unavailable to you. Problems with these appliances include increased salivation, jaw pain, and tooth shifting.
Some people will suffer from sleep apnea more when they sleep on their back. For such people, it may help them to lie on their side when sleeping.
Oxygen can help increase oxygen levels in the blood. However, this does not relieve sleep apnea itself. A doctor might supplement PAP therapy with oxygen if low blood oxygen levels persist.
What Are the Surgical Treatments for OSA?
While positive airway pressure therapy can be helpful in treating sleep apnea, it is not easy for everyone to comply with it. Studies have shown that the actual usage of PAP only constitutes about 50 percent of sleep time. Patients many times find that they are unable to wear the mask throughout the night. They may also be uncomfortable with the high pressure of the air blown into their system. Surgery for sleep apnea is a feasible solution to the problem.
There are many surgical options for the treatment of sleep apnea. Here, orthognathic surgery will be discussed.
A person’s airway is confined by the upper and lower jaws. If you move the upper jaw and lower jaw forward, the airway can be made bigger. This procedure is considered to be the most effective surgical treatment for OSA. It is used on patients as the sole treatment for the condition. It is also used on patients who have significant jaw deformity that causes sleep apnea. The procedure is done in the hospital under anesthesia. The surgery takes about three to four hours to complete.
Dr. Jamali is a board certified oral and maxillofacial surgeon. He holds a doctorate degree from Tufts University and has a lot of experience in dealing with the administration of anesthesia. You can set up a consultation with Dr. Jamali to discuss the unique set of issues that are affecting you. We are located at 42 Broadway, New York, NY 10004. Our phone number is 212-480-2777.