procedures
When obstructive sleep apnea (OSA) occurs, the tongue is sucked against the back of the throat. This blocks the upper airway and airflow stops. When the oxygen level in the brain becomes low enough, the sleeper partially awakens, the obstruction in the throat clears, and the flow of air starts again, usually with a loud gasp or snore. Not all patients who snore will have OSA and as well, not all patients with OSA will snore. Assessment by a sleep center is essential in the proper management of the problem.
Repeated cycles of decreased oxygenation lead to very serious cardiovascular problems. Additionally, these individuals suffer from excessive daytime sleepiness, depression, and loss of concentration.
Some patients have obstructions that are less severe called Upper Airway Resistance Syndrome (UARS). In either case, the individuals suffer many of the same symptoms.
The first step in treatment resides in recognition of the symptoms and seeking appropriate consultation. Oral and maxillofacial surgeons offer consultation and treatment options.
If you answer Yes to 3 or more of these questions, there is a high likelihood of OSA:
- Do you snore loudly enough to be heard through a closed door?
- Do you feel tired during the daytime, feel unrefreshed following sleep, or ‘doze off’?
- Has your bed partner witnessed episodes of long periods of not breathing/
- Are you being treated for high blood pressure/
- Is your Body Mass Index (weight in kilograms divided by height in meters squared, BMI) greater than 35?
- Are you male and over 50 years old?
- Is your neck size greater than 17″ or 40cm?
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. In most cases, an overnight sleep study will be ordered.
There are several treatment options 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. Oral appliances that allow the lower jaw to be advanced during sleep have been developed and are often indicated in mild and moderate OSA. The “Klearway appliance” was developed by Dr. Alan Lowe of the Department of Orthodontics at the University of British Columbia and is often suggested as an option byour surgical team.
In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (orthognathic surgery). This procedure is done in the hospital under general anesthesia and requires a one to a two-day overnight stay in the hospital.
OSA is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.
Procedure FAQ
Questions About Sleep Apnea
When should I ask about sleep apnea in Waterloo?
Patients should ask about sleep apnea when a dentist has recommended specialist oral surgery care, symptoms are affecting comfort or function, or imaging suggests that airway, jaw position, or sleep-related breathing concerns may need coordinated care. The Waterloo office can review referrals, records, and next steps during consultation.
What happens during a consultation for sleep apnea?
A consultation usually includes a review of medical history, dental concerns, referral information, and any needed imaging. The surgical team explains whether sleep apnea is appropriate, what alternatives may exist, and how treatment is planned.
How should I prepare for sleep apnea?
Patients should bring sleep study information, physician recommendations, CPAP history, and any dental appliance details. Patients should bring medication details, referral information, insurance questions, and any X-rays or imaging requested by the office.