Obstructive Sleep Apnea
What is Obstructive Sleep Apnea?
Obstructive sleep apnea (OSA) is the repeated cessation of breathing during the night. With repeated interruptions in your sleep pattern, patients begin to have daytime drowsiness. Chronic untreated sleep apnea can lead to serious and life-threatening medical conditions, such as heart attacks, strokes, irregular heart beats, high blood pressure, heart disease, and decreased libido.
The cessation of breathing is caused by obstruction of the upper airway. This obstruction can result from excess tissues in the neck, large tonsils, large tongue, narrowed nasal passages, excess tissue on the soft palate, and relaxation and collapse of the airway muscles.
How is Obstructive Sleep Apnea Diagnosed?
If your doctor suspects you to have obstructive sleep apnea, he/she will refer you for a sleep study called “polysomnography.” This type of study requires that you spend the night at a sleep clinic while doctors monitor your sleep patterns. During the sleep study, every effort is made to limit disturbances to your sleep.
How is Obstructive Sleep Apnea Treated?
Obstructive sleep apnea is treated both with and without surgery depending on how severe a form you are diagnosed with.
Nonsurgical Treatments
- Behavior Modifications--This often works satisfactory in people diagnosed with mild sleep apnea. Some suggestions for behavior modifications are: weight loss, avoid alcohol, avoid caffeine and heavy meals within two hours of bedtime, no sedatives, and possible changes in sleeping positions (avoid sleeping on your back).
- CPAP or Bi-PAP Machines--The Continuous Positive Airway Pressure and Bi-Level Positive Airway Pressure machines are the first line of treatment for obstructive sleep apnea. These machines use a specially made mask which fits over your nose to allow a prescribed constant amount of pressure to be maintained which helps to keep the airway and throat from collapsing. These machines only treat the condition of sleep apnea and do not cure it. These machines also are often difficult for some patients to accept and use.
Surgical Treatments
Surgical intervention is a viable alternative for some sleep apnea patients. Two surgical specialties, ENT and Oral and Maxillofacial Surgeons, offer surgical procedures to help with obstructive sleep apnea. Every patient has a different shaped nose and throat, so a thorough evaluation is necessary to determine which surgical specialist and surgical procedure is right for you.
Surgical procedures performed by ENT surgeons:
- Uvulopalatopharyngoplasty (UPPP)
- Hyoid suspension
- Tracheostomy
Surgical procedures performed by Oral and Maxillofacial surgeons:
- Genioglossus Advancement--This procedure is designed to open the upper airway. The surgery tightens the front muscle of the tongue and pulls the tongue forward opening the airway at the base of the tongue. This procedure is not usually performed alone but in combination with another procedure.
- Maxillomandibular Advancement--This procedure is the most common one performed by the Oral and Maxillofacial surgeon for obstructive sleep apnea. The surgery moves the upper and lower jaws forward. This in turn advances the soft tissues of the tongue, palate, and neck, thereby opening the upper airway. For some individuals, this procedure is the only technique that can create the necessary air passageway to resolve or significantly improve their sleep apnea.
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***Information referenced from www.aaoms.org
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