People with obstructiove speal 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 lecel in the brain becomes low enough, the sleeper partially awakens, the obstruction in the throat clears, 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 symtoms.
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 detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (skull x-ray) analisis, the doctors can ascertain the level of obstruction. Sometimes a naso-phryngeal exam is done with a flexible fiber-optic camera. To confirm the amount of cardiovascular comprimise and decreased oxygenation levels, a sleep study may be recommended to monitor and individual overnight.
There are several 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. One of the surgical options is an uvulo-palato-pharyngo-plasty (UPPP), which is performed inthe back of the soft palate and throat. A similar provedure is sometimes done with the assistance of a laser and id called laser uvulo-palato-pharyngo-plasty (LAUPPP). In other cases, a radio-frequency probe is utilized to tighten the soft palate. These procedures usually performed under light IV sedation in the office.
In more complex cases, the bones of the upper and lower jaw may be respositioned to increase the size of the airway (orthognatic surgery). This procedure is done in the hospital under feneral anesthesia and requires a one to two day overnight stay in the hospital.
Snoring and Sleep Apnea
People who snore loudly are often the target of bad jokes and middle of the night elbow thrusts; but snoring is no laughing matter. While loud disruptive snoring is at best a social problem that may strain relationships, for many men, women and even children, loud habitual snoring may signal a potentially life threatening disorder: obstructive sleep apnea, or OSA.
Snoring Is Not Necessarily Sleep Apnea
It is important to distinguish between snoring and OSA. Many people snore. It’s estimated that approximately 30% to 50% of the US population snore at one time or another, some significantly. Everyone has heard stories of men and women whose snoring can be heard rooms away from where they are sleeping.
Snoring of this magnitude can cause several problems, including marital discord, sleep disturbances and waking episodes sometimes caused by one’s own snoring. But, snoring does not always equal OSA; sometimes it is only a social inconvenience. Still, even a social inconvenience can require treatment, and there are several options available to chronic snorers.
Some non-medical treatments that may alleviate snoring include:
Weight loss — as little as 10 pounds may be enough to make a difference.
Change of sleeping position — Because you tend to snore more when sleeping on your back, sleeping on your side may be helpful.
Avoid alcohol, caffeine and heavy meals — especially within two hours of bedtime.
Avoid sedatives — which can relax your throat muscles and increase the tendency for airway obstruction related to snoring