At our center, we offer comprehensive management of both snoring and Obstructive Sleep Apnea (OSA). Dr. Matorin is one of the few sleep specialists in Houston that is trained and board certified in both the medical and surgical treatment of sleep apnea and snoring.

Snoring

  • Snoring is the noise created by breathing through a partially obstructed airway while asleep.
  • The obstruction usually occurs at the palate level and is often associated with an elongation of the soft palate, elongation of the uvula, and/or enlarged tonsils.
  • Not everyone who snores has obstructive sleep apnea, but nearly everyone who has obstructive sleep apnea snores.
  • Treatment for OSA almost always eliminates snoring.
  • There are treatment options available for those who snore but do not have sleep apnea.
    • These treatments may include the Pillar Procedure, uvulectomy, septoplasty, and/or tonsillectomy.
    • When performed alone, septoplasty may have unpredictable effects on snoring. Therefore, it is usually performed for nasal obstruction in combination with another procedure for the control of snoring.

Sleep Apnea

  • Apnea is a Greek-derived root word meaning ‘without breath’.
  • Sleep apnea is a breathing disorder characterized by brief episodes of either stopped breathing or shallow breathing for periods of time while asleep.
  • The brain must have oxygen in the bloodstream to survive, so it constantly monitors oxygen levels.
  • In patients with sleep apnea, oxygen saturation drops too low, forcing the brain to wake up in order to breathe more deeply. The awakening may not rise to the level of consciousness.
  • Once oxygenation is restored, the brain returns to sleep but will continue to repeat the cycle over and over again.
  • As a result, the amount of true restful sleep may be greatly diminished. We need an average of six hours of sleep per night. Many studies show that patients sleeping less than six hours per night over many years have greatly increased medical problems and higher death rates.
  • There are two basic types of sleep apnea:
    • Obstructive sleep apnea
    • Central sleep apnea

Obstructive Sleep Apnea (OSA)

  • OSA is the more common type and occurs when airflow is blocked from the upper airway (nose, mouth, or throat). During this blockage, you become deprived of oxygen for seconds or minutes.
  • Over time, untreated sleep apnea may cause irreversible changes to some of the body systems, leading to the development of high blood pressure, hypertension in the lungs, diabetes, heart disease, heart attacks, strokes, weight gain, and even death.
  • Sleep apnea can be diagnosed with a sleep study.
  • A sleep study is a test in which various body signals are monitored while you sleep. The monitored signals include brainwave activity, muscle activity, respiratory effort, oxygen saturation, heart rhythm, and airflow.
  • Obstructive sleep apnea may be treated with several different methods.
    • CPAP (continuous positive airway pressure) is a machine worn like a mask to help maintain an open airway while sleeping.
    • The CPAP pressure settings are determined by performing a titration sleep study in which the pressure is changed during the study to minimize obstructive episodes.
    • A special machine called an auto-titrating CPAP can be used to determine the CPAP settings using an algorithm
    • CPAP is successful in treating OSA about 80% of the time.
    • Oral appliances may be used in mild to moderate cases of OSA.
    • Oral appliances are custom devices worn in the mouth while sleeping to slowly pull the jaw forward and open up the airway. The amount of pull is gradually increased over several weeks until the obstructive episodes are resolved.
    • Use of oral appliances may be limited by tooth grinding, TMJ disorders, or pain.
    • Oral appliances may also cause tooth shifting and alteration of your bite over many years.
    • Surgery may also be used to treat sleep apnea. The surgery may be complex and may require more than one procedure depending on the patient.
    • Surgery is usually reserved for patients that are unable to tolerate any other form of treatment.
    • In many situations, the obstruction may be caused by a combination of blockages at several different levels of the airway—the nose, the palate and tonsils, the lower throat (hypopharynx), and the base of the tongue.
    • Surgical interventions are directed at the sites of the obstruction and are often performed at different times.
    • The surgeries may include septoplasty, palate reconstruction, base of tongue resection, hyoid suspension, or genioglossus advancement.

Central Sleep Apnea (CSA)

  • CSA occurs when the brain fails to initiate breathing.
  • Central sleep apnea may have several different causes including disruptions of the neurologic control system for breathing and untreated congestive heart failure.
  • CSA may also be triggered by CPAP treatment if CPAP pressure is too high.
  • CSA may be treated with special types of ventilators.
  • If the CSA is associated with congestive heart failure, treatment of the heart failure may resolve the problem.
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