Obstructive Sleep Apnea (OSA)
According to the National Sleep Foundation, some form of snoring or obstructive sleep apnea (OSA) occurs in 90 million Americans. Obstructive Sleep Apnea (OSA) is associated with higher risks for hypertension, coronary artery disease, stroke, congestive heart failure, impotence, mortality and behavioral and cognitive problems. Sleep apnea leads to excessive day time sleepiness (hypersomnolence) may be responsible for many job related injuries and it is estimated that people with sleep apnea are 10 times more likely to die in a car accident than someone without sleep apnea.
Dr. Bolourian is well trained in various treatments of primary snoring and /or OSA. The following are an outline of treatment modalities available for the management and treatment of snoring and OSA.
Dental treatment for Obstructive Sleep Apnea (OSA):
This is a simple non-invasive treatment that takes advantage of an appliance fitted over the teeth. Over the past 15 years, oral appliances have developed into a viable and scientifically sound method for eliminating upper airway obstruction in a large percentage of patients.
How do the oral appliances work in improving signs and symptoms of OSA?
During sleep our lower jaw falls back which leads to a narrow airway. In patients with OSA the airway narrowing leads to lower oxygen levels and other inherited problems associated with obstructive sleep apnea. The oral appliance is fabricated and designed to non-invasively bring the lower jaw forward while we sleep opening up the airway and reducing the incidence of snoring associated conditions.
Who is a good candidate for non-invasive oral appliance therapy?
Many patients can benefit from non-invasive oral appliance therapy. American Academy of Sleep Medicine recommends oral appliance therapy as the first line of treatment for mild to moderate OSA and the treatment of primary snoring. For severe OSA the first line of treatment maybe continuous positive airway pressure (CPAP). However compliance with this treatment modality is poor and many patients end up not using this expensive machine at all. The severity of OSA is determined by sleep studies including a polysomnogram.
Surgical Therapy for Obstructive Sleep Apnea (OSA):
Many surgical therapies have evolved from tracheotomies to tonsillectomies and volumetric oral cavity/ throat tissue reduction procedures known as Somnoplasty. Unfortunately, there simply is not sufficient evidence that these procedures are beneficial for patients with sleep apnea.
Jaw Advancement Surgery (Telegnathic Surgery)
Jaw advancement surgery (maxillomandibular advancement surgery) is a highly successful and potentially definitive surgery for treatment of OSA. Success rate has been reported to be as high as 100% in many studies. This surgical procedure is better tolerated and has far more beneficial effects on breathing.
This procedure is usually performed in a hospital or ambulatory surgery center. The upper and the lower jaws are advanced to allow more space in the upper airways. Recovery after this procedure is from one to two weeks.
Dr. Bolourian is a board certified oral and maxillofacial surgeon with extensive experience in management and treatment of OSA. Please call us if you have any questions or wish to consult with Dr. Bolourian.