Sleep Apnea Specialist

What is sleep apnea?

Sleep apnea is a disorder where your breathing stops during sleep. A potentially serious condition, sleep apnea can leave you feeling tired in the morning, even after a full night's sleep. Left untreated, sleep apnea can lead to health problems, such as high blood pressure, heart disease, depression, dementia, and even death.

What are the types of sleep apnea?

There are 3 main types of sleep apnea:

• Obstructive sleep apnea: a common form of sleep apnea that occurs as a result of the blockage in the upper airways, including the nose, the mouth and the back of the throat including the base of the tongue and the soft tissues of the neck.
• Central sleep apnea: a form of sleep apnea caused when your brain fails to send proper signals to the muscles that regulate breathing
• Complex sleep apnea syndrome: occurs when you have both central sleep apnea and obstructive sleep apnea
  
  

Men and older adults are at the greatest risk for obstructive sleep apnea. More than 85% of people with obstructive sleep apnea have never been diagnosed.

What are the symptoms of sleep apnea?

The most common sign of sleep apnea is loud snoring. Other typical signs and symptoms include:

• Periods of time where you stop breathing while sleeping that another person notices
• Gasping for air while sleeping
• Waking up with a dry mouth or a headache
• Insomnia
• Feeling extremely sleepy during the day
• Difficulty focusing or paying attention during the day
• Irritability
  
  

The symptoms of central sleep apnea and obstructive sleep apnea overlap. Dr. Caballero at Advanced Sinus and Allergy Center can determine whether you have sleep apnea and which form you might have.

How is sleep apnea diagnosed?

Dr. Caballero begins by taking a detailed medical history and conducts a physical exam. She will perform a flexible nasopharyngoscopy to examine all the areas of your upper airway that may be causing or contributing to the obstruction. She may recommend a polysomnogram, also known as a sleep study to confirm the diagnosis and determine the severity of your sleep apnea.  This is considered the gold standard diagnostic test for obstructive sleep apnea. Typically, the test involves being monitored overnight at a sleep lab, but you may also be monitored at home.

How is sleep apnea treated?

There are several treatment options depending on the type and severity of your sleep apnea. In all cases, weight loss is of crucial importance. The more weight you lose, the less severe your sleep apnea will become. Dr. Caballero refers all patients with obstructive sleep apnea to a nutritional and exercise program as part of the treatment plan.

The gold standard for the management of obstructive sleep apnea is continuous positive airway pressure (CPAP). When used appropriately, CPAP can restore your AHI to normal. However, some patients are unable to tolerate CPAP due to claustrophobia, air leaking around the mask, gastric bloating and becoming tangled in the hose.

In those cases, a combination of surgical procedures to address the sites of obstruction such as a septoplasty if you have a deviated septum, a Uvulopalatopharyngoplasty (UPPP) if you have large tonsils and a long weak palate with a pendulous uvula and coblation of the base of your tongue if you have a prominent tongue base, among others. These surgeries can be helpful, especially if followed by using a dental appliance, a device similar to a mouth guard that brings the jaw forward during sleep to keep the back of the throat open.

A newer treatment modality called Inspire®, was approved by the FDA in 2014. The device is also known as the Hypoglossal Nerve Stimulator. The device consists of 3 parts: a sensing lead which gets placed over the chest, a neurostimulator piece that is placed under the clavicle and a stimulation lead that runs from the stimulator to the hypoglossal nerve under the tongue.

Inspire® works similarly to a pacemaker, detecting apnea episodes and sending an electrical signal to activate the hypoglossal nerve. Activation of the nerve causes the tongue to contract and move forward, which opens the airway.  When implanted in the correct surgical candidate, it can decrease the severity of the sleep apnea from an AHI of 46 to 4.6, which means going from severe apnea (AHI > 30) to normal (AHI < 5).

If you’re ready to explore your options for a good night’s sleep and to Breathe Better and Enjoy Life Again, call or book a consultation online today with Advanced Sinus and Allergy Center.

Please remember that 

Dr. Caballero is a Sleep Surgeon not a Sleep Doctor. She can diagnose and surgically treat sleep apnea but she does not routinely manage CPAP care. For that you will have to see a Sleep Doctor.