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Sleep apnea means "cessation of breath." It is characterized by repetitive episodes of upper airway obstruction that occur during sleep, usually associated with a reduction in blood oxygen saturation. In other words, the airway becomes obstructed at several possible sites. The upper airway can be obstructed by excess tissue in the airway, large tonsils, and/or a large tongue, and usually includes the airway muscles relaxing and collapsing when asleep. Another site of obstruction can be the nasal passages. Sometimes the structure of the jaw and airway can be a factor in sleep apnea.
Repeated cycles of decreased oxygenation may 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. These patients are diagnosed with Upper Airway Resistance Syndrome (UARS). In either case, the individuals suffer many of the same symptoms.
The first step of treatment is to recognize symptoms and seek appropriate consultation. Otolaryngologists (Ear, Nose & Throat doctors) offer consultation and treatment options.
In addition to obtaining a detailed history, Dr. Feinfield will assess the anatomic relationships in the maxillofacial region. With an endoscopic evaluation of the upper airway, Dr. Feinfield can ascertain the level of obstruction. A polysomnogram (sleep study) is needed prior to any treatment. The sleep study confirms the diagnosis and dictates the type of treatment needed.
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 an 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 and base of tongue.
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 1 to 2 day inpatient hospitalization.
Obstructive Sleep Apnea (OSA) is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.
THOUSAND OAKS
SIMI VALLEY
415 East Rolling Oaks Drive, Suite 190
Thousand Oaks, CA 91361
Tel: 805.494.4797 Fax: 805.494.4810
1687 Erringer Road, Suite 103
Simi Valley, CA 93065
Tel: 805.494.4797 Fax: 805.494.4810