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 air flow 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 sever called Upper Airway Resistance Syndrome (UARS). In either case, the individuals suffer many of the same symptoms.

The first step in treatment resides in recognition of the symptoms and seeking appropriate consultation.  Dr. Allen offers consultations and treatment options.

In addition to a detailed history, Dr. Allen will assess the anatomic relationships in the maxillofacial region. With utilization of an acoustic pharyngometer we are able to get an objective measurement of the oropharyngeal airway using analysis of a reflected acoustic signal to display cross-sectional area (CSA) as a function of distance. With clinical characteristics (body mass index: BMI, and Epworth Sleepiness Scale, ESS) would predict presence and severity of OSA. To confirm the amount of cardiovascular compromise and decrease oxygenation levels, a sleep study may be recommended to monitor individuals overnight.

 Dr. Allen uses the ARES home sleep testing.  ARES provides a better profile of you breathing during sleep by allowing you to be studied in your normal sleeping environment. The device collects physiological data while you are asleep, and integrates the data with clinical history and physical data to determine the presence and severity of sleep apnea.  ARES is worn on your forehead, and is usually worn for on night.  The small size allows the device to be comfortably worn in all sleep positions, and ARES even notifies you with a voice prompt that you are wearing it correctly. Your sleep data is reviewed by a certified sleep technologist and then interpreted by Dr. Allen.  At that time Dr. Allen will recommend the appropriate therapy.

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.  One of the surgical options is a uvulo-palato-pharyngo-plasty (UPPP), which is performed in the back of the soft palate and throat.  A similar procedure is sometime done with the assistance of a laser and is called a Laser Assisted uvulo-palato-plasty (LAUP).  In other cases, a radio-frequency probe is utilized to tighten the soft palate. 

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 -2 days 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.