Board-certified Oral and Maxillofacial Surgeon Dr. Majid Jamali has extensive training and experience that allows him to address the complex issues associated with obstructive sleep apnea (OSA). Individuals suffering from OSA typically stop breathing numerous times during each sleep session, and this can create serious health issues.
OSA is a potentially life-threatening condition, and individuals with symptoms of obstructive sleep apnea should visit a board certified oral and maxillofacial surgeon. Dr. Jamali was awarded Top Oral and Maxillofacial Surgeon in 2013 by the Top Doctor Competition in New York, and Dr. Jamali also has excellent customer ratings and reviews on sites such as ZocDoc, Google, Yelp and Facebook.
Oral Surgeon Jamali offers his patients efficient and permanent solutions. There are answers for patients with OSA that will replace the need for uncomfortable sleep masks, dental devices and surgical opportunities that have impressive success rates and are commonly performed by Dr. Jamali.
Obstructive Sleep Apnea
Episodes of Obstructive Sleep Apnea or OSA occur while an individual is asleep. The tongue relaxes, falls against the back of the throat and restricts the airway. A man or woman with OSA is unable to breathe during the time that the airway is obstructed because breathing through the nose or the mouth is ineffective during an airway obstruction. When the airway is blocked, the brain sends a signal that triggers the individual to partially awaken, move their tongue and to reestablish breathing again.
Patients with sleep apnea typically experience repeated episodes each night when they stop breathing for 10 seconds to a minute. Obstructive sleep apnea can generate dangerous consequences as the carbon dioxide blood levels rise and the oxygen levels decrease. Low oxygen levels place a strain on the circulatory system and may lead to heart conditions or premature death because OSA requires the heart to pump fast and hard to compensate for the lack of oxygen repeatedly each night. OSA airway obstructions may occur dozens of times each hour or hundreds of times each night.
There are different types of apnea. Obstructive sleep apnea is the most common form. Only 10 percent of OSA sufferers seek treatment. Upper airway resistance syndrome (UARS) is another condition that is similar to OSA but is less severe. There are different levels of OSA, and an individual may experience mild, moderate or severe OSA. It is important to be seen by Dr. Jamali for treatment options if you are experiencing episodes of OSA because many individuals suffer silently or are unaware of why they experience symptoms such as:
- Dry mouth
- Sore throat
- High blood pressure
- Wakening with a headache
- Difficulty concentrating
- Mood changes
- Decreased libido
- Night sweats
Individuals with these conditions have an increased risk for obstructive sleep apnea:
- Overweight or obese
- Narrow airway
- Enlarged tonsils
- Enlarged adenoids
- High blood pressure (Hypertension)
- Family history of OSA
- Chronic nasal congestion
Men and individuals who smoke are at a greater risk for OSA.
Obstructive Sleep Apnea Procedures
First line treatments, such as breathing machines, oral devices and therapeutic pillows are often ineffective. Dr. Jamali specializes in providing patients with long-term answers that stop OSA episodes and replace the need for breathing machines.
Tonsillectomy is medically necessary when enlarged tonsils or adenoids create a nasopharyngeal obstruction. Reports from sleep studies show that all patients experienced a reduction in OSA after a tonsillectomy and 64 percent were cured.
UPPP is a procedure that expands the oropharyngeal air space and reshapes the soft palate, uvula, tongue, pharyngeal pillars and pharynx. UPPP studies revealed that 97 percent of patients were satisfied but 65 percent of patients continued to require additional sleep apnea treatments. UPPP can also be combined with a tonsillectomy and tongue channeling to address the precise needs of a patient. Dr. Jamali customizes each surgery to match the needs of the patient and can share result expectations with you during your consultation. UPPP treatments can include the use of laser technology.
Laser-assisted Uvulopalatoplasty (LAUP)
LAUP is a laser assisted surgical alternative to UPPP–uvulopalatopharyngoplasty, which removes excess throat and palate tissues to open the airway and treat obstructive sleep apnea. LAUP is similar to UPPP and is frequently used to control extreme or chronic snoring.
