The Dangers of Sleep Apnea & Oral Surgery as a Solution
Though many people have heard of sleep apnea, many are unlikely to understand fully the trials and dangers posed by this disorder until they, or someone close to them, feels the effects of the condition. When left untreated, sleep apnea can be a life-altering and life-threatening disorder, increasing a person’s vulnerability to heart disease, diabetes, and stroke. The chronic fatigue endured by sleep apnea sufferers also poses serious risks.
Those diagnosed with sleep apnea may struggle in their professional or social lives, which, when combined with the lack of sleep, can significantly increase the risk of depression. The excessive tiredness brought about by sleep apnea can also lead to dangers on the road, with sleep apnea sufferers more likely to fall asleep at the wheel. According to the American Academy of Sleep Medicine, “obstructive sleep apnea is associated with a significantly increased risk of motor vehicle accidents” by a factor of 2.5 to 1.
Sleep Apnea Explained
The word “apnea” means a “temporary cessation of breathing.” The breathing of those who suffer from sleep apnea is temporarily brought to a complete halt throughout the night, sometimes hundreds of times, for durations lasting up to sixty seconds and above. Despite this serious assault to respiratory functioning, those suffering from sleep apnea usually remain unaware of these interruptions to their breathing. Nonetheless, in their waking lives, they’ll endure the nagging fatigue and focal impairments brought on by persistent sleep deprivation. For those sharing a bedroom or close living quarters, the persistent snoring and sudden gasps for breath in sleep apnea sufferers is readily apparent, and often problematic.
There are three different types of sleep apnea: obstructive, central, and mixed, with obstructive being the most common. The three variations of this disorder, though variant in their root causes result in the same symptom: a regular cessation of breathing during sleep. In obstructive sleep apnea (OSA), the soft tissue in the throat collapses during sleep and obstructs the respiratory pathway. In central sleep apnea, though the respiratory pathway remains clear, a neuro-muscular communication necessary for breathing is disrupted during sleep. Mixed sleep apnea refers to the combination of both the soft tissue obstruction and the neuro-muscular failure.
Causes and Risk Factors
According to the National Sleep Foundation, 18 million Americans have sleep apnea, with obstructive sleep apnea being vastly more common than both central and mixed sleep apnea. Obesity is the most common cause of sleep apnea, as there is a direct correlation between an excess in body weight and the amassment of soft tissue in the mouth and throat that slackens during sleep to block airflow. Less common causes include tumors or other abnormal growths inside the throat or airway that can inhibit normal breathing. Certain birth defects, such as Down syndrome and Pierre-Robin syndrome, may also result in sleep apnea due to weaker muscle tonnage in the upper airway and physiological abnormalities in the mouth and throat.
Men are at a greater risk of suffering from sleep apnea than are women, and African-Americans, Pacific-Islanders, and Hispanics bear greater risks than do other ethnicities. Certain physiological features are also risk factors, such as having a large overbite, a recessed chin, a small jaw, or a large neck. Behavioral risk factors include smoking and alcohol use. Estimates hold that a minimum of 2-3% of children suffers from sleep apnea, with that figure climbing to 10-20% among children who regularly snore. Those at the greatest risk, in terms of age, are persons over 40.
The many symptoms of sleep apnea—persistent fatigue, waking up gasping for air, loud snoring, morning headaches, and dry mouth—can come and go, making the disorder difficult to diagnose. Many individuals will go months or years at a time before reporting their symptoms to a physician. Because the symptoms of sleep apnea vary and may be attributable to other conditions, a sleep laboratory study or home sleep study is required to properly diagnosis the presence and severity of sleep apnea.
Continuous Positive airway pressure therapy, usually administered through the use of a nighttime mask, is the most commonly used treatment method for sleep apnea. In many cases, however, obtaining the needed level of compliance from the patient for this type of treatment proves exceedingly difficult. Studies show patients use the PAP mask just 50% of the time – and otherwise elect to suffer through their sleep apnea, while continuing to develop significant health liabilities.
Obstructions in the upper respiratory tract, nose, tongue, and throat may all contribute to sleep apnea. Therefore, there are several different surgical approaches that could help to curtail or eliminate a sleep apnea condition. It is important to remember to find a highly certified and trustworthy oral surgeon to complete these procedures. Here are a few:
For the past 25 years, the UPPP surgical procedure—short for Uvulopalatopharyngoplasty—has been the most commonly used surgery for diminishing or curing sleep apnea. The procedure focuses on the removal and constraint of tissue in the soft palate and pharynx. Once the problematic tissue is removed, sutures are used to ensure the upper airway remains open to normal airflow.
The septum, the turbinates, and the nasal valve—all parts of the nose—may be a part of the cause of a person’s obstructive sleep apnea. The surgical reformation of these physiological features through septoplasty and turbinate reduction can be accomplished as an outpatient procedure and is generally quite easy on the patient.
Soft Palate Implants
Also known as “the pillar procedure,” this minimally invasive process implants three polyester rods in the patient’s soft palate. Once embedded, the tissue surrounding the rods becomes inflamed, resulting in a slight stiffening of the soft palate. The stiffening of this tissue prevents it from collapsing and obstructing the patient’s airways. It also prevents the soft palate from making contact with the pharynx during sleep, thus reducing both snoring and apnea.
Finding the Right Solution
There is a multitude of other surgical and non-surgical treatment options available to those who suffer from the danger and discomfort of sleep apnea. Finding the right solution for a given patient requires a logical consideration of the potential solutions, their probability of success, and their overall impact on the patient’s quality of life.
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