Sleep Dentistry in Seattle, WA
An individual with Obstructive Sleep Apnea (OSA) have disrupted and fragmented sleep with a disturbance of the stable sleep cycle. Certain individuals may include a reduction of the blood oxygen levels that can affect the heart and brain functions., among other systems of the body functions. When obstruction occurs many time the tongue, soft palate or muscles of the throat are sucked against the back of the throat from inhalation of the air. This action blocks the upper airway and airflow either slows down, restricted or stops.
If the Oxygen level in the brain and heart becomes low enough the individual moves to attempt to inhale more air utilizing muscles of the shoulder, throat, face ( bruxism or clenching), legs and upper body that awakens the person to clear the throat of the obstruction thus allowing flow of air to continue, usually with a gasp, but leads to disruption of the deep sleep (reparative and restful sleep).
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 below threshold of what is medically diagnosed as OSA. This is call Upper Airway Resistance Syndrome (UARS). In either case, the person suffer similar symptoms but the treatment can be simpler. All treatment is geared towards reducing the risk of leading into a medical diagnosis of OSA.
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Sleep Apnea Treatment
The first step in treatment for Sleep Apnea resides in recognition of the symptoms and seeking appropriate consultation. A Sleep Test is needed to get data while a Sleep Doctor will read and diagnose the condition. The Sleep Physician and an experienced Dental Sleep Doctor can offer consultation and treatment options.
In addition to a diagnosis, a detailed history of the patient along with craniofacial anatomic assessment will be conducted using a 3D CBCT analysis to ascertain the level of obstruction. Sometimes a naso-pharyngeal exam by a medical doctor is done using a flexible fiber-optic camera. The severity of the condition, symptoms and medical history dictate the multimodal therapy given to the patient.
Treatment Options for Sleep Apnea
There are several treatment options available. The golden standard used in medicine is a CPAP machine which delivers pressurized oxygen through a nasal mask to introduce the needed oxygen amount of the patient. One of the surgical options is uvulo-palato-pharyngeal-plasty (UPPP), which is a surgical reduction of the oral soft tissues performed in the throat and soft palate. This will be performed by a licensed and experienced medical doctor.
A similar procedure is done using laser; it is a non-invasive treatment using CO2 laser to reduce snoring by tightening the soft tissue of the mouth and throat by stimulating collagen production leading to a reduction and/or elimination of the vibration and obstruction of the airflow by reshaping and tightening the soft palate, uvula, throat and tongue muscles. This action creates a more open airway reducing the resistance of inhaled airflow from the nose preventing disruption of sleep and reduction of oxygen inhalation.
In more complex cases, an implanted medical device, called Inspire Therapy, is placed to the individual to stimulate the hypoglossal nerve which controls the tongue to prevent it from relaxing and blocking the airway during sleep. This surgery is performed by a licensed and experienced medical doctor.
If the craniofacial bone is severely underdeveloped thus blocking the soft tissue of the oropharynx then a surgical intervention of the craniofacial bones is performed by repositioning and widening these bones to increase the size of the airway (orthognathic surgery). This procedure is completed in a hospital under general anesthesia.
Modern, research-based, proven and less invasive therapy are now available under the care of the Sleep Dentist using FDA approved biomimetic oral appliance, customized Mandibular Advancement Oral Appliance, Myofunctional therapy, Tethered oral tissue releases (like tongue and lip tie laser-assisted releases), Breathing exercises, ENT performed Laser surgery to reduce obstruction of the nose, Clear Aligners therapy designed by an Airway Orthodontist using an Airway Protocol.
OSA is a serious, silent condition that needs careful and immediate attention once diagnosed with a multimodal treatment options available.
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