Sleep Apnea Essay example

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Sleep apnea is a sleep disorder that occurs when upper airway ventilation is partially or completely obstructed. The most common sleep apnea is called Obstructive Sleep Apnea (OSA). Symptoms of OSA are loud snoring, excessive day time sleepiness, mood swings, and hypertension and / or memory impairment. Oral anatomy can play a large role in developing this sleep disorder. The three most frequent problems in oral anatomy are the uvula, soft palate and tongue. If diagnosed with mild, or moderate OSA, a small surgery might be needed, or treatment can be as easy as seeing your local dentist.
The uvula which hangs from the end of the soft palate might contribute to OSA by being too large. Patients with OSA had a significantly greater percentage of muscle and fat content in the uvula. (Stauffer 1989) This normally doesn't pose as a threat to most patients during the daytime when the maybe working or enjoying their regular routine. It is when they lay down to sleep at night that having a large uvula becomes a threat. The uvula becomes the obstruction by decreasing or even blocking air flow. If someone were to have this condition, a surgery might be advised. The first surgery that may help is an uvulectomy, which is trimming the inferior rim of the soft palate and uvula, leaving the tonsils intact. An uvulopalatopharyngoplasty (UPPP or UP3), is the most common surgical procedure done to treat snoring and OSA in adults. The surgery involves removal of the adipose (fatty) tissue on the uvula or removing the uvula entirely. Tissue is removed at the end of the soft palate as well as the surrounding area (tonsils). This, in effect, shortens the soft palate and reduces redundant tissue volume in the airway. (Sleep Center@CCNT). Laser-assisted uvulopalatoplasty (LAUP), uses a carbon dioxide laser to enlarge the airway by vaporizing the sounding tissue. (Caple, C., & Schub. 2012)
The soft palate can partially or completely obstruct the pharynx which can cause your breathing to stop. Energy, over time can cause stretching or "pulling" of the soft palate, which eventually leads to the elongation of the tissue. When this occurs, snoring may become more prevalent because the tissue which is now loose and floppy will vibrate more. People are not born with a long soft palate; instead their palates become "stretched-out" over many years of rapid airflow. (Caple, C., & Schub. 2012) One surgical way people can treat this is with a pillar palatal implant which is a non-invasive surgical treatment. The implant can help stiffen the soft palate and reduce vibration and movement. This procedure is usually by an ENT (ear, nose and throat doctor). They will place three tiny woven implants (approximately 0.7 inches long and 0.08 inches wide) into the soft palate using a sterile delivery tool. The implants will eventually come together with the body's natural fibrotic response and add structural support to stiffen the soft palate.
Macroglossia, which means having an unusually large tongue, is another leading factor to obstructing the airway. It can also become worse when lying on your back. The force of gravity pulls the tongue toward the back of the mouth blocking air. One of the surgeries is tongue advancement. "This procedure involves advancing one of the main tongue muscles, the genioglossus muscle, forward; thereby limiting the tongues backward fall during sleep." (OSA Treatment Response 2013) The other surgery is tongue base reduction which removes some tissue at the base of the tongue which makes the tongue smaller and less likely to be so bulky.
A more severe surgery is the maxillofacial surgery. This is the permanent advancement or the mandible or sometimes both the mandible and lower maxilla. “Although maxillofacial surgery for sleep apnea has certain technical similarities to maxillofacial surgery done for dental and cosmetic reasons, it differs significantly from those procedures. The focus of treatment is airway, not dental
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