Snore and Sleep Apnea Appliances
Do you snore or feel tired after sleeping all night? If you do, it is possible that you aren’t getting enough oxygen at night. As we age, the muscles in the head and neck region get looser and our airway collapses. As we sleep, we gasp for breath to get oxygen. Then, we don’t get enough oxygen during sleep. Over time this can seriously affect your health!
Technically speaking, 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, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (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 is recommended to monitor an individual overnight.
There are several treatment options available:
1. CPAP : The initial treatment recommendation may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. This is the gold standard and delivers the most oxygen to patients while they sleep. However, it tends to be bulky and noisy so it is not tolerated well by all patients.
2. A Sleep Appliance worn over the teeth can help many patients with mild or moderate sleep apnea, as well as those who cannot tolerate the CPAP. These snore or sleep apnea appliances are made in out office. They work by bringing the lower jaw forward when worn. This opens up the airway to eliminate snoring and bring in more oxygen.
3. Uvulo-palato-pharyngo-plasty (UPPP), This is one of the surgical options 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 uvulo-palato-plasty (LAUPP). In other cases, a radio-frequency probe is utilized to tighten the soft palate. These procedures are usually performed under light IV sedation in the office.
4. Orthognathic surgery In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway . 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.