Sleep Apnea

Unless your bed partner complains, most of us are not concerned about snoring.  Loud snoring alongside daytime sleepiness may be an indication of sleep apnea.  Sleep apnea is fairly common and can be potentially serious because breathing repeatedly stops and starts as during sleep.  Although sleep apnea is treatable, it often goes unrecognized.  

In untreated sleep apnea, breathing is continuously interrupted for brief periods during sleep.  These breathing pauses typically last between 10 to 20 seconds and can occur up to hundreds of times a night.  As a consequence, you spend more time in light sleep and less time in the deep, restorative sleep. 

This chronic sleep deprivation results in daytime sleepiness, poor concentration, slow reflexes, and an increased risk of accidents.  Sleep apnea is associated with serious health problems over time, including high blood pressure, heart disease, stroke, diabetes and weight gain. With treatment, symptoms can significantly improve, resulting in more energy.

Signs and symptoms of sleep apnea
  • Pauses occur while you snore, followed by gasping or choking
  • Fighting sleepiness during the day, at work, or while driving
  • You may find yourself rapidly falling asleep during the quiet moments of the day
  • Feeling irritable, depressed, or having mood swings or personality changes
  • Memory or learning problems and not being able to concentrate
  • Morning headaches
  • Dry mouth or sore throat when you wake up
  • Waking up frequently to urinate
  • Overweight
  • Male
  • Over the age of 65
  • Small lower jaw
  • Nasal obstruction

A sleep physician diagnosis sleep apnea using a polysomnogram (a.k.a. a sleep study).   This diagnosis is usually required before any treatment can be provided.

Continuous Positive Airflow Pressure (CPAP) is the most common treatment for moderate to severe obstructive sleep apnea.  Many patients experience instant symptom relief, an increase in concentration and additional physical energy.  A CPAP machine prevents sleep apnea by blowing air into a mask that covers the nose and mouth. The stream of air keeps the airways open.

However, being able to breathe through your nose is required for CPAP to work. 

Surgery as treatment for sleep apnea

If you have been diagnosed by a sleep physician and have exhausted other apnea treatment options, you may want to discuss surgical options with Dr. Medel.  Surgery can increase the size of your airway, thus reducing your episodes of sleep apnea.

When using CPAP, the airway is stented open by a constant flow of air through the nose.  If a patient cannot breathe adequately through their nose, then CPAP does not work well.  If this is a concern, please discuss nasal surgery with Dr. Medel.

Orthognathic surgery can increase the size of your airway thus reducing episodes of sleep apnea.  Other than a tracheostomy (a surgical breathing hole made in your trachea below your voice box), orthognathic surgery is often the best surgical management for sleep apnea.  A patient’s overall health influences whether orthognathic surgery is a safe and valid treatment option.  If you think orthognathic surgery is right for you, please discuss it with Dr. Medel.  Also, please see the section on Jaw Surgery.