Sleep Apnea

Obstructive sleep apnea (OSA) is a serious condition that affects 4-9% of the United States population. People with OSA have disrupted sleep due to blockage of the tongue in the back of the throat that can lead to snoring, gasping, and pauses in breathing. This can cause oxygen levels to drop, which over time, can lead to serious health problems including high blood pressure, stroke, increased risk of car accidents, insulin insensitivity (diabetes), and non-alcoholic fatty liver disease. OSA is also highly associated with obesity, gastroesophageal reflux disease (GERD), impotence or loss of libido, frequent nighttime urination (nocturia) and dementia. 

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea 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.

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 from a medical professional. Dr. Sherpa can recommend several local doctors if a patient is in need of a physician.

There are several treatment options available. In severe cases, an initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. While in most mild to moderate cases, Oral Appliance Therapy (OAT) can be considered and be very effective as it is both comfortable and easy to wear. OAT can also be used in conjunction with CPAP in some severe cases for increased efficacy. Dr. Sherpa is passionate about providing OAT to her patients. To learn more about OAT, visit the Procedures Tab and visit “Sleep Appliances.”

For very severe cases of OSA, typically where OAT and CPAP have been ineffective, surgical options such as uvulo-palato-pharyngo-plasty (UPPP) can be considered, which is performed in the back of the soft palate and throat. A similar procedure is sometimes done with the assistance of a laser and is called a laser assisted uvulo-palato-plasty (LAUPP). In other cases, a radio-frequency probe is utilized to tighten the soft palate. These procedures usually performed under light IV sedation in the office. Upper airway stimulation in the form of an implanted device in the chest is another surgical treatment option for severe cases. 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 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.