Sleep Apnea

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.

The first step in treatment 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. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight.

There are several conservative treatment options available. An initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. There are also custom appliances that patients can wear on the teeth at night that help prevent the collapse of the tissues commonly involved in causing obstructive sleep apnea. 

In more complex cases or in those that fail conservative treatment, surgery may be indicated. 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.

OSA is a very serious condition that needs careful attention and treatment. If you believe you have sleep apnea we encourage you to contact your primary medical physician and explain the symptoms you have to begin the process of evaluating you for sleep apnea.