What is Sleep Apnea?

Sleep apnea is a disorder that affects more than 12 million people in the United States.  People with sleep apnea literally stop breathing repeatedly during their sleep often for a minute or longer and as many as hundreds of times during the night.

Sleep apnea can be caused by either complete or partial obstruction of the airway, both of which can wake one up.  Obstructive sleep apnea (OSA) occurs in approximately 2% of women and 4% of men over the age of 35, and with increasing percentages as we get older.

What causes sleep apnea?

The exact cause of OSA still remains unclear.  In most patients, the site of the obstruction is behind the soft palate, extending to the region at the base of the tongue.  During the day, while a person is awake, muscles in the area keep the passage open, but as a person with OSA falls asleep, these muscles relax, causing the airway to relax and become collapsed.

Once the airway closes, breathing stops, and the person awakes causing the airway to open.  These brief arousals from sleep prevent the person from reaching the deep stages of sleep, which the body requires to rest and restore its energy.

How can obstructive sleep apnea be treated?

Several treatment options exist for dealing with OSA.  These include positive pressure therapy, surgical options, and oral appliances.

Positive pressure sends air pressure through a tube into a mask that the person wears.  This uses positive air pressure to keep the airway from collapsing.  The CPAP machine is the most common positive pressure device.

Several surgical procedures may be used for the treatment of OSA  Uvulopalatopharyngeoplasty (UPPP) is the most common surgical procedure for treating OSA.  This involves removing the uvula and some of the surrounding soft palate.  UPPP adequately reduces OSA approximately 50% of the time.

Oral appliances can also be used in the treatment of OSA.  One commonly used device is the Elastic Mandibular Advancement appliance (EMA).  This is custom made from dental impressions.  The appliance fits over the upper and lower teeth and uses bands of varying elasticity which act to pull the lower jaw forward.  This forward position of the lower jaw causes a forward movement of the tongue reopening the airway and allowing air to flow through the back of the throat.

Which treatment is best for me?

The first step is to have an evaluation by a medical doctor certified in sleep medicine.  Your sleep physician can guide you as to which treatment would work best.  If an oral appliance is their recommendation, then they will refer you to our office and we would fabricate your appliance.