Dr. Brazinsky shares knowledge of a few common Treatments for sleep apnea.
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Sleep Apnea-Some treatments Right now there are series of oral appliances that dentistry are using. There is one that they use to use where it was kind of like a suction cup on your tongue and would pull your tongue forward, so that it would open up the airway. The thing that’s being used now is silicone, looks kind of like what your kids retainer would look like and it pulls your jaw forward. So, it actually pulls your jaw forward and its done with a spring and they slowly pull your jaw forward enough, so that your apnea is resolved because they pulled it forward. What I have not seen as long term follow up in terms of the people start to get jaw pain after a year, so doing the short term, that’s not been a problem. And then the other treatment for sleep apnea, two other things. Simple as thing as positional therapy. Some wacky people, their apneas are only when they land their back and when you look at their sleep study, when they’re on their back, they stop breathing 30 or 40 or 50 times an hour and when they launch to their side, they don’t stop breathing or they only stop breathing a few times an a hour. If that’s the case, you can fix them with positional therapy. This is a very sophisticated thing we do. you haven’t put some Velcro on the back of their t-shirt and couple of tennis balls on the Velcro and every time they roll on their back in their sleep, it’s uncomfortable, so they will off a bit. Sophisticated medicine at its best works really great. You can also do it with a wedge pillow, a really deeply wedge pillow. The problem with that is it doesn’t allow you to roll back and forth and if you’re like me, I would roll over the wedge or I go off the bed, but with the tennis balls, people just kind of fix it bed and find a comfortable place. And then the surgery. In the old days, the surgery was a horrible surgery. They would put a hole in your trachea, completely bypassing the airways, 100%. There is no apnea when you have a hole in your trachea. But not something people want to do as a surgery, and so what they’ve come up now with is a surgery called a UPPP, Uvulopalatopharyngoplasty. And what they do is they cut your Uvulo which is that thing hanging at the back of your throat. They take out your tonsils, the tonsil beds, the adenoids and then they make two incisions in your palate. And when those heal, they pull your palate which is the roof or of your mouth, up and it opens up the back of your airway and when you look in there all of a sudden you can see things that you couldn’t see before. And now, what they add to that in a lot of people is a base of tongue reduction. So if the person has a real thick base of the tongue that’s obstructing, they actually cut down some of the muscle at the base of the tongue. It doesn’t work in everybody. Even when you look at the patient and see all the stuff and say gosh, that should help. It doesn’t always and the reason it does because a lot of times the obstruction is down lower in the airway from the muscles collapsing, nothing to do with the upper airway disease and we don’t do people with severe disease. We only do people with mild disease and we always tell them surgery is not absolutely not a 100% going to fix you and it may not fix you at all and you may still need the CPAP, but for those people who are CPAP intolerant, it’s an option we give them.
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