Sleep Apnea Johns Hopkins

Is surgery the only option for treating sleep apnea or snoring

I do predominantly the line share of sleep apnea surgery in our department. I collaborate closely with the pulmonologists, who are the sleep medicine s. Those are the s that help diagnose and treat sleep apnea, as well. If those patients fail their, their medical or their conservative therapy, that's typically when they get sent to see me for surgical considerations to, to look at potential cures for their apnea. It's not uncommon for me to see a lot of patients for, who come in for snoring complaints and, you know, are wondering whether or not they have sleep apnea. So sleep apnea is condition where you actually stop breathing at night.

Snoring is somewhere on that spectrum, towards the more mild, you know, milder end of that spectrum. But, you know, really the only way to determine if you have sleep apnea, the gold standard of testing, is really getting a sleep study. And that's an overnight, monitored study where patients, you know, sleep in a room that's similar to a hotel room but they're being monitored and they're hooked up, you know, for sound so to speak with different monitors and cables on them. And that's really our best test to diagnose sleep apnea. The treatment for sleep apnea is typically a nonsurgical therapy; something called CPAP,

which stands for Continuous Positive Airway Pressure. And it's the patients that don't tolerate their CPAP who end up seeing me for surgical considerations. And there's a number of reasons why patients may not tolerate their CPAP. But there are some surgeries that can be helpful in patients who are not tolerant of their medical therapy. And I offer a variety of surgeries including nasal surgery, a variety of palatal surgeries for the kind of tonsil and soft pallet region and then also a variety of tonguebased procedures, as well. But we typically see a patient back after their procedure in about three weeks to recheck everything, make sure that they're healing okay.

After that, I normally recheck a sleep study in about three months after their surgery, just to give everything a chance to heal and to scar. And we, you know, make further recommendations based on the result of their followup sleep study after their surgery. We're exploring the, a new technology now which is actually a nerve stimulator for sleep apnea. It's an implantable device, very similar to a pacemaker that goes into the patient's chest. And there's an electrode that will actually stimulate the nerve that goes to the tongue to provide the tongue with a little bit of more tone when they're sleeping at night, and thereby eliminating their sleep apnea.

Obstructive Sleep Apnea

MUSIC Obstructive sleep apnea. 30 million Americans may sufferfrom obstructive sleep apnea, or OSA. It is more common thanadult diabetes and asthma, affecting 24% of men and 9% of women between the agesof 30 to 60 years of age. OSA is even more commonin overweight people and

persons older than60 years of age. It is a major risk factor for the development ofcardiovascular disease. Studies show that 80%of difficult to control hypertension, 50% ofcongestive heart failure, and 60% of strokes are relatedto undiagnosed OSA. Apnea means without breath, ifyou have obstructed sleep apnea you literally stop breathingwhile you're asleep.

The apnea can last fora few seconds to a minute or more, as many as 100 oftimes during the night. Forms of sleep apnea includeobstructive, central and mixed with obstructivebeing the most common type. OSA prevents you from reachingdeep stages of sleep, which the body needs to rest andreplenish itself. Causes ofObstructive Sleep Apnea. Even though the exact causeof OSA remains unclear,

the sleep disorderfollows a pattern. During the day muscles keepthe airway passages wide open. When a person withOSA falls asleep, these muscles relax to a pointwhere the airway collapses and causes a breathing pause. These breathing pauses occurbecause of a blockage in the upper airway. Usually when the soft tissuein the upper airway or

rear of the throat collapses. When the airway closes,breathing stops and the sleeper wakes upto open the airway. The sleeper thenreturns to sleep and the breathing pauseoccurs again. This pattern is repeated untilyou wake up for the day. Symptoms ofObstructive Sleep Apnea. OSA is most commonlyseen in overweight

people with loud snoring,breathing pauses, usually noticed by the bedpartner, daytime sleepiness, thrashing around in bed,morning headaches, a dry mouth in the morning, andgasping for breath at night. Loud snoring and daytime sleepiness are the mostcommon of these complaints. Other symptoms of OSAinclude memory problems, as well as difficultyconcentrating and thinking.

Sleep Apnea in Children

Sleep apnea in children. Sleep disorders in childrenrange from mild snoring to a condition known asObstructive Sleep Apnea, or OSA. A child with obstructiveSleep apnea has partial or complete airwayblockage during sleep, usually with loud snoring andbreathing pauses. This breathing pauseis called Apnea. Obstructive sleep apneais a serious condition

that affects 2 to 4%of preschool children. It is most common betweenthe ages of two to seven. But can effect infants andadolescents as well. About 10% of children snore, of those children 20 to 30% willhave obstructive sleep apnea. Any child that snores shouldsee their health care provider. Many children have mild symptomsand may outgrow the condition. However, untreatedsleep apnea in children

can lead to serious problems,including delays in growth and development, behavior problems,hyperactivity, heart problems, and high blood pressure. The most common cause ofobstructive sleep apnea in children is enlarged adenoids ortonsils. Other causes include obesity,poor muscle tone and abnormal structures in the face,such as a deviated septum or nasal polyps.

Symptoms ofObstructive Sleep Apnea. Snoring is a common symptomof obstructive sleep apnea. In children under the ageof five years old parents may report other nighttime symptoms, such as mouth breathing, sweating, difficultbreathing, restless sleep, frequent awakenings, andwitness periods of apnea. Daytime sleepiness isuncommon in young children. Sleep deprivationcan cause symptoms

of Attention DeficitHyperactivity Disorder. ADHD during the day. In children, five years and older, bed wetting isa common occurrence. As well as behavior problems,decreased attention span and developmental issues. Nightmares, night terrors and frequent morningheadaches may also occur.

Children and teens with sleep disorders mayexhibit poor school performance, daytime sleepiness,irritability, and depression. Diagnosing ObstructiveSleep Apnea in Children. Children between ages of fiveto ten need at least nine hours of sleep ona regular basis. If you suspect your childhas obstructive sleep apnea, contact his orher healthcare provider.

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