Orthognathic Surgery or Maxillomandibular Advancement Surgery
Orthognathic or maxillomandibular surgery treats misalignments of the teeth or jaw that create OSA and is recognized as a very efficient operation for treating sleep apnea by significantly increasing upper airway volume. Patients with jaw asymmetry who have difficulty biting, chewing, or swallowing, may benefit from the surgical repositioning of the jaw. The lower jaw may be moved forward surgically to correct a significant overbite or a weak chin. Patients with a significant underbite may benefit from having their jaw shortened and realigned. Dr. Jamali may determine that the surgery should focus on the upper or lower jaw or he may surgically adjust both to alleviate the symptoms of obstructive sleep apnea.
Orthognathic or maxillomandibular advancement surgery will create noticeable changes in the bite and braces are often needed before and after maxillomandibular surgery. Dr. Majid Jamali works in close collaboration with the orthodontist to ensure that an optimal outcome is achieved. Dr. Jamali assesses the anatomy of the patient’s throat and mouth during the initial consultation to determine the cause of OSA symptoms. This examination may involve a skull X-ray or nasopharyngeal exam to determine if widening the airway with orthognathic surgery will correct the problem.
What to Expect During the OSA Procedure
Uvulopalatopharyngoplasty (UPPP) and Laser-assisted Uvulopalatoplasty (LAUP) and tonsillectomy procedures are commonly completed in the Dr. Jamali’s office in New York City under IV sedation. UPPP results can be achieved with assistance from lasers. Details pertaining to your surgery will be provided at your consultation.
Orthognathic or maxillomandibular advancement surgery is performed by Dr. Jamali in the hospital. You will meet the anesthesiologist in the pre-surgery room, and you will be transported to the operating room under Dr. Jamali’s care. The surgery will require two to four hours. Patients usually are hospitalized for one or two days after the surgery.
Obstructive Sleep Apnea Surgical Recovery
Swelling, bruising and congestion may be experienced the first week after an OSA surgery. Dr. Jamali will provide you with medication that can control pain and inflammation. You will take a course of antibiotics, which are needed to prevent infection. Keep your mouth clean by using a baby toothbrush and antiseptic rinse. You will rinse several times a day with warm salt water. You may have splints and wires to stabilizing your jaw.
Stay hydrated by drinking broth, water and tea. You will be on a liquid diet for one week, and you will then slowly incorporate pureed foods, including yogurt and soup. Chewing foods must be avoided for one month, and regular, solid foods are gradually added back into the diet after six weeks.
Dr. Jamali will meet with you for a follow-up appointment one week after the surgery. By this time, most of the swelling will have subsided. You must avoid strenuous work and any heavy lifting for six weeks because vigorous activities will increase your blood pressure and aggravate swelling or bleeding. You may return to work after one week if your job requires light activity, such as office work.
Obstructive Sleep Apnea Expectations
Surgical obstructive sleep apnea treatments can improve a patient’s overall health by providing restful, uninterrupted sleep and possible freedom from CPAP machines. Dr. Jamali provides patients with computer imaging so they can view the surgical expectations before the surgery.
Dr. Jamali will meet with you to answer all of your questions and to explain your OSA treatment options during a private consultation.
Obstructive Sleep Apnea Consultation
The sleep apnea evaluation and diagnosis are completed with a physical examination and a sleep study. The sleep evaluations or polysomnograms may be performed at the individual’s home or a medical facility. The evaluation will monitor the amount and frequency of all OSA episodes during the test night. Dr. Jamali will diagnosis a patient with OSA based on their apnea-hypopnea index (AHI), which is founded on the number of OSA events.
Individuals are frequently unaware of OSA disturbances until someone mentions the problem and they often experience daytime sleepiness and other symptoms. OSA can be life threatening, and during your consultation and subsequent testing with Dr. Jamali, you will learn about your sleep patterns as-well-as any physical problems that may be causing the OSA episodes. If Dr. Jamali recommends surgery to treat an OSA issue, he explains the process in detail and uses digital imaging to show jaw changes that are recommended.
The Ideal OSA Surgery Candidate
The ideal OSA surgery candidate is a nonsmoker, has a BMI over 30, is under the age of 50, has been diagnosed with OSA, has had a sleep study that shows a moderate to severe OSA case or has enlarged adenoids, oversized tonsils or a jaw deformity that requires surgery. Surgery is sometimes recommended for individuals who have been unsuccessful with conservative OSA treatments, such as a mouth device, nose splint or CPAP machine.
