A good night’s sleep is invaluable. Adequate sleep helps us stay focused and productive, keeps our brain elastic and improves our mood. It even reduces the risk of certain diseases. For patients with obstructive sleep apnea (OSA), their own bodies steal away the sleep they need night after night. OSA has different causes, and oral surgery is a potential treatment option for certain candidates.
What Is Obstructive Sleep Apnea?
Sleep apnea is a serious sleep disorder that causes your breathing to stop and start while you sleep. There are two main types. With central sleep apnea, the brain fails to send proper signals telling your body to breathe. With obstructive sleep apnea, a structure in the upper respiratory system is slumping when your muscles relax and blocking air flow. OSA is the most common form of sleep apnea
Picture the respiratory system like a straw that you’re inhaling and exhaling through. In a healthy respiratory system, air can flow easily in and out of the straw. For people with OSA, it’s as if they have a rubber flap partially or completely blocking the tube. You have to inhale and exhale harder to force air through. When you exhale hard enough, the flap can vibrate and make noise. This is why people with OSA tend to snore.
In adults, OSA can cause:
• Nighttime restlessness
• Snoring that tends to be severe
• Teeth grinding
• Night sweats
• Headaches
• Low blood oxygen during sleep
• Cardiovascular stress
• Daytime drowsiness and fatigue
• Trouble concentrating and decreased productivity
• Depression, forgetfulness and irritability
In children, OSA can also cause:
• Bedwetting
• Learning and behavior disorders, both short and long term
• Difficulties at school
• Trouble socializing
When Oral Surgery Is Appropriate
OSA needs to be diagnosed by a sleep specialist following a sleep study. After diagnosis, most patients are given a device called a PAP (positive air pressure) machine to help them breathe at night. PAP machines use air pressure to keep the airway open and have high treatment success rate. PAP does require wearing a face mask at night, and not all patients adjust to it. For patients that find themselves not using their machine, surgery could be an alternative treatment.
To determine if you’re a good candidate for oral surgery, your doctors need to determine the extent, type and location of your blockage. They’ll take a detailed medical history and assess your maxillofacial region. They may review or take new x-rays and could perform a naso-pharyngeal endoscopy with a flexible camera.
Different types of doctors may handle different types of blockages. For the soft palate, hard palate, jaw and some structures in the back of the throat, an oral surgeon steps in.
Maxillomandibular Advancement (MMA)
MMA addresses the bone structure of the upper jaw, lower jaw and chin. Rather than trimming back tissue to open the airway, MMA widens the airway by shifting bone forward. The jaw is advanced by 10 to 12 milometers and stabilized with titanium plates and screws. It’s typically limited to patients with small, narrow jaws or a recessed lower jaw and chin. MMA is rarely recommended, but it sees a roughly 90 percent success rate when it is.
At Gateway, MMA is performed under general anesthesia at the hospital. A brief hospital stay is necessary. In order to ensure the teeth match up correctly, the jaw must be held shut while the bones heal. Patients start on a liquid diet and progress gradually back to a solid diet. MMA procedures also alter the patient’s appearance. The chin is moved forward and becomes more prominent.
These are only a few of the surgical procedures for OSA. If you have OSA and want to know if maxillofacial surgery is an option for you, schedule a consultation with Gateway Oral Surgery today.