Snoring & Sleep Apnea

In the Fort Worth, Arlington and Weatherford areas snoring and sleep apnea are treated by Drs. Stella, Warner and Zide, specialists in the diagnosis and treatment of Obstructive Sleep Apnea and Upper Airway Resistance Syndrome. Many people who snore also have a dangerous condition known as sleep apnea.

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When sleep apnea occurs, the tongue is sucked against the back of the throat which blocks the airway and the airflow stops. After the oxygen level in the brain becomes low enough, this deprivation of oxygen awakens the sleeper and the tongue moves temporarily from blocking the airway; the sleeper gasps for air and goes back to sleep. Repeated cycles of decreased oxygen lead to very serious cardiovascular problems including heart attack. A secondary problem caused by sleep apnea is daytime sleepiness, depression and loss of concentration. Some patients have obstructions that are less severe called Upper Airway Resistance Syndrome (UARS). Individuals with this condition will suffer the same symptoms as sleep apnea.

Snoring is a signal of sleep apnea that should be taken very seriously. Sleep partners of snorers should help their loved one make an appointment for a medical assessment by calling Facial & Oral Surgery Associates. The first step in treatment is proper diagnosis. Drs. Stella, Warner and Zide, with specialized diagnostics for sleep apnea in each of their Fort Worth, Arlington and Weatherford offices, offer consultation and treatment options for sleep apnea. After a detailed history, you will have a cephalometic (skull x-ray) to determine the degree of obstruction. In some cases the surgeon may use a fiber-optic camera to examine the back of the throat. A sleep study may be recommended to monitor your heart and breathing overnight and to confirm the amount of cardiovascular compromise and decrease in oxygenation level.

There are several treatment options available: Use of a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction worn during sleep; the surgical option called uvulo-palato-pharyngo-plasty (UPP), performed to firm the back of the soft palate and throat; a laser option a called Laser Assisted uvulo-palato-plasty (LAUP) also firms the skin of the soft palate and the back of the throat. In other sleep apnea cases, a radio-frequency probe may be used to tighten the soft palate. At Facial Oral Surgery Associates these procedures are performed in the office’s surgical suite under light intravenous sedation.

About Sleep Apnea

Sleep apnea may be life-threatening. It is characterized by the absence of spontaneous breathing during sleep and choking sounds may be noted. This places the patient at increased risk for heart failure or stroke. Symptoms include loud snoring and excessive daytime sleepiness.

Commonly treated problems:

• Snoring
• Obstructive Sleep Apnea Syndrome (OSAS)

Treatment:

Snoring caused by nasal swelling due to environmental allergies may be successfully managed by medications.

Snoring caused by nasal obstructions due to abnormal anatomy are best treated surgically. An example is straightening a deviated nasal septum. Some patients snore due to an excessively long palate. Procedures known as a radiofrequency-assisted-uvuloplatoplasty (RAUP) shortens the plate, eliminating much of the nightly disturbance.

Individuals with OSAS can have increased heart risks such as hypertension, coronary heart disease and stroke. Treatment is oriented to identifying and correcting the area of obstruction within the nose or tongue base. Surgical options are available for patients who cannot tolerate continuous positive airway pressure (CPAP) or approved oral therapies. Radiofrequency tissue volume reaction reduction (RTVR) can be performed to reduce excessive tongue, palatal or nasal tissue obstructing the airway. Correction of moderate to severe OSAS may require moving the upper and lower jaw forward (maxillomandibular advancement) and moving the tongue attachment forward (genioglossus advancement osteotomy).

Outcome:

Resolution of snoring and/or sleep apnea:

• Provides a quiet home where everyone can sleep soundly
• Curtails daytime sleepiness due to OSAS
• Improves health by reducing cardiac risks