Signs of Obstructive Sleep Apnea:

1. Excessive sleepiness during the day
2. Snoring with obstruction or choking
3. Headaches
4. Hypertension
5. Fatigue
6. Inability to concentrate
7. Frequent awakenings at night
8. Obesity or large neck circumference
9. Depression
10. Cardiovascular disease at a young age (heart attacks, strokes, high blood pressure)
11. Sleepiness while driving or car accidents

Sleep Apnea

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs the upper airway is blocked and air flow stops. When the oxygen level in the brain becomes low enough, the individual 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. Oral and Maxillofacial Surgeons offer consultation and many treatment options.

In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (skull x-ray) analysis, 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, an overnight sleep study (polysomnogram) may be recommended to evaluate individuals.

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. 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 1 to 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.