What is Sleep Apnea?
Sleep apnea is a condition where a person’s breathing pattern is interrupted frequently during sleep. This condition is referred to as Obstructive Sleep Apnea (OSA) and the interruptions during sleep can occur hundreds of times during the night. The underlying cause of the disruption is that, for a variety of reasons, there is an obstruction in the airway. This may be the result of the relaxation of the throat muscles, the tongue sliding backwards, a misaligned jawline, an enlarged tongue, excessive throat tissue, or if the brain fails to correctly signal the muscles that control a person’s breathing.
Depending on how often these disruptions occur, a person may have mild, moderate, or severe sleep apnea. When the body is deprived of a steady breathing pattern, the result can cause a decrease in a person’s oxygen blood levels. Some common symptoms of sleep apnea are snoring, waking up gasping for breath, and feeling sleep deprived during the daytime even after a full night of bed rest. Sleep apnea is a serious ailment that can contribute to heart failure.
Who is at Risk for Sleep Apnea?
While anyone can have a sleep apnea problem, there are some physical factors that increase a person’s risk of developing this ailment. Not everyone who has OSA is overweight, but being overweight increases the chances of having excess fat in the airways that can obstruct breathing. Certain health conditions that increase a person’s risk of developing OSA are diabetes and heart problems. Individuals with thick necklines, 17 inches or larger for males and 15 inches or larger for females, tend to have narrow airways which can limit a person’s breathing capacity. Age is another risk factor. The number of OSA patients tends to increase as people age.
Facial structure also affects a person’s airway. Jaw and chin problems can force the tongue to slide backwards toward the throat which will then block the airway during sleep. These problems can include an unusually small chin, a small lower or upper jaw, a large lower or upper jaw, a crooked lower jaw, or a misalignment that prevents the teeth from closing together.
How does a Non-Machine Sleep Apnea Treatment Work?
While the use of a Continuous Positive Airway Pressure (CPAP) machine works for the majority of OSA patients, there are situations, and individuals, who do not respond well to these machines. This is generally the case for individuals with jaw alignment problems due to the positioning of the face mask.
The ideal solution for OSA patients with jaw problems is Orthognathic surgery (OS), also called jaw surgery. This operation re-positions the jaw and aligns the teeth to function perfectly together. The operation also improves the patient’s chewing, talking, breathing, and sleeping abilities. OS also enhances the patient’s facial esthetics.
Because a patient’s teeth may also require alignment, OS is a joint procedure that may involve a dentist, an orthodontist, and a maxillofacial surgeon. If braces are required for alignment or spacing of the teeth, the braces will put on before the surgery to keep the teeth correctly positioned during the operation. The braces will be removed after the jaw has healed or the orthodontic corrections are completed.
Jaw Surgery Procedure
While OS is considered to be an outpatient operation, it is performed at a hospital. Because of post-operative care, the patient generally stays in the hospital for one or two nights before being discharged. Before the actual surgery, the patient is given a general anesthetic so that there will not be any pain during the procedure, and a nasal tube, rather than an oral tube, is used for breathing.
The surgery is done inside of the mouth so there will not be any external scarring. The surgeon will use special medical instruments to cut into the jawbone, or jaw bones if both of the upper and lower jawlines are involved, and then adjust the jawbone into the new, correct position. To secure the jawbone, bone plates, screws, or extra bone will be used to reinforce the new formation. The entire operation can be completed in one to two hours.
In the case where a patient needs chin surgery, called genioplasty, in addition to corrective lower jawline surgery, both procedures can typically be accomplished at the same time. Genioplasty involves a cut in the chin bone and then securely repositioning it.
Jaw healing can differ from patient to patient, but complete jawline healing typically requires 8 to 12 weeks. Orthodontic care may require 12 months or longer. The surgeon will instruct the patient in all post-operative care before being released from the hospital. Those instructions will include when to make follow up appointments, what dietary liquids and foods can be eaten, and when it is permissible to resume daily activities, including sports.
Dr. Majid Jamali, DMD, has been recognized as one of New York City’s top oral and maxillofacial surgeons by a panel of his peers. He is a dedicated surgeon who specializes in patient-first orthognathic reconstructive surgery. Dr. Jamali has enhanced the lives of his patients throughout the five boroughs and Westchester, with his demonstrated ability to correct facial jawline imperfections. He is a valued member of several professional associations that include, the American Association of Oral and Maxillofacial Surgeons, the American Dental Society of Anesthesiology, the American Dental Association, and the New York State Dental Association. To schedule a consultation with Dr. Jamali, individuals with orthognathic needs are encouraged to call his New York City office at 212-480-2777 or to fill out the form on the Contact Us page of this website.