Obstructive sleep apnoea syndrome (OSAS) is a disease that consists of repeated episodes of respiratory pauses during sleep, apnoea, usually longer than 10 seconds. The main cause of obstruction is the collapse of the upper airway walls.
Obstructive sleep apnoea syndrome affects just over 25% of the population, with very negative impacts on the quality of life of those who suffer from it. Not only disturbing rest during the night, which in extreme cases can even lead to death, but also daily activity, which is accompanied by drowsiness and chronic fatigue. Even more serious, sleep apnoea causes a reduction in oxygen carried by the blood, leading to high blood pressure, cardiovascular disease, metabolic and hormonal disorders and an increased risk of accidents.
The presence of two of the following symptoms, in the absence of other causes, may be an indicator of Obstructive Sleep Apnoea Syndrome:
- Irregular, loud and interrupted snoring (accompanied by sleep apnoea)
- Daytime fatigue
- Chronic fatigue
The diagnosis of sleep apnoea is made by a polysomnography test, which monitors several variables during sleep, using special devices. Being a multidisciplinary disease, this examination is performed by the Neurophysiology team’s maxillofacial surgeons who coordinate the entire team of specialists, usually pulmonologists, neurophysiologists and otorhinolaryngologists.
Four levels of performance are usually involved in the treatment of Obstructive Sleep Apnoea Syndrome:
- Weight loss
- Mandibular advancement splints
- Orthognathic surgery
One of the treatments that has been recommended for many years is CPAP, acronym for "Continuous Positive Airway Pressure", a nocturnal device consisting of a mask connected to a machine, which blows in compressed air and prevents the collapse of the patient's airways. Most patients who have suffered from sleep apnoea describe CPAP as a "hellish" machine. Noise and mask intolerance, nasal congestion and mucosal irritation make up to 70% of patients want to abandon CPAP and find a much more comfortable and effective alternative.
On the other hand, mandibular advancement dental splints are a diagnostic element as well as a temporary solution for mild cases of sleep apnoea. According to recent studies, prolonged use of this brace can cause changes in the way of biting and deterioration of the temporomandibular joint.
Thanks to the continuous dedication and intense research of Obstructive Sleep Apnoea Syndrome, nowadays, the specialists of the Maxillofacial Institute, together with other groups at an international level, have scientifically demonstrated that orthognathic surgery is the definitive solution to this serious problem in patients with dentofacial deformities.