Sleep Apnea

Sleep Apnea Syndrome is defined as a break in breathing or a reduction in oxygen saturation of more than 4% for at least 10 seconds during sleep. The definition of a break in breathing as an illness means at least five breathing breaks per hour during sleep. People considered at risk for this are: men, those overweight, adults, smokers, those with short and wide neck structure. Similarly, Retrognatia (abnormal posterior mandibular positioning) also increases the risk.

The syndrome involves snoring, non-refreshing sleep, dozing during the day, headaches, mood swings and learning and concentration difficulties. This syndrome can also cause many wider complications such as strokes (CVA), abnormal cardiac activity, convulsions and taking epilepsy sufferers out of their drugs balance, all because of a drop in blood perfusion to critical tissues.

Diagnosis of the problem is obtained through a combination of clinical findings and a sleep lab examination. The most efficient treatment for Sleep Apnea Syndrome is non-invasive and based on the use of a breathing machine working on CPAP (Continuous Positive Airway Pressure). Despite the device’s effectiveness, patients are not keen about using it and so we have to employ alternative methods.

There has recently been an increase in treating Obstructive Sleep Apnea patients through orthognathic surgery (corrective jaw surgery), in which the upper and lower jaws are brought forward. The aim of the operation is to widen the air passages, from the top of the soft palate in the upper part of the windpipe to the edge of the hyoid bone in the lower part. This operation has a 90% success rate in the short term. Whether success is maintained in the long term depends – among other factors – on the stability of the dental occlusion completed during preliminary orthodontic treatment. There are specific indications for this operation, determined through a physical examination, lateral cephalometric x-rays and a CT of the jaws.

You can undergo a clinical examination and clarification in the Maxillofacial Surgery Clinic to ascertain the severity of the Sleep Apnea and receive an explanation of the different treatment options. The test is based on a protocol to assess obstruction levels in the air passages and – with an Otolaryngologist (ENT specialist) – to rule out or treat obstructions stemming from problems in the nose, uvula or soft palate. At Shaare Zedek you can also have an examination of your air passages under sedation using Drug Induced Sleep Endoscopy (DISE). You can receive an explanation of this method at the clinic. In advance of the examination you should have an updated sleep lab test, your medical background (from your family doctor, including a list of your regular drugs and blood tests), and updated blood count and biochemistry. Please bring a guarantee from your Kupat Holim as well.