Obstructive Sleep Apnea, Baltimore, MD

People with obstructive sleep apnea (OSA) have disrupted sleep patterns with low blood oxygen levels. When obstructive sleep apnea occurs, the tongue is sucked against the back of the throat, blocking the upper airway and stopping airflow. When oxygen levels in the brain become too low, the sleeper partially awakens, the obstruction in the throat clears, and the flow of air starts again, usually with a loud gasp. OSA is a very serious condition that requires careful attention and treatment.

Research has shown that repeated cycles of decreased oxygenation lead to serious cardiovascular problems. Additionally, these affected individuals suffer from excessive daytime sleepiness, depression, and loss of concentration.

Airway obstructions that are less severe are categorized under Upper Airway Resistance Syndrome (UARS). These individuals suffer many of the same symptoms as OSA.

The first step in treating OSA is recognizing the symptoms and seeking appropriate consultation. You will be asked to give a detailed history and undergo a complete physical examination. With the aid of cone-beam CT scan analysis, the doctors can determine the areas and degree of obstruction. Sometimes a naso-pharyngeal exam is performed with a flexible fiber-optic camera. A sleep study may be scheduled to assess the amount of cardiovascular compromise and decreased oxygenation levels that occur with OSA.

Several treatment options are available. Initially one can use a nasal CPAP machine that delivers pressurized oxygen through a nasal mask, thereby limiting obstruction at night. A surgical option is an uvulo-palato-pharyngo-plasty (UPPP), which is performed on the soft palate towards the back of the throat. A similar procedure performed with a laser is a laser-assisted uvulo-palato-plasty (LAUPP). Also, a radio-frequency probe can be used to tighten the soft palate. These procedures are usually performed in our office under IV sedation or general anesthesia.

More complex cases may require the repositioning of the bones of the upper and lower jaw to increase the size of the airway (orthognathic surgery). This procedure is performed in the hospital under general anesthesia and requires a one to two day stay.