One of the most common patient complaints is snoring, which interrupts sleep for both the patient and partner. Snoring may be a symptom of sleep apnea, a serious condition that causes a person’s airway to temporarily close during sleep. In severe cases, interruptions can occur 30 or more times per hour. This disturbs the sleep architecture, decreases blood oxygen levels, causes irregular heart rhythms, and can lead to increased blood pressure. When the airway reopens it is common for the patient to awaken, disrupting restorative sleep and leading to daytime drowsiness.
Sleep apnea is diagnosed with a sleep study.
Non-Surgical Treatments for Sleep Apnea
- CPAP machine – Considered the gold standard for treating sleep apnea, the CPAP machine (Continuous Positive Airway Pressure) applies measured air pressure in the patient’s throat through a facial or nasal mask. This prevents the airway from closing while breathing. It enables the patient to take full breaths and eliminates snoring sounds. In recent years, CPAP machines have become more comfortable and less cumbersome to use. When selected as a treatment, patients undergo an overnight CPAP titration study during which our trained therapists slowly adjust CPAP pressure until normal airflow is achieved.
- Dental device – Relieves the obstruction by shifting the lower jaw forward, separating the tongue base from the back of the throat and soft palate.
Surgical Treatment for Sleep Apnea
For patients unable to tolerate a CPAP mask or dental device, a surgical treatment may be needed, depending on the severity of the problem. For simple snoring or mild sleep apnea, your doctor may perform an in-office uvulectomy (a surgical procedure in which all or part of the uvula is removed) or a palatal pillar procedure (a minor surgery to insert tiny implants into the soft palate to reduce the tissue vibrations that cause snoring).
For more complex cases, a combination of surgical procedures on the soft palate and various tongue base advancement procedures can be performed. For the most difficult cases, maxilla-mandibular advancements (surgery that moves the upper jaw and the lower jaw forward) could be recommended.
Narcolepsy is a chronic neurological disorder that affects the brain’s ability to control sleep-wake cycles. Many people with narcolepsy experience frequent waking during the night and may feel overwhelmingly sleepy throughout the day. Some uncontrollably fall asleep during the day even if they are in the middle of an activity like driving, eating, or talking. Other symptoms may include sudden muscle weakness while awake, vivid dream-like images or hallucinations, and total paralysis just before falling asleep or just after waking up. Left untreated, narcolepsy can interfere with psychological, social, and cognitive function and disrupt work, social, and leisure activities.
Narcolepsy is diagnosed with a fatigue study (Multiple Sleep Latency Test--MSLT). Once diagnosed narcolepsy can be treated with medication.
Periodic Limb Movement Disorder (PLMD)
Patients with PLMD disorder experience involuntary and repetitive twitches or jerking of the legs, every 20-40 seconds, during sleep. While PLMD is a neurological condition, it is also considered a sleep disorder since the movements disrupt normal sleep and leads to daytime sleepiness. PLMD is often linked with other sleep disorders like restless legs syndrome, a condition involving strange sensations in the legs while awake. The patient has an irresistible urge to move the limbs to relieve the sensation.
PLM disorder is screened for with a standard sleep study and can be treated with medication.