Obstructive Sleep Apnoea (OSA) results from repeated episodes of airway obstruction that occur during sleep. OSA is more common in adults but can also occur in children and infants.
Managing OSA is very important, as the condition has been shown to have a detrimental effect on long-term health. People with untreated OSA have an increased risk of heart disease, stroke, obesity, hypertension and depression and there is a recognised increased risk of death in people with OSA.
Signs and symptoms
Common signs and symptoms include snoring or noisy breathing, disturbed sleep with intermittent waking, daytime tiredness, fatigue and a lack of concentration. In adults there may be weight gain, however in children there may be loss of, or failure to gain, weight.
Causes
There are a quite a few causes of OSA and a number of different levels in the airway that can be involved, including from inside the brain, which is called ‘central apnoea’. Investigations such as sleep studies are done to determine the potential cause(s) so OSA can be optimally managed. In children, OSA can be associated with enlarged tonsils and adenoids, and in infants with rare craniofacial conditions there is often an associated small jaw (micrognathia).
Managing OSA is very important, as the condition has been shown to have a detrimental effect on long-term health.
Treatment
Treatment options range from conservative strategies through to surgical management. These include weight loss, reducing alcohol intake, or a mandibular positioning splint (a prescription custom-made medical device worn in the mouth during sleep). For moderate to severe OSA cases, Continuous Positive Airway Pressure (CPAP) can be recommended, which is mask-to-CPAP machine therapy where oxygenated air is pumped into your airways during sleep. For severe cases, or for those who do not respond to conservative treatment, a surgical approach may be taken.
This may include a referral to an Oral and Maxillofacial Surgeon or an ENT Surgeon. The ENT Specialist may perform nasal surgery, tonsillectomy/adenoidectomy, tongue base or palatal procedures such as UPPP. The OMS surgeon can undertake chin advancement (genioplasty) or jaw advancement surgery (osteotomy) that moves the chin and/or jaws forward to open the airway in the posterior nasal region and the base of the tongue. The upper or lower jaw, or both jaws together, may be moved forward. If the occlusion (bite) is not aligned then orthodontic treatment with braces is sometimes required in combination with jaw surgery. In infant and paediatric patients, advancing the jaw can be undertaken by a technique called distraction osteogenesis.
Assessing and then managing OSA requires a multidisciplinary approach and the first step is to discuss this with your family doctor, and then if relevant, get a referral to a sleep medicine and respiratory specialist.
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Note: The information covered within this web page and across this website is not intended as a substitute for professional medical or dental advice, diagnosis, or treatment. It is listed to provide you with a general overview to help you communicate effectively when you seek the advice of an oral and maxillofacial surgeon.
