We are treating the patients who have been diagnosed with Obstructive Sleep Apnea ( OSA). The first choice of treatment is CPAP machine, but 90% of people could not tolerate it. We are treating the patients who are CPAP Intolerant with the alternative choice of treatment- FDA approved custom made Oral Aplliance. If the patient could not tolerate, refused CPAP or is claustrophobic, we can fabricate the oral appliance.OBSTRUCTIVE SLEEP APNEA
Obstructive sleep apnea is a condition in which the flow of air pauses or decreases during breathing while you are asleep because the airway has become narrowed, blocked, or floppy. A pause in breathing is called an apnea episode. A decrease in airflow during breathing is called a hypopnea episode. Almost everyone has brief apnea episodes while they sleep.
Normally, the upper throat still remains open enough during sleep to let air pass by. However, some people have a narrower throat area. When the muscles in their upper throat relax during sleep, their breathing can stop for a period of time (often more than 10 seconds). This is called apnea.
The snoring in people with obstructive sleep apnea is caused by the air trying to squeeze through the narrowed or blocked airway. However, everyone who snores does not have sleep apnea.
Sleeping on the back also increases sleep apnea episodes.TREATMENT
The goal is to keep the airway open so that breathing does not stop during sleep.
The following lifestyle changes may relieve symptoms of sleep apnea in some people:
- Avoiding alcohol or sedatives at bedtime, which can make symptoms worse
- Avoiding sleeping on the back may help with mild sleep apnea
- Losing weight may decrease the number of apnea spells during the night
Continuous positive airway pressure (CPAP) is now the first treatment for obstructive sleep apnea in most people. CPAP is delivered by a machine with a tight-fitting face mask.
Many patients have a hard time sleeping with CPAP therapy. Good follow-up and support from a sleep center can often help overcome any problems in using CPAP. For information on this treatment, see: CPAP.
Some patients may need dental devices inserted into the mouth at night to keep the jaw forward.
Surgery may be an option in some cases. This may involve:
- Uvulopalatopharyngoplasty (UPPP) -- to remove excess tissue at the back of the throat. This surgery has not been proven to completely clear up sleep apnea. Long-term side effects are also possible.
- More invasive surgeries -- to correct problems with the face structures in rare cases when patients have severe sleep apnea and treatment has not helped
- Tracheostomy -- to create an opening in the windpipe to bypass the blocked airway if there are physical problems (rarely done)
Surgery to remove the tonsils and adenoids often cures the condition in children. It does not seem to help most adults.
Downtown Medical Services
81 Willoughby Street, 4th floor
Brooklyn, NY 11201