Center for Sleep Disorders and Sleep Apnea
The Center for Sleep Disorders and Sleep Apnea at ENT Associates of Southern Indiana offers a comprehensive management program for patients with sleep disorders of all sorts. Our surgeons are board certified otolaryngologists and also are board eligible in Sleep Medicine, with completion of board certification expected by 2011. Our surgeons are experts in the diagnosis of sleep disorders as well as the medical and surgical management of these chronic and debilitating conditions. Let us help you sleep better.
What is Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA) is a potentially life-threatening condition that is more common than generally recognized. Over 20 million Americans suffer from OSA and don't even know it! An apnea is when breathing stops for 10 seconds or more while you are asleep. Coughing or choking sensations, which force you to wake up – or “get elbowed” by your sleeping partner – are common signs of OSA. These abrupt disturbances during sleep place significant strain on your heart and cardiovascular system. Snoring is often associated with OSA, although not everyone who snores has this condition. OSA prevents air from reaching the lungs even though your body continues its effort to breathe. This condition is associated with a higher risk for heart attacks and stroke.
How do I know if I am at risk for OSA?
This can be a difficult question to answer. Ultimately, you will need to be evaluated by one of our physicians to know for sure, but the Epworth Sleepiness Scale (ESS) can be used to quantify your potential risk of being an OSA patient.
The Epworth Sleepiness Scale is a set of questions that have been used to evaluate the restfulness of a patient. Though it is not a true test that can prove you have sleep apnea, it is certainly can suggest that you are more prone to fall asleep than others and should be evaluated by a physician. The questions are useful, assuming that you are sleeping regularly and are in your usual state of health.
For the following situations, answer with one of the following numbers:
0 - Would never doze
1 - Slight chance of dozing
2 - Moderate chance of dozing
3 - High chance of dozing
Situation Score
- Sitting and reading
- Watching television
- Sitting, inactive in a public place
- As a passenger in a car for an hour without a break
- Lying down to rest in the afternoon when circumstances permit
- Sitting and talking to someone
- Sitting quietly after a lunch without alcohol
- In a car, while stopped for a few minutes in traffic
Total score =
A score of 10 or more means that you may be at risk. Call our office today for an appointment.
I think I may have OSA. Now What?
Traditionally, sleep disorders were diagnosed and treated only by primary care physicians, ENT's, pulmonologists and neurologists. Recently, the dental profession has begun to recognize the role they can play in early detection and treatment of OSA. Modern technology makes it practical for dentists trained in dental sleep medicine and physicians trained in traditional sleep medicine to treat patients in close collaboration with one another. However, an accurate diagnosis can only be achieved through the efforts of properly trained practitioners. Two distinct test protocols are being used during the evaluation and treatment process.
Polysomnography (PSG)
This test records a variety of body functions during sleep. It is used both to diagnose sleep apnea and to determine its severity. It is conducted overnight in a hospital or clinic, where sensors attached to the body measure 12 or more parameters, including video monitoring of your sleep. Most medical insurance companies reimburse for a PSG.
Ambulatory or “at home”
This test records many of the same values of the PSG but is conducted in the privacy of your own home. Several ambulatory devices are available. The Watch-PAT100 is the only device that has exhaustive clinical research validating its accuracy. This compact device fits easily on a Velcro® armband with 2 finger sensors attached. You press a button and then go to sleep. The next morning the device is returned to the office and you may receive your results in a matter of minutes. The average cost of a Watch-PAT100 study is far less than a PSG.
Many physicians and dentists are incorporating this advanced technology into their practices because of its accuracy and ease of use. In most cases, you can walk out of the initial consultation with the device and test yourself that very same evening.
My Doctor says I have OSA now what?
Treatment Options:
CPAP - A CPAP is a medical device that delivers continuous positive air pressure through a facemask or nasal tube attached to a pump. Typically the unit is placed next to the bed and it operates on normal house current. It functions by keeping the upper airway unobstructed during sleep. Proper adjustment of the CPAP is vital to achieve maximum clinical benefits and minimal side-effects. Wearing a CPAP is a lifetime commitment and the mask (or tubes) must be in place whenever you sleep or nap.
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Oral Appliances Therapy (OAT) - OAT is often a viable alternative to CPAP therapy. A specially designed and adjusted oral appliance (OA) repositions the jaw and tongue during sleep. The OA expands the airway by moving the tongue and jaw forward, thus creating more room for air to flow. Dentists who are trained in dental sleep medicine are qualified to fabricate an OA. They can be highly effective for those who suffer from snoring and mild to moderate sleep apnea. A quiet and restful night’s sleep is important for the person who snores and the bed partner as well.
Surgical Procedures -
Several surgical procedures are available to address snoring and sleep apnea. As with all surgeries, there is always risk of post surgical complications, but surgery may be an alternative treatment of sleep apnea. In addition to the removal of adenoids and tonsils, other surgical options include UPPP (uvulopalatopharyngeoplasty), LAUP (laser-assisted uvulopalatoplasty), tongue reduction surgery, jaw reconstruction and tracheostomy.
