Sleep Apnea Syndrom (SAS)

The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

10 million Americans have been diagnosed with sleep apnea; 20-30 million Americans are estimated to have sleep apnea: 1-3% of children; 12-24% of adult men; 4-9% adult women (fewer women have snoring as a symptom). The percentages vary according to the parameters used by the studies (eg, pre-menopausal vs. post-menopausal women).

Types of Apnea

• Central - uncommon - Central sleep apnea (CSA) is where the airway is not blocked and with no neurological signal to breathe, there is no respiratory effort
• Obstructive - the most common - Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep
• Mixed - uncommon - a combination of the above which begins as central and becomes obstructive and is treated as obstructive

Normal Breathing During Sleep                      Snoring                                   Obstructive Sleep Apnea




Normal Breathing During Sleep- Notice how wide the airway is between the back of the tongue and the back of the throat. 

Snoring- During sleep, the tongue and other muscles relax. Notice how small the airway between the back of the throat becomes in a person who snores. 

Obstructive Sleep Apnea- Here the muscles have relaxed so much that the airway is blocked, thereby making it very difficult to breathe.

Risk Factors for Sleep Apnea

• A family history of sleep apnea
• Excess weight
• A large neck
• A recessed chin
• Male sex
• Abnormalities in the structure of the upper airway
• Smoking
• Alcohol use
• Age
• Yet sleep apnea can affect both males and females of all ages (including children) and any weight

Presenting Symptoms

• Loud snoring
• Excessive daytime sleepiness (i.e., falling asleep easily and sometimes inappropriately)
• High blood pressure and other cardiovascular complications
• Morning headaches
• Memory problems
• Feelings of depression
• Reflux
• Nocturia
• Impotence

Treatments for Obstructive Sleep Apnea  

1. Oral appliance therapy - one of the best and simplest method of treatment


We use FDA-approved oral appliances (Tap III®) that are custom-fitted to help the patient sleep soundly and minimize the effects of sleep apnea, such as snoring. These FDA-approved devices essentially treat OSA (Obstructive Sleep Apnea) by preventing airway obstruction and allowing the patient to breathe easily and continuously. Worn in the mouth like an orthodontic appliance during sleep, oral appliances keep the soft tissue from collapsing and interrupting normal breathing patterns. The purpose of the oral appliance may be to reposition the lower jaw, tongue, soft palate, and hyoid bone into a certain position, to keep the airway open with stabilization of the tongue and jaw, or to provide artificial muscle tone to prevent collapse and resulting airway blockage. Dr Han  will fit your oral appliance for comfort by using a mold of your mouth to design your unique fit.

Call for your consultation and treatment (909) 945-2002

2. Positional device (anti-snoring cushion)

This new device is a natural and non-invasive treatment for snoring. The cushion is worn like a soft, lightweight backpack positioned along the middle of the back. It rests comfortably in place and is not noticeable when you are sleeping on your side or stomach. However, this cushion will prevent you from rolling onto your back during sleep. This cushion can be successful when used alone or in combination with other treatments for snoring or obstructive sleep apnea.

3. Continuous positive airway pressure (CPAP) treatment
 
The device has a small air blower connected by a flexible hose to a cushioned plastic mask that covers your nose. The blower forces air through the hose and mask into your nose and throat to keep the air passage open during sleep. Although, this maybe a good treatment, for most of us, it maybe impossible to fall a sleep with this device.

 
4. Surgery in the throat area or jaw

The most common surgical procedure for treating snoring is laser-assisted uvulopalatoplasty (LAUP). This technique removes a portion of the soft palate and most of the uvula. The treatment is done in the physician's office by a qualified surgeon. It is usually completed in phases, which may require separate surgical procedures. This treatment can be effective in reducing snoring. It is less effective for treating people with moderate or severe obstructive sleep apnea.

A similar but more extensive surgical procedure called uvulopalatopharyngioplasty (UPPP) is done in the hospital. This procedure removes all of the uvula and about one-third of the soft palate. It requires a longer healing time, and it can be effective for treating people with snoring and mild obstructive sleep apnea. It is not as effective for treating people with moderate to severe obstructive sleep apnea.

Somnoplasty (radio frequency surgery) is a minor surgical procedure completed in the physician's office using local anesthesia and a customized electrode that delivers radio frequency energy to the tongue and/or soft palate. This treatment reduces snoring by creating scarring which decreases vibration of the tissues.

 

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