What is Obstructive Sleep Apnea?
Obstructive sleep apnea is a condition where airflow through the upper airway stops periodically while sleeping. When this happens more than 5 times per hour it is classified as Obstructive Sleep Apnea, causing serious medical problems and daytime fatigue.
What causes Obstructive Sleep Apnea?
Sleep apnea is caused by many factors and a thorough evaluation by an Ear, Nose, and Throat and Sleep Medicine Specialist is critical to identify the causes specific to each patient. Typical causes include nasal and sinus conditions such as septal deviation and chronic sinusitis, long uvula and soft palate, enlarged tonsils, large tongue base, small jaw, thick neck, and obesity.
Dangers of Untreated Obstructive Sleep Apnea
- Heart attack
- Congestive heart failure
Symptoms of Obstructive Sleep Apnea
If you or your bed partner suspect you have sleep apnea because of snoring, witnessed gasps or pauses, and daytime sleepiness, chances are you do have obstructive sleep apnea. Testing is now very easy as we can perform Home Sleep Testing in one night to diagnose this condition.
Snoring Vs. Sleep Apnea
Dr. Daniel Slaughter talks about the different between snoring and sleep apnea and how we diagnose it and how we treat it.
Obstructive Sleep Apnea Treatment
There are nonsurgical treatments such as CPAP (pressure mask) and oral appliances. There are also surgical options including simple office based procedures to open the nasal and sinus airway such as balloon sinuplasty, endoscopic septoplasty, and turbinate reduction. In addition the long floppy uvula and soft palate can be elevated and stiffened with a simple office procedure the Dr. Slaughter has pioneered. In this procedure the uvula is trimmed and a stiffening injection using alcohol is placed above the uvula to cause elevation and stiffening while it heals.
CPAP and BiPAP
CPAP and BiPAP are good non-surgical options for patients with snoring and apnea in the right candidate. This equipment can be now be set to auto-titrate which means that the appropriate pressure setting to relieve your snoring and apnea can be determined in the comfort of your own bed. Unfortunately there are many patients who cannot tolerate CPAP therapy. We do not offer a one size fits all approach and will not force you into CPAP. There are many other options. Many times patients will fail CPAP because they have nasal and sinus issues. It is impossible to force pressure through a closed hole. Correction of the nasal and sinus issues with a balloon sinuplasty procedure may make CPAP therapy tolerable and much more effective at a much lower pressure setting.
If you have Obstructive Sleep Apnea and unable to tolerate CPAP therapy, your nose may be blocked. Dr. Slaughter discusses alternatives to CPAP therapy.
Oral Appliance Therapy
Oral Appliance Therapy (OA) can be quite effective for both snoring and apnea. The basic principle is that relaxation of the jaw in sleep allows the tongue to fall back and crowd the airway. We work closely with specialized sleep dentists and orthodontists. They make custom fitted oral appliances for our patients that would benefit. Typically these are patients tha have a large tongue. In many cases we will be performing a balloon sinuplasty procedure along with a UPPP to correct the nasal and soft palate issues. An oral appliance is then used to further assist by addressing the large tongue. The oral appliance helps hold the jaw and therefore the attached tongue forward a few millimeters to further open the airway.
Minimally Invasive treatments for Sleep apnea
- Sinus and Nasal Procedures
- Balloon Sinuplasty
- Soft Palate Tightening
Dr. Slaughter offers many of the most advanced sinus and nasal procedures available as part of our Sinus and Nasal Center. These procedures can dramatically reduce snoring and apnea.
Snoring usually comes from issues in the nose and the throat. Any form of nasal congestion increases snoring and obstructive sleep apnea. Think about a garden hose. If you place your thumb over the exit of the hose the water comes out faster and more turbulent. Anatomical obstruction in the nose will similarly cause the airflow to speed up and become more turbulent as it passes through the nose while the patient sleeps. This rapid turbulent air will reach the back of the nose and throat causing vibration and noise as it passes through on the way to the lungs.
A deviated septum, swollen turbinates, chronic sinus infection, nasal polyps, and nasal allergies are all common reasons for the nose to be congested. We offer many options for the correction of snoring and obstructive sleep apnea.
All of these procedures are performed in our state of the art office procedure room with the comfort and safety of IV sedation by a board certified anesthesiologist. The procedures are typically done in combination with each other where necessary and take about 15 minutes. There is rapid recovery with most patients working the next day.
The treatment options offered for Snoring and obstructive sleep apnea include:
Balloon Sinuplasty offers gentle non-surgical opening of the sinus outflow tracts. This resolves chronic sinus congestion and recurring sinus infections with a great improvement in nasal breathing, reduction in snoring as well as obstructive sleep apnea.
Endoscopic septoplasty allows Dr. Slaughter to correct the patient’s deviated septum with the most modern technique without the need for any packing or splinting. This will greatly reduce snoring and obstructive sleep apnea.
Submucosal turbinate reduction
Submucosal turbinate reduction can reduce the congestion in the patient’s nose with a gentle non-surgical technique similar to liposuction with big improvements in snoring and obstructive sleep apnea.
Endoscopic polyp removal
Endoscopic polyp removal can also vastly improve the patient’s nasal breathing and reduce snoring and obstructive sleep apnea.
Soft Palate Tightening (UPPP)
Soft palate tightening procedures (UPPP) are also a very important part of snoring and sleep apnea treatment. The soft palate and uvula are where most of the noise and collapse originates. As the rapid and turbulent air from the nose passes the soft palate it actually stretches the soft palate and uvula over time. Obstructive Sleep apnea patients can actually wake up with a swollen uvula in the morning from this suction. In this procedure the uvula is trimmed and a stiffening injection using alcohol is placed above the uvula to cause elevation and stiffening while it heals. There is significant improvement for up to 9 weeks. This is usually performed under IV sedation in the office and usually in conjunction with a balloon sinuplasty procedure. No foreign body or implant is required and the results are very long lasting. Snoring and sleep apnea are greatly reduced with this technique especially when combined with nasal procedures.
Surgical treatments for sleep apnea
Surgical treatments under general anesthesia still play a role in treatment of apnea.
- Inspire Upper Airway Stimulator Therapy
- Maxillary Mandibular Advancement Surgeries
Tonsillectomy can be very successful in the right candidate especially when combined with uvulopalatopharyngoplasty (surgical stiffening of the soft palate and pharyngeal folds). We perform this latest outpatient procedure with the latest techniques to reduce the pain and downtime.
Inspire Upper Airway Stimulator Therapy
Inspire Upper Airway Stimulator Therapy is also available as a novel approach to treat severe apnea. This surgical therapy involves placing an implantable sleep apnea pacemaker to stiffen the airway during sleep.
Maxillary Mandibular Advancement Surgeries
Maxillary Mandibular Advancement Surgeries can also be performed in conjunction with Board Certified Oral Maxillofacial Surgeons to expand the back of the airway in certain cases.