Obstructive Sleep Apnea

What is Obstructive Sleep Apnea (OSA)?

Obstructive Sleep Apnea is when there is a partial or complete blockage of the throat and airway, which causes a person to stop breathing in their sleep. Obstructive Sleep Apnea in adults is often caused by a narrowing of the throat and face structures. OSA in adults may be accompanied by other health concerns such as high blood pressure, heart conditions, and obesity.

Dr Julia Crawford specialises in the surgical treatment of Obstructive Sleep Apnea or OSA. She undertook a six-month subspecialty fellowship in surgery for OSA to learn about assessing and implementing treatment and care for people with OSA who meet the criteria for surgical intervention.

What are the symptoms of OSA?

Pauses in breathing caused by Obstructive Sleep Apnea may vary between a few seconds, up to a minute or more. A person with Obstructive Sleep Apnea may feel like their sleep quality is poor, that they snore, toss or turn a lot in their sleep, or frequently wake during the night. If you have OSA, you may wake tired and also tire easily during the day. A bed partner or parent may also observe breathing pauses and report the severity of snoring and behaviour changes such as increased tiredness, irritability, and depression.

How is OSA diagnosed?

An Obstructive Sleep Apnea diagnosis is given after a Sleep Study is completed where sensors track sleep patterns, breathing, and oxygen levels. This can be done by either a formal Polysomogram in an overnight sleep study lab  or as a Home Sleep Study.   For a  sleep study to be performed, patients need to be reviewed by a Respiratory Physician or Sleep doctor. 

Dr Crawford is able to organise this referral for her patients, and she may also arrange for a referral for diagnostic imaging such as a CT Scan, or MRI to view the head and neck structures.

Non-surgical treatment for Obstructive Sleep Apnea (OSA)

Once you have been diagnosed with OSA, there is a range of treatment options to consider. Dr Julia Crawford works through the most up to date and suitable options available from non- invasive through to surgical options.

Every patient’s case is individual, and the treatment options may vary depending on what structures are most likely to be causing an obstruction during sleep such as a blocked nose. If examination shows that you may be best assisted with non-surgical treatment there are one of two devices that can help stabilise the body while sleeping to ensure waking up well-rested and ready for the day. These two treatment devices are the Mandibular Advancement Splint (MAS) and Continuous Positive Airway Pressure (CPAP).

Mandibular Advancement Splint (MAS)

Dr Julia Crawford may recommend a Mandibular Advancement Splint (MAS) based on an examination of your airway. A Mandibular Advancement Split works like a mouthguard that you wear while you sleep. The MAS changes the position of your jaw while you are wearing it, bringing your chin forward, making more space in the back of your throat for your tongue. It can also help to stabilise the soft palate and uvula. 

To have a MAS made, Dr Crawford may ask for your dentists details or refer you to a specialist dentist. A Mandibular Advancement Splint is not invasive and does not require any special care or treatment. Your self-evaluation of tiredness, surveys, and follow up testing such as a repeated Sleep Study will confirm if the MAS has improved your quality of sleep. 

Obstructive Sleep Apnea

Continuous Positive Airway Pressure (CPAP)

In some instances, Dr Crawford may refer you to a specialist Respiratory Physician or Sleep Doctor or refer you back to your Sleep Doctor for a trial of a Continuous Positive Airway Pressure (CPAP) or sleep apnea machine.  A CPAP device consists of a mask you wear over your nose and mouth while sleeping and a pump that delivers air. 

CPAP works to make sure your airway always stays open by creating a flow of air into your nose or mouth to prevent structural collapse. The airflow created by CPAP machines is gentle and does not affect your ability to breathe normally. Continuous Positive Airway Pressure is a common and often successful non-surgical and minimally invasive treatment for sleep apnea. Your self-evaluation of tiredness, surveys, and follow-up testing such as a repeated Sleep Study will confirm if CPAP has improved your sleep quality.

When is surgical treatment an option for Sleep Apnea (OSA)?

Some people’s symptoms do not significantly improve with MAS or CPAP as they may have other structural causes of Obstructive Sleep Apnea. In these cases, surgical intervention may be the best option. If you have utilised MAS or CPAP and have not achieved improved sleep quality, Dr Crawford can assess whether surgery is a suitable treatment option for you.

To arrange for a consultation, please arrange for a referral from your GP or Sleep Doctor and contact our team on 02 8319 9434.