Sleep Apnea

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.

Sleep Apnea Treatment

The first step in treatment for sleep apnea resides in recognition of the symptoms and seeking appropriate consultation. Drs. Lohr and Hollabaugh often work in conjunction with your sleep physician in management of these problems. 

In addition to a detailed history, the doctors will assess your nasal passages, oral airway and the anatomic relationships in the maxillofacial region. With cephalometic (skull x-ray) analysis, the doctors can ascertain the level of obstruction. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight.

sleep apnea diagrams

Treatment Options for Sleep Apnea

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. However, not all patients are able to tolerate a CPAP well due to discomfort of the mask, trouble sleeping, or very high pressure settings. If CPAP is poorly tolerated, you may be a good candidate to have surgery improve your sleep apnea.

One of the surgical options is a functional rhinoplasty. In patients with nasal obstruction, or difficulty breathing through their nose, a CPAP machine may not be well tolerated. We evaluate all sleep apnea patients for nasal obstruction to see if they would benefit from a this procedure. A functional rhinoplasty is an outpatient procedure performed under general anesthesia and patients may go home on the same day.

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 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.