SLEEP APNEA
People suffering from snoring and sleep apnea contend with disrupted sleep every night, resulting from irregular breathing and low blood oxygen levels. It’s a serious disease that occurs when the tongue is sucked against the back of the throat, obstructing airflow in the upper airway. The brain’s oxygen level steadily decreases until the sleeper awakens, usually with a gasp, and clears the breathing impediment. Repeated cycles of decreased oxygenation lead to very serious cardiovascular problems.
Increased airway space after advancement of the maxilla and mandible.
Position of the mandible is one of the main factors in sleep apnea.
Maxillary and mandibular surgery improves mid-face and lower face projection.
Reduced airspace way.
What are the symptoms of sleep apnea?
- Breathing interruptions during sleep
- Loud snoring
- Sudden awakenings, followed by a shortness of breath
- Difficulty remaining asleep
- Chronic, morning headaches
- Frequent and superfluous daytime drowsiness
The diagnosis of sleep apnea is made based in the signs and symptoms and other studies. With cephalometric (skull x-ray) analysis, the oral and maxillofacial surgeon 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 individuals overnight.
What are the types of sleep apnea?
Obstructive sleep apnea: The most common form of sleep apnea that occurs when throat muscles relax, restricting airflow to the brain. Once sensed, the brain forces you awake in order to open your airflow.
Central sleep apnea: This happens when the brain fails to transmit signals to the muscles that regulate breathing. Unlike obstructive sleep apnea, the sleeper suffering from central sleep apnea typically remembers their inability to stay asleep.
Complex sleep apnea: A combination of obstructive and central sleep apnea.
An initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. One of the surgical options is a uvulopalatopharyngoplasty (UPPP), which is performed in the back of the soft palate and throat. A similar procedure is sometimes done with the assistance of a laser and is called a laser assisted uvulopalatoplasty (LAUP). Nasal septum surgery and/or turbinectomy can also be done. All these procedures are 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 under general anesthesia and requires 1 to 2 days overnight stay in the hospital.
