What is OSA?
Obstructive Sleep Apnea (OSA) affects millions of people in the US.
In OSA your airway collapses and gets blocked while you are asleep. This disrupts your natural sleep cycle and can cause low blood oxygen. You may wake up feeling unrested, then stay sleepy all day long. A bed partner may notice loud snoring, pauses in breathing, snorting and/or gasping.
Untreated severe OSA is a big problem, not only for quality of life, but also for health. When your sleep is constantly interrupted, it can be hard to concentrate making it tough to be your best at work and home. OSA has been linked to heart disease including coronary artery disease, heart failure, and abnormal rhythms; diabetes; depression; and high blood pressure. Untreated severe OSA puts you at a higher risk of potential heart attacks, strokes, and death.
Some patients have a less severe form of airway obstruction called Upper Airway Resistance Syndrome (UARS); similar symptoms can be reported.
How is OSA Diagnosed?
Sleep apnea is diagnosed through a sleep study, either in a lab or at home.
What if usual treatments don't work?
First line treatment for OSA is use of positive airway pressure (PAP), which holds the airway open with air pressure causing it to stay open at night. Some people, though, cannot use PAP for a variety of reasons. Your sleep medicine doctor can assist you in trying different masks and air delivery methods. Oral appliances can be very helpful, as well, but can result in permanent changes in your bite.
There are many surgical options for OSA when the usual treatments do not work. When considering surgery, you may require an endoscopy, a procedure in which a small camera is passed through your airway to see where and how your airway collapsed. This information can help your surgical team select the best surgical option for your specific situation.
Our experienced team at WisNova will evaluate traits of your face, bite and airway at your visit both clinically and with sophisticated 3-D imaging. We will draw on our rich network when needed to get you to the right surgeon if you need a procedure we do not routinely provide. Our surgeons are experts in skeletal (bone) surgery for OSA. There are several procedures that may be recommended for you, most common procedures are briefly discussed below.
DOME (Distraction Osteogenesis Maxillary Expansion) is a slightly modified version of a procedure that has been used to correct abnormal bites for decades. This surgery widens a narrow upper jaw, which also widens the inside of the nose, improving nasal airflow and breathing. Orthodontics or braces are required to help your teeth meet together after this procedure.
MMA (Maxillomandibular Advancement) brings both jaws forward, giving you the option to either keep your normal bite, or improve upon and fix your abnormal bite. This improves the airway at multiple levels, which conventionally requires multiple soft tissue procedures. While having braces is ideal for this surgery, if you do not wish to or need to change your bite, it can also be accomplished with “surgical braces” that are placed during surgery and removed in the office after healing is complete.
Genioglossal advancement can be done alone or with other procedures. In this procedure the part of the lower jaw that supports your tongue is brought forward.