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.
The first step in treatment resides in recognition of the symptoms and seeking appropriate consultation.
In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended and can be done in your own home.
There are several treatment options available. One treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. A oral appliance is another option. Oral appliances open the airway by 1 — keeping the lower jaw from falling down and back and 2 — holding the lower jaw slightly open and forward. Because the tongue is attached to the jaw, as the jaw moves forward your airway is made larger by the forward movement of the tongue. In severe cases, surgery may be necessary.
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.