Sleep apnea is a disorder in which breathing is interrupted periodically throughout the night. These pauses, or gaps, in breathing may be accompanied by choking or gasping but rarely awaken the sleeping individual. An estimated 18 million Americans suffer from sleep apnea, many of them unaware of their condition.
WhatCauses Sleep Apnea?
There are two main types of sleep apnea: obstructive and central. Obstructive sleep apnea occurs when the throat muscles relax and droop during sleep, blocking the airway and causing breathing difficulty. It is by far the most common form of the disorder. Central sleep apnea is the result of the brain failing to properly control breathing during sleep; this is rare.
Themain sign of sleep apnea is chronic, loud snoring. Symptoms include daytimedrowsiness, lack of concentration, memory loss, irritability and depression.You may experience frequent morning headaches and sore throats and wake up witha dry mouth.
Thosewho are male, overweight and older than the age of 40 are most at risk, thoughsleep apnea can – and does – affect people of both sexes and all ages. Otherfactors that can contribute to sleep apnea include natural aging, excessive orbulky throat tissue, large soft palate or uvula, small jaw, large neck andoversized tonsils or adenoids.
Allergies,sinus infections, tobacco use and alcohol all may play a role as well.
HowIs Sleep Apnea Treated?
Sleepapnea is more than just a nuisance that robs you of sleep. Left untreated, itcan lead to serious health issues such as congestive heart failure, stroke,heart attack, high blood pressure and cardiac arrhythmia. If you suspect youare suffering from sleep apnea, schedule a visit with your physician who willperform a thorough physical examination and may set up a sleep study test.
Youmay be able to reduce the severity of your symptoms by implementing certainlifestyle changes. Try losing weight, cutting back or eliminating alcohol(especially before bedtime) and quitting smoking. Sleeping on your side insteadof your back and elevating your head may also help.
Continuous Positive Airway Pressure (CPAP)
Themost popular type of treatment for obstructive sleep apnea is the CPAP(continuous positive airway pressure) device. This machine utilizes a face ornasal mask connected to a pump, which provides a positive flow of air powerfulenough to keep your airway passage open. The device must be worn every night tobe effective.
Whilesome find it inconvenient and uncomfortable, the results are typicallyinstantaneous and worth the discomfort. Both machines and masks are availablein a variety of styles and sizes, which can be geared toward your individualneeds. Some people benefit from a nasal mask that covers the nose, while othersrequire a full-face mask that covers both the nose and mouth.
Nasalpillows, consisting of soft silicone tubes that are placed directly in thenostrils, are another popular option. An optional humidifier can help preventnasal irritation and drainage by providing a steady flow of heated andmoisturized air.
A number of alternative PAP devices areavailable. Autofiltrating positive airway pressure (APAP) automaticallyincreases or decreases air pressure throughout the night as needed. Bi-levelpositive airway pressure (BiPAP) devices increase the pressure level when thepeople breathes in, and decrease it when they breathe out. These machines oftenhelp individuals who have trouble with the basic CPAP device.
Oral Appliances
While continuous positive airway pressure (CPAP) therapy is thepreferred method of treatment, not everybody is able to tolerate sleeping witha mask attached to a machine that delivers bursts of air to the throat. Oralappliances are an alternative for these patients. They work by either movingthe lower jaw forward to keep the airway passages open or holding the tongue inplace to prevent it from falling backward and blocking the airway.
Oral appliances may be either fixed or adjustable and areavailable in many different styles with as many as 40 different patents inexistence. Some are custom designed to fit the individual’s mouth afterimpressions are made and must be prescribed by a dentist, oral surgeon or ENTphysician with sleep medicine experience. Others are consideredone-size-fits-all.
There are several advantages to using oral appliances over othersleep apnea treatment methods. They are easy to use, inexpensive and effectivefor treating a number of sleep disorders including snoring, upper airwayresistance syndrome and obstructive sleep apnea. They are easy to insert andremove and tend to have higher compliance rates than CPAP. Younger patients whohave to moderate sleep apnea, lower BMI and smaller neck sizes are most likelyto see positive results from oral appliances.
UPPP
Uvulopalatopharyngoplasty(UPPP) is a surgical procedure to remove excess tissue in the throat in orderto widen the airway, making it easier to breathe.
