Services

Sleep Apnea

Sleep apnea is a condition in which normal breathing during sleep is interrupted or compromised. Signs that a patient might have sleep apnea are restless, non-restorative sleep, witnessed cessation of breathing during sleep, persistent fatigue during the day despite adequate hours in bed, and loud snoring. It is possible to have snoring during sleep and not have sleep apnea. The diagnosis of sleep apnea is made by analyzing the results of a sleep study, or polysomnogram. Ideally, the study is done in a sleep lab and analyzed by physician sleep specialists.

There are several possible causes of sleep apnea, one of which is obstructive sleep apnea. Obstructive sleep apnea (OSA) means that there is a mechanical collapse or obstruction of the airway during sleep. The usual treatment for obstructive sleep apnea is to place the patient on a CPAP (continuous positive airway pressure) device for use during sleep. The CPAP device pressurizes the airway and pushes the obstruction open so that the airway remains clear during sleep. In situations where the patient poorly tolerates the CPAP device, a mandibular advancement device (MAD) may be a helpful alternative. A common site of airway obstruction during sleep is the back of the tongue pressing against the back of the throat. An MAD positions the lower jaw forward during sleep, so that the tongue is moved away from the back of the throat, thus opening the airway. Requirements for use of an MAD are stable teeth and healthy TMJ’s (jaw joints).

If OSA is severe, the patient may benefit from reconstructive jaw surgery. In this treatment, the upper and lower jaw are moved forward and permanently fixated in that position, bringing with them the tongue and other attached soft tissue. Research has shown this treatment to be very effective when the primary cause of the airway obstruction is the tongue against the back of the throat. This treatment is also very effective when there is a pre-existing jaw deformity associated with the diagnosis of obstructive sleep apnea. Generally, a period of orthodontic preparation is required prior to reconstructive jaw surgery for the treatment of OSA.

‍

Want to schedule an appointment?

Schedule appointment