|
What are snoring and sleep apnea?
Snoring is the loud, bothersome noise
created by vibrating soft tissues in the throat
of someone who is asleep.Obstructive Sleep
Apnea is a serious medical condition in which
the soft tissues of the throat, known as your
airway, collapse and impede breathing for
10 seconds or longer while asleep.
During such an apneic episode, the oxygen
levels in the bloodstream drop and eventually
may lead to harmful health problems and
early death. Although most patients
diagnosed with sleep apnea snore loudly,
everyone who snores does not necessarily
suffer from sleep apnea.
What are the common symptoms of sleep apnea?
Loud snoring
Excessive daytime sleepiness
Awaking feeling unrefreshed after sleep
Morning headaches
Problems with memory or concentration
Irritability
Sexual dysfunction
Why should I be concerned about possibly having sleep apnea?
Medical studies have shown that
Obstructive Sleep Apnea increases the
mortality rate; that is, people die sooner
than if they did not have the problem.
Apnea interrupts the normal pattern of
sleep, which causes tiredness and
immediately increases the likelihood of
having accidents while driving or operating
machinery. Over many years, the stress
created by low oxygen levels magnifies the
risk of developing high blood pressure and
suffering a heart attack or stroke.
How can I tell if I have sleep apnea?
Dr. Brodner is Board Certified in Sleep
Medicine, which qualifies him with the
expertise to ask pertinent questions about the
typical symptoms listed above. He will perform
a complete physical examination to evaluate for
common anatomic abnormalities associated
with sleep apnea. This examination will include
flexible fiberoptic endoscopy – a tiny camera
utilized to fully visualize the inside of your throat
and localize the sites of obstruction. Finally, Dr.
Brodner will send you for a sleep study
(polysomnogram) to accurately diagnose the
presence or absence of sleep apnea.
|
Am I at risk for sleep apnea?
8% of men and 4% of women
are estimated to have
Obstructive Sleep Apnea.
Risk factors associated with suffering
from sleep apnea include:
Obesity
Anatomic abnormalities
- Enlarged tonsils
- Enlarged tongue
- Excess tissue in the soft palate (roof of the mouth)
Family history
Neuromuscular disorders
Sleep position (on your back)
Use of alcohol or sedative
|
View this informative Sleep Apnea Video in our Patient Information section.
I have been diagnosed with obstructive sleep apnea;
how is it treated?
There are three treatment options available to treat sleep apnea:
Weight Loss -
Weight loss is a great idea;
how much do I have to lose
and how can I achieve my goal?
| |
For some patients, 10% to 20% weight loss
can greatly improve, or even resolve, their
sleep apnea. This depends on height and
weight, as well as their airway anatomy. After a
thorough evaluation, Dr. Brodner can explain
how weight loss will fit into your individual
treatment strategy. Fortunately, there are many
popular diet plans to choose from in the media
so please discuss which one, if any, is right for
your personal needs. Dr. Brodner may also
recommend a nutrition and weightmanagement
program available in your area. |
Non-invasive treatment:
- Lifestyle changes
| |
During sleep apnea throat muscles relax,
allowing soft tissues to collapse and block the
air passages. Anything that increases the
relaxation of these muscles will worsen the
problem. As a result, lifestyle changes such as
avoiding alcohol and sedating medications can
greatly reduce the severity of sleep apnea.
Since lying on your back also worsens this
collapse, sleeping on your side or propped up
on several pillows can also help. |
- Oral dental appliances
- CPAP mask
| |
Sleep apnea can be treated with CPAP
(Continuous Positive Airway Pressure), a
machine that uses air pressure to prevent the
tissues in the throat from collapsing while you
sleep. The air is blown through a mask fitted
over your nose, and sometimes mouth, that is
worn while sleeping.
How well does CPAP work in treating sleep apnea?
If used properly, CPAP resolves sleep apnea in nearly 100% of patients. CPAP needs to be worn
all night, every night, in order to be effective or else the symptoms and harmful medical effects of
sleep apnea will return immediately. To help patients get comfortable with their treatment,
Dr. Brodner moderates monthly CPAP Support Group meetings to discuss the latest technology,
offer guidance, and allow patients to share their experiences and advice. |
Surgery:
Who should have surgery for sleep apnea?
| |
Surgery is considered when weight-loss has failed and the patient cannot tolerate or chooses not
to wear CPAP. As with all surgical treatment, success depends on choosing the right combination
of procedures to effectively correct the anatomic abnormalities unique to the patient.
Dr. Brodner is experienced in
performing multi-level surgery to
correct areas of airway collapse and
prevent the obstruction causing
sleep apnea. These treatments, often
used in combination, include:
UvuloPalatoPharyngoPlasty (UPPP),
tonsillectomy, bony reconstruction of
the face and jaw, reduction of the
tongue, tracheotomy, and nasal
procedures such as septoplasty,
shrinking of the turbinates, and
removal of polyps.
|
How effective is
surgery in treating
sleep apnea?
| |
UPPP is successful in
stopping snoring in 90% to
95% of patients. Dr. Brodner
utilizes the cutting-edge
Friedman criteria, combined
with advanced multi-level
surgery, to achieve higher
rates of improvement or
resolution of Sleep Apnea
than traditionally reported.
Subjectively, the vast
majority of patients
experience relief of their
symptoms – gaining more
energy, improving memory
and concentration, and finally
enjoying the feelings of a
“good night’s sleep.”
|
- Uvulopalatopharyngoplasty (UPPP)
| |
The most commonly performed surgery for
treatment of Obstructive Sleep Apnea is the
UvuloPalatoPharyngoPlasty (UPPP). This
procedure removes the uvula, trims the
redundant tissue of the soft palate, and widens
the air passage at the back of the throat. When
enlarged tonsils are present, these are also
removed as part of the procedure.
|
- Base of Tongue reduction
| |
Reducing the muscle bulk at the back of the
tongue is utilized in cases of severe sleep
apnea and in patients with an over-sized
tongue, which contributes to the blockage of
airflow during sleep. This may be achieved with
removal of tongue muscle or by using newer
radio-frequency technology, which shrinks the
tongue at low heat, allowing for less pain and
postoperative swelling.
|
- Tracheotomy
| |
For patients with extremely severe sleep apnea not amenable
to other treatments, tracheotomy is used to bypass the areas
of collapse in the throat. By placing a plastic tube in the
throat, directly into the trachea (windpipe), sleep apnea is
cured. Given the reluctance of most patients to undergo such
an extreme procedure, this is rarely performed, but for the
unfortunate few who suffer extremely severe sleep apnea, it
remains the only option that guarantees 100% success.
|
- Correction of nasal obstruction
Why would the doctor want to fix my nose?
| |
We normally breathe through our nose while asleep.
Anything that blocks airflow through the nose, such as a
deviated septum (crookedness in the middle partition of the
nose), enlarged turbinates (structures inside the nose
responsible for heating and filtering air), or polyps (fluidfilled
sacs often associated with allergies) can worsen
snoring and sleep apnea. By correcting these deformities,
Dr. Brodner can improve, though usually not cure, sleep
apnea. Also, maximizing airflow through the nose may allow
a person to use CPAP more easily and thus treat sleep
apnea non-invasively.
|
|
