A common and very serious condition, sleep apnea occurs when a patient's breathing is interrupted during sleep, due to a blockage in the airway. This is called obstructive sleep apnea and is by far the most common type of sleep apnea. Another reason for interrupted breathing is due to the brain failing to send breathing signals to the breathing muscles. This less common form of sleep apnea is called central sleep apnea. Treatment varies depending on the severity and type of sleep apnea.
Either type of sleep apnea results in a breathing pause that can last from a few seconds to several minutes. When the blockage clears and normal breathing resumes, it is typically marked by a loud gasp or choking sound.
Because sleep apnea cannot be diagnosed during routine office visits, most individuals will discover the condition due to a family member or partner noticing the signs. In addition to chronic snoring and breathing pauses during sleep, other symptoms include excessive tiredness throughout the day, dry mouth or a sore throat upon waking, depression, mood swings and morning headaches.
Board-certified as an oral and maxillofacial surgeon, Dr. Mizrahi in Los Angeles is fully qualified to treat among the most complex cases of sleep apnea. With countless patients breathing easier and enjoying deeper, more restful sleep, Dr. Mizrahi has earned her reputation for delivering among the best treatment for sleep apnea Beverly Hills has available.
Causes of obstructive sleep apnea
Obstructive sleep apnea, where the airway is partially or completely closed, can be caused by the throat muscles and tongue becoming unusually relaxed. In children and some adults, the tonsils are too large in ratio to the airway. When sleeping the tonsils partially or fully close the airway for varying times.
This cause of sleep apnea has a relatively simple treatment. Removal of the enlarged tonsils or other excess tissue clears the airway allowing normal breathing patterns during sleep.
Obesity can cause sleep apnea by the accumulation of fatty tissue in the airway. This narrows the opening, making it harder to maintain even breathing while asleep.
In some cases there is a structural abnormality in the head and neck which creates a smaller airway opening. The muscle relaxation naturally experienced during sleep closes an already narrow airway. Treating this form of sleep apnea is done under the care of a maxillofacial surgeon such as Los Angeles oral surgeon Dr. Parvaz Mizrahi with years of experience treating this disorder.
Causes of central sleep apnea
People with central sleep apnea may not snore or give any hint of their condition until other symptoms are obvious. This type of sleep apnea is caused by a lack of communication from the brain, not simply a physical obstruction in the airway.
Central sleep apnea can be caused by medical conditions such as congestive heart failure, Parkinson’s disease and stroke. This type of breathing pattern is identified by increases and decreases in breathing effort. Since the signals sent by the brain travel through the brainstem to the spine, conditions that affect the spine may cause this condition. Radiation treatments, spinal surgery and arthritis of the spine can result in central sleep apnea.
Opioid drugs can also cause central sleep apnea by interfering with respiratory signals sent by the brain to the breathing muscles. People who regularly use drugs such as codeine, morphine or oxycodone to manage long term pain may experience sleep apnea.
Aging is another potential cause of central sleep apnea. The brain signals the throat muscles to remain stiff during sleep. As we age, the signals may become disrupted causing the airway to become obstructed.
CPAP intolerance can complicate sleep apnea treatment by creating central sleep apnea while using the device. This is a combination of both types of sleep apnea and is referred to as complex sleep apnea. As a highly respected oral surgeon in Los Angeles, Dr. Mizrahi is often referred these complex cases by her colleagues. Complex sleep apnea treatment requires the highest level of skill and experience.
Sleep Apnea Treatment
After performing an initial examination to determine the severity of your sleep apnea, Dr. Mizrahi will thoroughly explain your surgical and non-surgical options, as well as advise on which treatment plan will most effectively resolve the condition. She wants to make sure you are fully aware of your sleep apnea treatment options.
Non-Surgical Sleep Apnea Options
As an initial course of treatment for moderate to severe sleep apnea, Dr. Mizrahi will commonly prescribe a CPAP (or continuous positive airway pressurizer) machine. Worn snugly over the nose during sleep, the CPAP is a breathing mask that supplies pressurized air flow continuously into the patient's throat, preventing obstruction and enabling normal breathing.
For sleep apnea that is not resolved by a CPAP machine, Dr. Mizrahi may recommend surgery to provide permanent relief.
If severe snoring is negatively impacting the patient's quality of life, Dr. Mizrahi may recommend a UPPP procedure. Performed under light sedation in Dr. Mizrahi's comfortable, state-of-the-art office, UPPP involves removing excess tissue in the throat to widen the airway, thus allowing air to move through the throat more easily and delivering permanent relief from chronic snoring.
In the most complex sleep apnea cases, an abnormality in the maxillofacial skeleton may be contributing to the patient's condition. In these cases, Dr. Mizrahi will perform orthognathic surgery, which involves expertly repositioning the upper and lower jaw to increase the size of the airway. As this procedure requires precise bone incisions and extensive knowledge in jaw function and anatomy, orthognathic surgery should only be performed by an immensely skilled and experienced oral surgeon, like Dr. Mizrahi.