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 versus Central Sleep Apnea
Obstructive sleep apnea is when the airwaybecomes narrowed or obstructed and you're making the effort to breathe but we do notsee any flow in air movement coming from your nose or mouth. Where central sleep apnea occurswhere your brain forgets to tell your body to breathe. If we're looking at it from avery simplistic term and so we do not see the drive to breathe. So the first step isto come into the and be seen by one of our physicians in the sleep medicine .We'll go through a questionnaire and try to determine what risk factors we think you havefor sleep apnea such as obesity, snoring, daytime sleepiness and then if we think thatyou have a high risk for meeting those criteria
then we would set you up for a sleep studyeither in your home to do an overnight sleep study or in our laboratory, depending on yoursituation. The CPAP can be used to treat both conditions and, in some patients, that isenough. However, there are some patients that have more complex types of central sleep apneathat require more complicated types of machines to treat that condition. Obstructive sleepapnea actually has been linked to a lot of other problems such as high blood pressureand then, you know, difficulty functioning during the day. If it goes untreated for along period of time there's an increased risk of early heart problems and those types ofthings.