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.
Sleep Apnea Treatment
The first step in treatment for sleep apnea 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.
Treatment Options for Sleep Apnea
There are several treatment options available. An initial treatment by a sleep Medicine specialist may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. Several Dental Specialists in the area also offer various splint therapies to aid in treatment of OSA. We are happy to refer you for initial treatment at one of these specialists.
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 by the Oral and Maxillofacial Surgeons at Southeast Oral and Maxillofacial Surgery in the hospital under general anesthesia and requires a one to two day overnight stay in the hospital. This Bi-maxillary Advancement Procedure has been shown to significantly reduce measures of sleep apnea on a sleep study including RDI.
OSA is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.