SLEEP APNEA
SLEEP APNEA DEPARTMENT
The Sleep Apnea Department is dedicated to the specialized treatment of sleeprelated breathing disorders through orthognathic surgery and mandibular advancement devices. We offer a personalized approach designed for patients with obstructive sleep apnea syndrome (OSAS) as an alternative to CPAP (Continuous Positive Airway Pressure).
WHAT IS SLEEP APNEA?
- 30% of the adult population suffers from undiagnosed sleep apnea
- 95% success rate with orthognathic surgery for severe OSA
OSA is a chronic condition characterized by repeated episodes of partial or total collapse of the upper airway during sleep, leading to breathing pauses, oxygen desaturation, and frequent micro-awakenings.
The spectrum of symptoms can range from snoring of varying intensities to sleep apnea, which is classified as mild, moderate, or severe. Although apnea may seem “harmless,” it is a condition with serious cardiovascular, metabolic, and neurological consequences when left untreated—including hypertension, atrial fibrillation, type 2 diabetes, and an increased risk of stroke.
The anatomy of the face and upper airways plays a decisive role in predisposition to the condition. In this regard, surgical intervention on facial structures represents the most definitive form of treatment.
OSAS
SIGNS AND SYMPTOMS OF OSAS:
- Recurrent, severe, or irregular snoring;
- Observed breathing pauses;
- Excessive daytime sleepiness and difficulty concentrating;
- Hypertension that is difficult to control;
- Non-restorative sleep and frequent awakenings;
- Morning headaches and irritability.
THE FACE AND RESPIRATORY DISORDERS:
The anatomy of the jaws determines airway patency.
The shape, size, and position of the facial structures (upper jaw, lower jaw, palate, and tongue) directly determine the space available for airflow during sleep.
THE TREATMENT
ORTHOGNATHIC SURGERY
The most definitive approach for moderate-to-severe OSA or any severity provided or associated with dentofacial deformities.
- Maxillomandibular Advancement (MMA): increases pharyngeal volume in all three spatial dimensions. It is the procedure with the highest success rate in non-CPAP treatment of OSA, allowing for the resolution of the anatomical problems present in virtually all cases of this disorder.
- Surgery First: In cases of OSA, when the dental occlusion permits it, we use a protocol without presurgical orthodontics, yielding faster results in resolving apnea.
- SARPE: In cases of maxillary hypoplasia with nasomaxillary constriction, skeletal palatal expansion is the first step toward restoring normal airway anatomy, thereby improving nasal breathing.
- Simultaneous correction of aesthetic and functional deformities: Orthognathic surgery not only restores normal breathing but also improves facial aesthetics, achieving a more youthful appearance and providing a more harmonious projection of the jaws.
OSA resolution rate exceeding 85–95% in selected cases.
MANDIBULAR ADVANCEMENT DEVICE
A highly effective, non-surgical alternative for mild to moderate OSA in patients who are not candidates for other treatments or who seek an alternative to CPAP.
- MAD (Mandibular Advancement Device): a state-of-the-art, custom-made, titratable device offering high precision and superior comfort;
- Indicated for mild to moderate OSA in patients who are not candidates for other treatments or who prefer an alternative treatment;
- Remote monitoring protocol that allows for achieving the optimal advancement within 1–2 months;
- Treatment efficacy monitoring via a sleep study at 6 months.
MYOFUNCTIONAL THERAPY
Adjuvant treatment for orthognathic surgery and MAD to correct tongue posture and strengthen the tongue muscles.
What is it?
- Correction of tongue posture at rest and during swallowing;
- Strengthening of the oropharyngeal muscles—reduces airway collapse during sleep;
- Nasal breathing and lip-sealing exercises;
- Complements the results of orthognathic surgery and MAD;
- Reduces recurrence over time by correcting dysfunctional muscle patterns.
OUR PROTOCOL
We provide a comprehensive treatment plan in one or two appointments. In this department, we handle the entire process, so you don’t have to wait months or years to get a diagnosis or “go from doctor to doctor” to find a solution to your problem.
IN JUST ONE APPOINTMENT
If you have already undergone a sleep study, the first appointment will include a complete medical history and an evaluation that involves facial analysis with photographic documentation and a dental examination. This evaluation is supplemented by a three-dimensional analysis of the airways, enabling the development of a personalized treatment plan based on all the clinical information.
IN JUST TWO APPOINTMENTS
If you do not yet have a previous sleep study, during the first appointment we will take a complete medical history and perform an evaluation that includes a facial analysis with photographic documentation, a dental evaluation, and a threedimensional analysis of the airways.
Next, a sleep study is scheduled at our partner laboratory, and a second appointment is set for approximately one month later.
At the next appointment, the results of the sleep study (analyzed by a board-certified pulmonologist) are presented, and an individualized treatment plan is then developed based on all the clinical information.
- Rapid diagnosis and treatment plan;
- We handle the entire process, eliminating the need to schedule multiple appointments or tests;
- Level III or II sleep study conducted at home, scheduled through a partner laboratory;
- Three-dimensional analysis of the airways using CBCT to identify the area of greatest airway obstruction;
- Personalized treatment plan based on anatomical phenotype.
CLINICAL CASE
Nikita reached out to our team in hopes of finding an effective solution for Obstructive Sleep Apnea Syndrome (OSAS). Until the procedure, he relied on using a CPAP (Continuous Positive Airway Pressure) device at night to keep his airway open and improve his breathing while sleeping.
TREATMENT: ORTHOGNATHIC SURGERY
A treatment plan was developed that included bimaxillary orthognathic surgery and mentoplasty.
The results obtained were highly significant, both from a functional and aesthetic standpoint. Functionally, there was a substantial improvement in airway patency, with resolution of the obstructive sleep apnea. Aesthetically, the procedures resulted in a marked improvement in facial harmony, contributing to a more balanced profile and an overall enhancement of the face.
This case is yet another example of the positive impact that appropriate surgical treatment can have on our patients’ sleep quality, health, and, consequently, quality of life.
IPFACE TEAM ASSIGNED TO THE DEPARTMENT
DEPARTMENT COORDINATOR
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