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. A diagnosis of OSA from a formal sleep study is required before treatment planning with your surgeon. Speak to your family doctor for a referral to a sleep study clinic before you arrange a referral to a surgeon so that the planning is comprehensive.
In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With imaging, the doctors can ascertain the level of obstruction.
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 in the back of the soft palate and throat. A similar procedure is sometimes done with the assistance of a laser and is called a laser assisted uvulo-palato-plasty (LAUPP). In other cases, a radio-frequency probe is utilized to tighten the soft palate.
In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (orthognathic surgery), which is the modality of treatment offered by our surgeons. This procedure is done in the hospital under general anesthesia and requires usually a two day overnight stay in the hospital.
OSA is a very serious condition that needs careful attention and treatment.
