Patients with obstructive sleep apnea syndrome (commonly referred to as sleep apnea) have disrupted sleep usually due to anatomic variations in the upper airways. These obstructions typically occur at the base of the tongue and at the soft palate. When obstruction occurs the upper airway becomes blocked and air flow stops or is significantly reduced temporarily. When the oxygen level in the brain becomes low enough, the obstructed sleeper partially awakens, the obstruction in the throat clears and the flow of air starts again, usually with a loud gasp. Patients with sleep apnea may have up to 100 episodes of apnea or lack of breathing each night. Repeated cycles of decreased oxygenation may lead to very serious cardiovascular problems including high blood pressure, stroke and heart attack.
Symptoms of sleep apnea typically include daytime sleepiness, extreme tiredness, lack of concentration, memory loss, short attention span, poor judgement, rapid weight gain and may even result in depression and personality changes.
The first step in treatment of sleep apnea is recognition of the symptoms and seeking appropriate consultation. Oral and Maxillofacial Surgeons offer consultation and treatment options. In addition to a detailed history, Dr. Ferdowsmakan will assess the anatomic relationships in the maxillofacial region. This involves a thorough clinical examination and the use of specialized imaging. To assess the degree of obstructive sleep apnea, a formal sleep study (known as a polysomnogram) is performed in order to monitor individuals overnight in a controlled laboratory setting.
Continuous positive airway pressure (CPAP) devices are often used as the first line treatment. These devices are highly effective when properly used. Unfortunately the devices are very often not tolerated and compliance rates are poor.
Mandibular anterior positioning devices have been shown in studies to be equally effective in the treatment of sleep apnea when compared to CPAP devices. The mandibular devices are custom made appliances fabricated in a laboratory. These devices are well tolerated and have been shown to have excellent results.
In more severe cases, the bones of the upper and lower jaw may be surgically repositioned forward to dramatically increase the size of the airway and thus to decrease symptoms and the harmful sequelae of sleep apnea.
Sleep apnea is a serious medical condition that requires proper diagnosis and treatment. There are many surgical and non-surgical treatment options available. If you have sleep apnea or suspect that you may have sleep apnea, please contact our office for an evaluation.
