Obstructive Sleep Apnea (OSA) is the cause of numerous serious medical problems and deaths. Impaired airflow leads to sleep disturbances at night and a decreased oxygen level in the bloodstream. In many cases, individuals with obstructive sleep apnea actually stop breathing numerous times while sleeping. The decreased oxygen levels lead to a multitude of medical and psychological disabilities. Common signs and symptoms include snoring, restless sleep, frequent urination at night, daytime sleepiness, morning headache, decreased ability to concentrate, irritability, depression, personality changes, impotence, acid reflux, decreased performance at work and weight gain. Significant obstructive sleep apnea leads to serious medical problems and even death. Obstructive sleep apnea has been shown to cause pulmonary hypertension (increased blood pressure in the lungs which can lead to heart failure), polycythemia (an overproduction of red blood cells as a result of a chronic low level of oxygen in the blood stream) and cor pulmonale (failure of the right side of the heart) and may be fatal. Due to the seriousness of OSA, most major insurance plans provide coverage for treatment with a documented sleep study.
Obstructive sleep apnea is caused when an individual's airway is obstructed or blocked while sleeping. Obstruction usually occurs when an individual lays flat on their back and the tongue and soft tissue in the floor of the mouth fall backward and obstruct the airway. Once the brain detects the low oxygen level in the bloodstream, the brain stimulates an interruption of sleep in order to allow the individual to breath. Individuals with obstructive sleep apnea are rarely aware that that they temporarily stop breathing, however, this interruption in their sleep cycle explains the constant daytime sleepiness and other symptoms. Obstruction may also occur in the area of the soft palate and nose. These higher obstructions are frequently caused by excessive soft tissue in the area of the soft palate and/or a deviated nasal septum.
Patients are traditionally diagnosed with obstructive sleep apnea with a sleep study (nocturnal polysomnography). During this sleep study, patients are observed and monitored by a certified sleep technician overnight. Sleep apnea is classified with either an RDI (Respiratory Disturbance Index)or AHI (Apnea-Hypopnea Index) configured from the sleep center. Treatment of mild obstructive sleep apnea is usually weight loss, exercise and cessation of alcohol and depressant products. If these treatments fail, patients are placed on either a BIPAP (Bilevel Positive Airway Pressure) device or a CPAP (Continuous Positive Airway Pressure) device in order to force open their airways with high pressure oxygen. Although effective, many patients cannot tolerate or refuse to use their BIPAP/CPAP machines due to noise, pain, headaches, claustrophobia, dry eyes, inability to sleep on their stomachs or the inconvenience of traveling with their machines.
Treatment of Obstructive Sleep Apnea
Maxillomandibular Advancements enjoy over a 90% success rate in reducing significant sleep apnea. This procedure repositions the jaws in a more forward position in order to pull the base of the tongue and surrounding soft tissues forward, thus alleviating the obstruction. This highly successful treatment is usually covered by medical insurances and requires a 1 to 2 day stay in the hospital after the procedure.
A Uvulopalatopharyngoplasty (UPPP) is performed in order to decrease the excessive soft tissue of the soft palate. Although successful in specific cases, overall UPPP’s have around a 40% success rate and are extremely painful.
A Septoplasty is performed in order to correct major deviations (twistings) of the nasal septum. This is a relatively simple procedure which is done on an outpatient basis when needed. Please click here for additional information on obstructive nasal breathing.