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.
Some patients have obstructions that are less severe 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, Dr. Wightman or Dr. Slovan will assess the anatomic relationships in the maxillofacial region. With cephalometric (skull x-ray) analysis, Drs. Wightman or Slovan 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 decreased oxygenation levels, a sleep study may be recommended to monitor an 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. Many people are not able to tolerate a CPAP machine and for most of this group of people an Oral Appliance can be a wonderful treatment option. As a member of the American Academy of Dental Sleep Medicine I am well trained to provide this treatment. I find that most people tolerate the oral appliances very well and they can provide a treatment that can be literally life changing. Imagine a significant increase in energy, decrease in daytime sleepiness, and improved night time sleep on a consistent basis. We have treated many people with Oral Mandibular Repositioning Devices and find that they can provide a life changing treatment for MANY people.
In more complex cases, the bones of the upper and lower jaw may be positioned to increase the size of the airway (orthognathic surgery). This procedure is done in the hospital under general anesthesia and requires a one to two day overnight stay in the hospital.
OSA is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.