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. Dr. Frascella can screen for oral signs of sleep apnea like tooth wear, TM joint or muscle pain, tongue scalloping, crowded airway, and tonsillar enlargement. If it is found that there are signs OSA, a referral to a sleep physician my be appropriate for definitive diagnosis.
In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (skull x-ray) analysis, or a 3D cone beam CT scan, 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 may be recommended to monitor an individual overnight.
Treatment Options for Sleep Apnea
There are several treatment options available. An initial treatment may consist of using a CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. If indicated Dr. Frascella can fabricate a custom oral appliance that is worn while sleeping to advance the lower jaw and open the airway. Treatment will be coordinated between the sleep physician and Dr. Frascella. Even patients who must wear CPAP due to the severity of OSA can often benefit from the addition of a sleep appliance to help lower the pressure of their CPAP. Patients who are non compliant with the CPAP may benefit from an oral appliance.
Common symptoms of OSA may include some of the following:
- Daytime fatigue
- High blood pressure
- Mood disorders like depression, or ADD/ADHD
- Acid reflux
- Waking frequently to urinate
If you, or a loved one, including a child suffers from any of these symptoms please call for a free consultation to discuss the next step. It could save a life.