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It is estimated that 25% of all adults have obstructive sleep apnea and 10% have moderate or severe sleep apnea. Many patients who have obstructive sleep are unaware and live their lives with low energy, chronic fatigue and elevated risk for life-threatening long-term complications due to fragmented sleep and decreased oxygen levels at night. Known risk factors for sleep apnea include:
Many patients snore at night during these episodes but, snoring at night is not a sleep apnea test. The best sleep apnea test is an in-depth analysis of breathing patterns and oxygen levels during sleep either at home or in a sleep center. Feel free to ask for a referral from one of our surgeons for a sleep apnea test if you feel you have some of these risk factors. Determining whether you have sleep apnea with a sleep apnea test is extremely important because it is impossible to start to treat these long-term serious consequences without a diagnosis. The severity of sleep apnea symptoms is measured by the apnea hypopnea index often abbreviated AHI. The higher the AHI, the more severe the sleep apnea symptoms.
Continuous Positive Airway Pressure (CPAP)
Fortunately, there are many sleep apnea treatment options available. The most common and widely prescribed sleep apnea treatment is Continuous Positive Airway Pressure, often referred to as CPAP. CPAP is a sleep apnea treatment that uses a mask which must be worn anytime you sleep to continuously force air from your nose down into your airway to stent open your airway and prevent collapse while sleeping. This is a very effective treatment when patients can tolerate using it all night. However, due to the fact that it is a physical mask that must be worn anytime you sleep many patients find it cumbersome or uncomfortable. As a result, adherence to this sleep apnea treatment is low. Some patients find it easier to tolerate than others, but for many the idea of having to wear a machine to help them breathe every night for the rest of their life is not something they want to commit to. No matter how effective the treatment is, if it is not used, it does not work.
Maxillomandibular Advancement (MMA)
An alternative to CPAP is maxillomandibular advancement, MMA. MMA is a surgical treatment where both the upper and lower jaws are advanced to increase the airway space behind the upper jaw, lower jaw and tongue. This serves to both increase the airway space and stent open the airway which prevents collapse during sleep. This surgical treatment has been studied for many years and has a proven track record of long-term success. In a large clinical study, patients undergoing MMA for sleep apnea had a 43% chance of complete cure of their sleep apnea and an 86% chance of an over 50% reduction in their severity of sleep apnea and a reduction of their AHI to under 20.1 This is even more impressive when you consider that severe sleep apnea is defined as an AHI > 30 and the average pre operative patient in this study had an AHI over 60. This study took only the most severe patients and still 43% of them were able to achieve complete cure of their sleep apnea symptoms and almost all of them achieved a dramatic decrease in their sleep apnea symptoms. MMA is a type of corrective jaw surgery which has improved significantly with modern surgical and anesthesia techniques. Please refer to our other sections on corrective jaw surgery to learn more about recovery, medical insurance coverage and the overall patient experience.
At Peninsula Oral and Facial Surgery, we are committed to explaining all of your treatment options when it comes to your sleep apnea treatment. While surgical treatment for sleep apnea has many benefits, it is not for everyone. The biggest benefit of MMA is the fact that it is a one-time surgical treatment with life-long benefits which allows many patients to free themselves from their CPAP. In addition, this treatment is covered by most medical insurance plans. Dr. Adam Fagin is a Board Certified Oral and Maxillofacial Surgeon who has completed additional fellowship training specifically in jaw surgery and maxillomandibular advancement. This additional training results in reliable results, quicker recovery from surgery and an overall better patient experience. If you are interested in learning more about the surgical treatment options for sleep apnea, please give our office a call to schedule your free consultation.
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