Sleep Apnea

Snoring has been the subject of many jokes and comedy routines. But in reality, snoring can be an indication of a more serious problem than a loud annoyance. Habitual snoring might indicate a disorder called Obstructive Sleep Apnea. This is an unsuccessful attempt to breathe through the nose and mouth which is caused by obstruction involving the soft palate, uvula, nose, tonsils, adenoids, or base of the tongue.

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 air flow 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.

Some patients have obstructions that are less sever called Upper Airway Resistance Syndrome (UARS). In either case, the individuals suffer many of the same symptoms.

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 individuals overnight. If it is apparent that the problem is snoring, a take home monitor may be used to confirm the diagnosis.

There are several treatment options available. An initial treatment for Sleep Apnea may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. A very successful non-surgical procedure is the use of a night time oral appliance that positions the lower jaw forward to increase the airway space. One of the surgical options is a procedure done with the assistance of a laser called a Laser Assisted uvulo-palato-plasty (LAUP). In other cases, a stents may be utilized to tighten the soft palate. These are procedure usually performed under light intravenous sedation in the office.

In more complex cases, 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 and requires 1 to 2 days overnight stay in the hospital.

Dr. Bagnoli, Dr. Steffey or Dr. Dragoo can offer several courses of treatment for treating snoring and sleep apnea, as outlined above.

A consultation with Drs. Bagnoli, Steffey or Dragoo will be sure to get you back on track for a good night’s sleep.