Sleep Apnea Treatment
Oral Surgeon, Eric D. Ferrara, DDS, treats people with obstructive sleep apnea (OSA) which causes disrupted sleep & low blood oxygen levels.
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. A Sleep Medicine Doctor will diagnose your condition. Oral and Maxillofacial Surgeons offer consultation and treatment options after your diagnosis has been made.
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 (heart) compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight.
There are several treatment options available: non-surgical and surgical.
Non-surgical: An initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. A mouthguard or Sleep-Apnea-Appliance may be recommended to “open” your airway to help decrease periods of “non-breathing” Nasal strips or nasal medications may also help to open your nasal passage to allow air to flow more freely.
Surgical: A complete airway analysis and x-rays will help your surgeon locate the area or areas causing airway problems. One of the surgical options is an uvulo-palato-pharyngo-plasty (UPPP), which is performed in the back of the soft palate and throat – which removes tonsils and tightens & elevates the soft palate and throat muscles.
A similar procedure is sometimes done with the assistance of a laser and is called a laser assisted uvulo-palato-plasty (LAUPP). This procedure removes the uvula and also tightens & elevates the soft palate and throat muscles.
A second surgery option is a rhinoplasty, which aligns the nasal septum, opens the air-flow passages, and removes any blockage of airflow. A third option involved advancing the tongue muscles to open the oral-airway allowing an easier airflow and decreasing blockage.
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.