Obstructive Sleep Disorder Cost
Medical insurance pays for medically necessary OSA corrective surgeries. Patients typically are required by the insurance company to meet the following requirements for oral maxillofacial surgery.
- Sleep evaluation
- AHI index shows 15 OSA events per hour
- 30 OSA events or more during the sleep study
- Failed nonsurgical first-line therapies, including CPAP therapy and oral appliances
Insurance companies do not consider LAUP as a medically necessary treatment for addressing snoring or obstructive sleep apnea.
Dr. Jamali and the office staff work with each patient and their insurance to limit out-of-pocket expenses based on the severity of OSA symptoms and medical history. Orthognathic surgery commonly requires a separate approval and review by the insurance’s oral and maxillofacial surgical unit. Oral and Maxillofacial Surgery of New York will provide the information that is needed to establish a medical need when Dr. Jamali finds that surgery would be appropriate.
Frequently Asked Obstructive Sleep Apnea Questions
Q – What is Obstructive Sleep Apnea?
OSA is a condition that is caused by the blockage of the airway during sleep. This blockage may be caused by the sleeper’s tongue, by excess tissue or swelling in the throat, by enlarged adenoids or tonsils or by a jaw abnormality or misalignment.
Q -Who is in Danger of OSA?
Obstructive sleep disorder is twice as common in men as it is in women. OSA is a potentially life-threatening condition, and Dr. Jamali must clinically examine you to diagnosis and treat OSA. Call 212-480-2777 to request a consultation in New York, NY.
Q – Where is the OSA Surgery Performed?
Dr. Jamali completes OSA surgery in the office or a local hospital depending on the type of surgery.
Q – What Causes Obstructive Sleep Apnea?
Obstructive sleep apnea is experienced when a person’s airway becomes blocked while they sleep. A partial or a full blockage may be experienced, and a complete examination by Dr. Jamali can determine the cause for your OSA. OSA is often caused by factors such as a jaw deformity, excessively large tonsils, obesity or a narrow throat.
Q – What are Signs and Symptoms of Obstructive Sleep Apnea?
Obstructive sleep apnea is often recognized when snoring ends with a sudden gasp for air. Pauses in a snoring pattern are one indication of OSA, but everyone who snores does not have obstructive sleep apnea. Daytime sleepiness, a sore or dry throat, difficulty concentrating, high blood pressure and mood changes may be signs of OSA. Visit Dr. Jamali to determine if you have OSA.
Q – What Lifestyle Changes are Recommended for OSA?
Lifestyle changes can reduce the occurrence of OSA episodes. Quitting smoking, losing weight and limiting alcohol may relieve some sleep apnea issues. Smoke often causes inflammation in the airway’s sensitive tissues and increases tissue swelling which further complicates airway obstructions.
Q – Do I Have Obstructive Sleep Apnea?
You may be aware that you are suffering from sleep apnea, but many people are unaware that it is occurring. Your spouse or sleep partner may recognize a problem. You should request a consultation with Dr. Jamali if you are experiencing symptoms of sleep apnea. An OSA diagnosis will confirm your condition and will provide you with tools that can help.
Q- Am I a Candidate for OSA Surgery?
You may be an ideal OSA surgery candidate if you have been unsuccessful with conservative treatments, such as a nose splint, mouth device or CPAP machine. You may also be an ideal candidate if you are experiencing a craniofacial deformity, have a body mass index over 30, are under age 50 and are experiencing moderate to severe sleep apnea.
When Can I Return to Work?
You need to avoid any strenuous labor or heavy lifting for six weeks because these activities can increase your blood pressure and cause swelling or bleeding. You may be approved to return to work after your one-week appointment if your job is light.
Call Today for a Consultation
Call Sleep Apnea Surgery of New York at 347-417-5076 to request an obstructive sleep apnea consultation with Oral Surgeon Majid Jamali, DMD. Take a productive step towards a restful night’s sleep and better health! We have provided patients in New York City, Manhattan, Queens, Westchester, Staten Island, Brooklyn and the Bronx with a better night’s sleep.