Obstructive Sleep Apnea

It can be frustrating to wake up after a long night’s sleep feeling unrested. Obstructive sleep apnea happens if your airway is partially or completely blocked (obstructed) when you sleep. Left untreated, OSA can lead to complications. It’s important to see your provider if you snore and:

• Are really tired when you wake up.
• Are older than 50.
• Carry more weight than is healthy for you.
• Have high blood pressure, atrial fibrillation or coronary artery disease.

At your appointment, we’ll have you fill out a questionnaire to see if you’re at risk for obstructive sleep apnea. Then you’ll meet with a provider who’ll answer your questions and listen to your concerns. They’ll also review your health history and do a physical exam. Based on all of this information, they may recommend that you do a sleep study.

Sleep studies for OSA

A sleep study can help us find out if you have sleep apnea. If the idea of being watched while you sleep makes you uncomfortable, know that your sleep study will be done by compassionate professionals whose goal is to help you get the rest you deserve (and your body craves).

Depending on how bad your symptoms are and your insurance coverage, we’ll recommend either a sleep study at our clinic or one you can do at home.

• Overnight sleep study (polysomnogram test):You’ll spend the night in a comfortable, private room. While you sleep, Cleveland Clinic sleep specialists will measure your breathing patterns, brain activity and eye movements.
• Home Sleep Apnea Test (HSAT): We’ll give you a sleep monitoring device and instructions on how to use it. You’ll use the device as you sleep, just for one night. While you sleep in the comfort of your home, the device records any breathing disturbances.

After your sleep study, our providers will go over the results with you and tell you if you have obstructive sleep apnea.

Successfully treating obstructive sleep apnea can reduce your chance of developing heart disease, high blood pressure, stroke and cognitive disorders.

Once we know for sure that you have obstructive sleep apnea, our specialists will go over your treatment plan with you. We offer some treatments that don’t require surgery and some that do.

CPAP machine

We may first recommend a continuous positive airway pressure (CPAP) machine. This machine keeps your airway open while you sleep by sending a constant stream of pressurized air through your nose and mouth.

Oral appliance

If a CPAP machine doesn’t work for you, our providers may prescribe an oral appliance. Like an orthodontic retainer, the appliance fits over your teeth and supports your jaw to keep your airway open.

Our dentists who are board certified in dental sleep medicine, will customize an appliance for you. This option typically is best if you have mild to moderate obstructive sleep apnea.

Surgery

If a CPAP machine or oral appliance doesn’t help, your specialist may recommend surgery.

Before your procedure, we’ll do a sleep endoscopy. You’ll be sedated to mimic sleep, so you’ll be relaxed and comfortable. Then an otolaryngology surgeon will use a scope to pinpoint the specific areas of obstruction in your airway. This will help them decide which type of surgery and treatment is right for you. Your provider might recommend:

• Uvulopalatopharyngoplasty (UPPP): Your provider removes and rearranges tissue at the back of your throat to reduce the obstruction of your airway.
• Tonsillectomy: Your provider removes your tonsils, located in the back of your throat.
• Nasal surgery: Your provider corrects any nasal obstructions, including a deviated septum.
• Inspire® upper airway stimulation: Your provider implants a device that looks like a heart pacemaker under your skin with just two small incisions (cuts). You’ll be under general anesthesia for this same-day surgery, which means no hospital stay. After the procedure, you’ll work with your provider to fine-tune the device. Then, when you’re ready for bed, you use a remote to click the device on, and Inspire will open your airway so you can breathe easily. After treatment, we provide ongoing care to make sure your symptoms have improved, and we’ll adjust the device if necessary.
• Palatal z-plasty: Your provider raises a flap of tissue from the back of your throat and attaches it to your soft palate. The flap blocks some of the air that used to escape from your nose, causing you to snore.
• Tongue reduction surgery: Your provider removes excess tongue tissue that is blocking your airway.
• Hyoid suspension: Your provider repositions your hyoid bone (a horseshoe-shaped bone at the front of your neck) and nearby muscles to open up your airway.
• Maxillomandibular advancement or expansion surgery (jaw repositioning): Your provider moves your jaw forward to open up space behind your tongue.

Taking the Next Step

A good night’s rest helps restore your body and your mind. So if you wake up unrested, it’s time to get help. You don’t have to be tired all the time. And you don’t have to worry that your snoring and tossing and turning is keeping your partner from getting some shut-eye, too. There’s treatment available for your obstructive sleep apnea. Talking with a healthcare provider can help you get the treatment you need to get the rest you deserve.