February 12, 2014

Prosthodontic Treatment of Sleep Apnea

Sleep apnea symptoms

Diagnosis for sleep apnea can be made on the basis of signs and symptoms or an evaluation may be made by a sleep specialist.  A "sleep study" (nocturnal polysomnography) at a sleep disorder center involves monitoring of your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.  Sometimes simplified tests may be used at home with portable devices to measure heart rate, blood oxygen level, airflow and breathing patterns, to show drops in oxygen level during apneas and subsequent rises with awakenings.  

Mild cases of obstructive sleep apnea are typically addressed with lifestyle changes:  weight loss to relieve throat constriction, avoiding alcohol or CNS depressants, quitting smoking, sleeping on your side or stomach rather than your back, or using a saline nasal spray to help keep nasal passages open.  If obstructive sleep apnea does not respond to lifestyle changes, or is moderate to severe, additional therapies or surgery are employed. 

Sleep apnea treatment

Therapies include:  CPAC--continuous positive airway pressure--a machine that delivers air pressure through a mask placed over your nose while you sleep.  The pressure is greater than that of the surrounding air and is just enough to keep upper airway passages open and prevent apnea and snoring.  It is the preferred method of treating apnea and a comfortable and secure fit may require some adjustment.  BPAP--bilevel positive airway pressure--devices adjust pressures for both inhaling and exhaling.  Oral appliances--these devices are designed to keep the throat open by bringing the lower jaw forward.  We provide these types of appliances in our prosthodontic practice.  

Surgery:  UPPP--uvulopalatopharyngoplasty--removal of tonsils, adenoids and the part of the soft palate that hangs down.  This type of surgery helps to stop throat structures from vibrating and causing snoring.  Maxillomandibular advancement--a procedure to move the jaw forward from the facial bones to enlarge the space behind the tongue and soft palate.  This may require further oral surgery and orthodontic treatment.  Surgical procedures to treat snoring--laser removal of the uvula, for example, aren't usually recommended as sole treatments for obstructive sleep apnea.  

Source:  Mayo Clinic 

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

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