Sleep Apnea Surgery

Obstructive sleep apnea syndrome (OSAS) is a condition in a spectrum called Sleep Disordered Breathing. At one end of this spectrum are less severe conditions such as Simple Snoring and Upper Airway Resistance Syndrome. At the opposite end is obstructive sleep apnea that may be co-exist with other altered sleep behaviours. Ultimately, individuals with sleep apnea have disrupted sleep and low blood oxygen levels that may contribute to a number of health problems. Many of the signs and symptoms of these conditions are similar and a formal sleep study or polysomnography (PSG) is often required. Our office will help coordinate this for you if required.

During obstructive episodes, the airway may be blocked by normal anatomy such as the tongue resulting in diminished or a complete lack of airflow in the upper airway. This lowers the oxygen level in the blood delivered to the brain triggering an arousal from the normal sleep cycle. While this clears the obstruction in the throat (often with a loud gasp), it partially awakens the individual decreasing the total amount of restorative sleep that is important for optimal health. Repeated cycles of decreased oxygenation and stimulation to partially awaken may lead to very serious cardiovascular problems. Additionally, these individuals suffer from excessive daytime sleepiness, depression, and loss of concentration that may affect one’s safety and productivity.

The first step in treatment resides in recognition of the symptoms and seeking appropriate consultation. Oral and maxillofacial surgeons offer consultation and treatment options.

In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometric (skull x-ray) analysis, the doctors can ascertain the level of obstruction. 3-dimensional imaging of the airway with our cone beam CT provides valuable information both before and after treatment for sleep apnea. Sometimes a nasopharyngeal exam is done with a flexible, fiberoptic camera. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight. 

There are several treatments 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. 

In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway and help prevent its collapse. Orthognathic surgery is one of the most successful surgical interventions for obstructive sleep apnea. This procedure is done in the hospital under general anaesthesia and requires a 1 to 2 day overnight stay in the hospital. Sometimes, an orthodontist will become involved in your presurgical and postsurgical tooth alignment. 

Obstructive sleep apnea is a serious condition that requires careful attention and treatment.