Obstructive Sleep Apnea Treatment
People with obstructive sleep apnea (OSA) have disrupted sleep which causes lower blood oxygen levels. When a person is awake, the muscles in the throat maintain the opening of the airway. However, as a person falls asleep, the muscles in the throat relax, the tongue or the palate is sucked against the back of the throat, and the airway closes causing a complete or partial obstruction. 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 including high blood pressure, strokes and congestive heart failure. Additionally, these individuals suffer from excessive daytime sleepiness, depression, inability to concentrate, memory loss, change in personality, impotence, and depression. Typical signs of sleep apnea include loud snoring with witnessed episodes of no breathing and obesity. However, not all patients who are obese have sleep apnea.
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, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometric (skull x-ray) analysis, the 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 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.
In more severe 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 a one to two-day overnight stay in the hospital.
After undergoing orthognathic surgery to advance the upper and lower jaw, a significant increase in airway caliber is noted before and after surgery.
OSA is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.