Category Archives: Sleep Apnea

Maxillomandibular Advancement (MMA) for Sleep Apnea

There are several treatment options available for Obstructive Sleep Apnea (OSA) including weight loss and behavior modification like changing sleep position or decreasing alcohol consumption. Oral devices have been successful and Continuous positive airway pressure (CPAP) breathing devices are common, and can be effective if used properly. However, some patients prefer a remedy that allows freedom from the burden of sleeping tethered to a machine for the rest of their lives.

A surgical procedure known as Maxillomandibular Advancement (MMA) is a viable first line treatment option for specific candidates who meet the criteria for success. Younger age, lower body mass index (BMI), and existing anatomical structure are a few of the patient characteristics that predict greater surgical success. Most patients who choose this treatment option report satisfaction with OSA-related quality of life measures and with the reduction of daytime sleepiness.

MMA surgery actually changes the shape of the patient’s airway. This action reduces the collapsibility of the upper airway space, which improves or resolves the OSA (American journal of orthodontics and dentofacial orthopedics.)

Typical OSA symptoms of snoring and snorting, or the periodic interruptions in breathing which can leave the person gasping for air, are an annoyance to the patient and his or her partner. More importantly, these signs of sleep apnea are also linked to many serious health threats including heart disease, high blood pressure, Type 2 diabetes, weight gain, asthma, acid reflux and car accidents.

One measure used to grade the severity of OSA is the number of breathing cessations that occur per hour of sleep, known as the apnea-hypopnea index (AHI). Another measure is the reduction in blood oxygen levels that result from these stoppages. It is essential for the OSA patient to familiarize himself with success rates and potential pitfalls of various treatment options. He should discuss all treatment alternatives with his trusted healthcare professionals so he is able to make an informed decision on his course of action.

MMA corrects particular craniomaxillofacial abnormalities that are a known cause of the condition. MMA enlarges the skeletal framework of the jaw, which then enlarges the narrowed airway. MMA has been used to treat OSA for about three decades. The surgical procedure, which moves the maxilla and mandible forward by approximately 10 millimeters, has been shown to result in a cure rate of 97% for OSA. Substantial and consistent reductions in the AHI were observed following MMA; adverse events were uncommonly reported. (Surgical Modifications of the Upper Airway for Obstructive Sleep Apnea in Adults: A Systematic Review and Meta-Analysis; www.journalsleep.org)

What results determine whether or not a treatment is deemed successful? The patient’s self-reported resolution of the snoring and other symptoms of obstructive sleep apnea and acknowledgement of improved sleep quality are a major indication that the treatment was successful. Data showing a lower AHI score and restored oxyhemoglobin confirm the clinical results.

When performed by a skilled surgeon, MMA surgery is generally safe and highly effective for treating obstructive sleep apnea and its associated health risks. Corrective jaw surgery can deliver more predictable, permanent results by moving the lower jaw forward to relieve airway obstruction. If you’ve been diagnosed with sleep apnea, or you think you may be suffering from sleep apnea, schedule a consultation so we can discuss the best treatment plan. For more detailed information about MMA surgery visit http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941427/

picture crop Maxillomandibular Advancement (MMA) for Sleep ApneaKayvon Haghighi, DDS, MD, FACS is licensed to practice both medicine and dentistry in the state of New Jersey. Dr. Haghighi’s unique combination of surgical training and experience in facial reconstruction enables him to analyze your condition from multiple points of view.

 

 

 

 

 

Wake Up to the Perils of Excessive Daytime Sleepiness

bigstock Wake Up 52772422 Wake Up to the Perils of Excessive Daytime SleepinessHey, sleepyhead…wake up! If you suffer from sleep apnea (or another sleep disorder) and seem to be hearing this command frequently from colleagues or loved ones, you may be experiencing excessive daytime sleepiness. Take heart, though, you’re not alone. Nearly a quarter of us routinely feel so drowsy it negatively affects our work life, studies, leisure activities and interpersonal relationships.

More than a third of all adults, and up to half of younger adults, admit to sometimes nodding off during the day. Planned cat naps don’t count. These unintentional episodes of sleep may signal a chronic sleep disorder, such as sleep apnea. In general, getting seven to nine hours of sleep per night is the ideal, but not nearly the norm for almost half of adults. Lack of concentration and impaired memory have been reported by roughly 20 percent of sleep-deprived adults.

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CPAP’s Pickle of Noncompliance

bigstock Woman wearing CPAP machine for 64217995 CPAP’s Pickle of NoncomplianceWhen a sleep apnea diagnosis is given, chances are the patient will be advised to begin using a CPAP machine every night while sleeping. CPAP, or continuous positive airway pressure, is a commonly prescribed treatment for the episodes of interrupted breathing present in sleep apnea. The CPAP machine is a medical device that runs on electricity. It is placed next to the bed on a nightstand or table. There are three parts to a CPAP machine: a pump housed in a box about the size of a clock-radio; a long section of plastic hose or tubing; and a face mask designed to strap onto the patient’s head, covering his nose and mouth. 

The CPAP machine works by taking in air and pressurizing it. The pressurized-air then blows through a tube and mask into the patient’s throat. The pressure of the air keeps the patient’s throat open while he is sleeping. CPAP can be successful in treating sleep apnea when used correctly; however, there are many obstacles that lead to non-compliance among users and challenge the level of success. Continue reading

What is Sleep Apnea?

sleep apnea What is Sleep Apnea? Who doesn’t look forward to a restful night’s sleep after an active day of working or recreational exercise? Sleep allows our bodies to recharge, gearing up for another 16 hours or more of life, driving, walking, working out, attending meetings or taking care of children. Those with sleep apnea, however, may not experience the deep sleep needed to rejuvenate the body. Sleep apnea (AP-ne-ah) is a common but potentially serious sleep disorder in which shallow breathing or pauses in breathing occur while sleeping.

These involuntary interruptions in breathing can last just a few seconds or extend for a frighteningly long span of minutes. When normal breathing resumes it is sometimes accompanied by a resounding snort or choking sound. The pauses in breathing can happen every few minutes in some cases, preventing deep sleep from occurring. Sleep apnea patients often present with symptoms of excessive and persistent daytime sleepiness.

“Apnea” is a Greek word that means “without breath.” There are three types of sleep apnea, obstructive, central and mixed. Each leads to a hitch in breathing, but for different reasons. Typically, the sleeper isn’t even aware of these lulls. According to sleepapnea.org, without treatment sleep apnea can lead to cardiovascular disorders like high blood pressure, heart disease or stroke; automobile accidents caused by falling asleep at the wheel; memory problems, weight gain, headaches and other maladies.

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