Sleep Apnea

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs, the tongue is displaced 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, a person with OSA partially awakens, the obstruction in the throat clears and the flow of air starts again, usually after a loud gasp.

Repeated cycles of decreased oxygenation lead to very serious cardiovascular problems, such as heart attack and stroke. Additionally, these individuals suffer from excessive daytime sleepiness, depression, and loss of concentration.

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

The first step in treatment resides in recognizing the symptoms and seeking appropriate consultation. Oral and Maxillofacial Surgeons offer consultation and treatment options to patients suffering from OSA.

In addition to a detailed history, our doctors will assess the anatomic relationships of your airway. With cephalometic (skull x-ray) analysis, our doctors can ascertain the level of obstruction. Sometimes a naso-pharyngeal exam is done with a flexible fiber-optic camera. To confirm the amount of cardiovascular compromise and hypoxia, a sleep study may be recommended to assess the severity of your disease.

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 airway obstruction at night. One of the surgical options is a Uvulo-Palato-Pharyngo-Plasty (UPPP), which is performed in the back of the soft palate and throat. A similar procedure is sometimes performed with the assistance of a laser and is called a Laser Assisted Uvulo-Palato-Plasty (LAUP).  These procedures are usually performed under light intravenous sedation in our office.

In moderate to severe OSA 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 of overnight stay in the hospital. This treatment has the best long-term results in treating sleep apnea.

 

Supporting documents

Below are documents to help you before your visit and after.

Surgical instructions

Anesthesia
Medicines to avoid prior to surgery
Facial (Fraxel) laser surgery
Oral and Maxillofacial surgery

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