Ifyou suffer from snoring and sleep apnea due to excess tissue in the throat ormouth that causes blockages of the upper airway, are unable (or unwilling) touse continuous positive airway pressure (CPAP) – the preferred method fortreating sleep apnea – or do not respond to CPAP treatment, you may be acandidate for UPPP.
The Procedure
During the procedure, the patient is givengeneral anesthesia. The surgeon will remove the tonsils, excise the uvula andtrim or remove the soft palate. The cuts are sutured together with stitches. Abrief hospital stay may be recommended so the patient can be closely monitoredimmediately after surgery.
Complicationsmay include sore throat, swelling, infection, bleeding, difficulty swallowing,speech problems or changes to the voice, sleepiness or apnea due to medicationsyou’ll be given to promote healing, changes in the way food tastes andnarrowing of the airway related to scar tissue.
Aswith other sleep disorder surgeries, UPPP is not a viable solution foreverybody. It offers mixed results; some people report a drastic reduction inepisodes of snoring and apnea, while others still require additional treatment(e.g. CPAP) afterwards. Your doctor can discuss the risks, and help you todecide whether UPPP is right for you.
Pillar Procedure
The Pillar Procedure is asimple surgery designed to treat snoring and sleep apnea. It involves placingpolyester implants into the soft palate to offer structural support and reducetissue vibrations that cause snoring.
During this minimallyinvasive procedure, which is performed in a surgeon’s office and takes about 20minutes, a topical anesthetic is applied to the soft palate to numb it. Thesurgeon then injects the area with a local anesthetic and inserts three tinyimplants into the junction of the hard and soft palates. As tissue heals, theimplants help support and stiffen the soft palate, reducing relaxation andvibration of the tissues and preventing obstruction of the upper airway.
The Pillar Procedure is safeand effective, with few complications or side effects. Afterward, you may bedescribed anti-inflammatory pain medication and antibiotics to preventinfection, but you should be able to resume normal activities the same day. Youmay experience a sore throat, swelling, difficulty swallowing, but thesesymptoms are temporary and should disappear within a few weeks.
The Pillar Procedure isn’tfor everybody. Results vary depending on the severity of your sleep apnea.Speak with your doctor to see if you are a good candidate for this type of surgery.
condition.
What Causes Sleep Apnea?
There are two main types of sleep apnea: obstructive and central. Obstructive sleep apnea occurs when the throat muscles relax and droop during sleep, blocking the airway and causing breathing difficulty. It is by far the most common form of the disorder. Central sleep apnea is the result of the brain failing to properly control breathing during sleep; this is rare.
The main sign of sleep apnea is chronic, loud snoring. Symptoms include daytime drowsiness, lack of concentration, memory loss, irritability and depression. You may experience frequent morning headaches and sore throats and wake up with a dry mouth.
Those who are male, overweight and older than the age of 40 are most at risk, though sleep apnea can – and does – affect people of both sexes and all ages. Other factors that can contribute to sleep apnea include natural aging, excessive or bulky throat tissue, large soft palate or uvula, small jaw, large neck and oversized tonsils or adenoids.
Allergies, sinus infections, tobacco use and alcohol all may play a role as well.
How Is Sleep Apnea Treated?
Sleep apnea is more than just a nuisance that robs you of sleep. Left untreated, it can lead to serious health issues such as congestive heart failure, stroke, heart attack, high blood pressure and cardiac arrhythmia. If you suspect you are suffering from sleep apnea, schedule a visit with your physician who will perform a thorough physical examination and may set up a sleep study test.
You may be able to reduce the severity of your symptoms by implementing certain lifestyle changes. Try losing weight, cutting back or eliminating alcohol (especially before bedtime) and quitting smoking. Sleeping on your side instead of your back and elevating your head may also help.
The preferred method of treatment for sleep apnea is continuous positive airway pressure (CPAP). This involves controlled bursts of air pumped into your throat while you sleep, delivered through a mask that is worn over the nose and mouth and attached to a machine. Other options for treatment include oral mouth guards that reposition the lower jaw and tongue, nasal breathing strips and surgery.
Call ENT Specialists Of Northern Virginia at (703) 644-7800 for more information or to schedule an appointment.
