Approach to OSAS
Table of Contents
Obstructive Sleep Apnea Syndrome (OSAS) is a condition in which a person experiences repetitive upper airway obstruction leading to sleep fragmentation, oxygen desaturation, and stimulation of the cardiovascular system.
The treatment is planned according to the severity of symptoms and grade of OSAS which is calculated according to the Epworth Sleepiness Scale (ESS) and other factors.
Non-Surgical Treatment:
Conservative treatment is best for people with mild OSAS.
- Weight loss
- Avoid alcohol or sleeping pills etc
- Sleep in position with least snoring with help of pillows or support.
- Use nasal sprays or decongestants if you have nose or sinus issues.
Mechanical aids:
- C-PAP (Continuous Positive Airway Pressure)
When the muscles of your throat relax and the muscles collapse the airway causing difficulty in breathing in such conditions the machine pushes positive air through a mask causing relief from the OSAS and even reducing or resolving snore completely.
- Bi-PAP (Bi-Level Positive Airway pressure)
It’s also a Positive airway machine like C-PAP but unlike C-PAP it provides steam at less pressure so the patient is able to exhale out, which is a problem with C-PAP machines.
- ASV Machine (Adapto Servo Ventilation Machine)
It adapts and adjusts the air according to your breathing.
- VPAP (Variable Positive Airway Pressure)
It provides variable positive pressure according to the breathing requirement of the patient.
Mechanical ventilation seems difficult to manage but they’re quite easy with masks and airways.
Mandibular Advancement Devices:
These are dental implants that work on advancing the jaw forward to avoid the tongue from causing throat obstruction.
Surgical Treatment:
The last treatment option of OSAS is Surgery. There are various proposed surgeries to reduce the obstruction according to the level and severity of obstruction.
- Septoplasty or Functional Endoscopic Sinus Surgery (FESS): The nose is the foremost reason of obstruction so treating nasal causes is the first step in reducing nasal obstruction.
- UvuloPalatoPharyngoplasty (UPPP): it reduces the bulk of the soft palate, anterior pillars, or uvula causing obstruction and sleep apnea. It works on increasing the space at the back of the throat.
- Tonsillectomy: at times the enlarged tonsils also obstruct the airway causing OSAS.
- Radiofrequency Ablation: It reduces the soft tissue bulk of the soft palate and causes stiffness of the palate. It reduces obstruction and snoring.
- Hypoglossal Nerve Stimulator: the stimulator is implanted in between the rib. At night it could be activated by a remote & it continuously sends impulses to the tongue so that it doesn’t fall back and block the airway.
There are many approved and non-approved treatment methods for OSAS. These are the most common treatment modalities of Sleep Apnea.
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