Obstructive sleep apnea (OSA) is a condition in which the upper airway becomes obstructed as a person sleeps. When that happens, breathing ceases abruptly. As oxygen levels in the body drop, the person will awaken partially, clear the obstruction and start to breath again, often with a loud gasp. This cycle repeats over and over again as a person sleeps, and in severe cases, may occur hundreds of times per night.
For OSA sufferers, this often results in excessive sleepiness and difficulty concentrating during waking hours, as well as depression. Over the long-term, research has shown that, left untreated, OSA can lead to cardiovascular problems, significantly increasing risk of hypertension, heart attack and stroke.
The upper airway obstruction that causes OSA can be the result of any combination of the following factors: Excess soft tissue around the back of the throat, soft palate or tongue, large tonsils, a large tongue, defects in the nasal passages, airway muscles that relax or collapse during sleep and the position of jaws. While people who are over the age of 40 or are overweight are at greatest risk, OSA can affect anyone at any age. An estimated 18 to 20 million adults suffer from OSA, along with approximately 2 to 3 percent of children.
Patients who see Dr. Arroyo for a consultation related to obstructive sleep apnea symptoms can expect a thorough evaluation that will include a detailed health history and an assessment – via physical examination and medical imaging – of the anatomic relationships in the maxillofacial region, including factors such as airway shape and reactivity and any craniofacial relationships that may be contributing to OSA. In some cases, a flexible fiber-optic camera may be used to perform a naso-pharyngeal exam, and a sleep study may be recommended for further evaluation of the characteristics and severity of OSA.
A number of options are available for the treatment of obstructive sleep apnea. Initial treatment is often CPAP therapy, which uses a machine to deliver pressurized oxygen through nasal or facial mask as a person sleeps to limit airway obstruction. Oral appliances may be prescribed to aid in keeping airways open, and lifestyle changes – such as exercise and weight loss – may be recommended. Surgical treatment may be recommended in severe cases that have not responded to less invasive treatments, with options ranging from procedures that address soft tissue obstructions to orthognathic surgery to resolve airway restriction caused by poorly positioned jaws.
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