Sleep Apnea Treatment

Sleep Apnea

Sleep Apnea and Snoring

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When loud snoring is interrupted by episodes of obstructed breathing, it is known as obstructive sleep apnea. Serious episodes last more than ten seconds each and occur more than seven times per hour. Apnea patients may experience more than 100 such events per hour. These episodes can reduce blood oxygen levels, causing the heart to pump harder.
The immediate effect of sleep apnea is that the snorer must sleep lightly and keep his muscles tense in order to maintain airflow to the lungs. Because the snorer does not get a good rest, he may be sleepy during the day, which can impair job performance and make him a hazardous driver or equipment operator. After many years with this disorder, elevated blood pressure and heart enlargement may occur.

Sleep Apnea is a disorder where a person's ability to breathe is impaired, resulting in a restless sleep and remaining tired all the time.

If the patient has sleep apnea or has a surgical procedure to open the airway, repositioning the jaw during sleep may further assist in opening the airway even more.

A Sleep Apnea appliance may be an alternative to patients that cannot tolerate a Positive Airway Pressure unit (CPAP). In many cases it can be used with a CPAP to improve its performance.

The symptoms associated with these conditions range from:

Neck Pain
Mouth Pain
Face, Neck, Jaw Tightness
Mystery Tooth Pain
Jaw Pain
Burning Mouth and Tongue
Muscle Pain
TMJ Pain
Trigeminal Neuralgia
Facial Nerve Pain
Snoring
Abnormal Bite Sensations
Sleep Apnea
Post Trauma Pain
Post Surgery Pain
Facial Pain
Headaches
Popping or Clicking Jaw

The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.

Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.

Home Sleep Study

Home Sleep Study Image

Sometimes, it is worthwhile to obtain a sleep study to determine if a patient suffers from obstructive sleep apnea, as opposed to “simply snoring”. Traditionally, these sleep studies have been performed in specialized sleep laboratories designed to resemble hotel rooms. These overnight, attended sleep studies provide comprehensive information about a patient’s sleep. And while they are often “covered” by traditional insurance, they are very expensive, and many patients face significant co-payments and/or deductible payments. In addition, the need to sleep away from home is too inconvenient for some patients.

To undergo a sleep study at home, patients are evaluated by Dr. Dorfman, and sent home with a simple device that is worn to bed for one night. The device can be returned the next day, and the data is immediately available for interpretation by our medical staff. If desired, appropriate treatment can be carried out right then.

CPAP

CPAP, or Continuous Positive Airway Pressure, is a device that is worn during sleep to provide respiratory ventilation in the treatment of sleep apnea. CPAP is currently the most effective treatment for sleep apnea when the patient complies with wearing the device. However, over 50% of patients either cannot or will not comply. New, minimally invasive treatments such as the Pillar Procedure and Oral Appliances may be a good alternative for these patients who are not compliant with CPAP use.

Patients who cannot or will not comply with CPAP should talk with their physician, or set up a consultation with Dr. Dorfman. We can usually see a patient within 2 business days.

Uvulopalatopharyngoplasty (UPPP)

UPPP stands for Uvulopaltopharyngoplasty. It literally means to reshape the uvula, palate, and pharynx. The internet is full of both horror stories and miraculous cures with this procedure. The concept began over 50 years ago with palatal procedures being done and conceptualized by Ikematsu of Japan. In 1979, Fujita of the United States developed the more classic UPPP, similar to the one still practiced today. There have been several changes over the years to improve results, decrease the chance of complications, and reduce pain but the concepts have remained the same. The goals are:

1. To enlarge the airway
2. To stabilize the airway
3. To correct anatomical abnormalities

The main steps are to remove the tonsils and identify and remove redundant palate and uvula (that dangly thing at the back of your throat).

Patient 2 weeks post-UPPP