Center of Excellence - Snoring and Sleep Apnea

It has been said that “Snoring is the disease that only the unafflicted complain”. Although many would say that snoring is only a social nuisance, sleep medicine specialists understand that snoring is probably the most common symptom of a potentially lethal condition known as obstructive sleep apnea (OSA).

Snoring and mild obstructive sleep apnea is often treated with an office procedure with a high rate of success. Our doctors are trained in the use of Coblation therapy of the palate and the nasal tissues. Also available is the Pillar Implant System where in the office, under local anesthesia, implants are gently place in the palate. These FDA-approved fibrous implants stiffen the palate, reducing or eliminating snoring or mild OSA.

Obstructive sleep apnea and hypopnea syndrome (OSAHS) is a common disorder effecting 3-5% of the general population. The incidence increases with age with 25% of men and 15% of women effected after age 65. OSAHS occurs when some sort of blockage occurs within the airway in variable locations between the tip of the nose to the entry into the lungs. This can be due to a wide variety of problems including a deviated nasal septum, nasal polyps, enlarged tonsils or adenoids, redundant palatal tissue, or collapse of the tongue base.

OSAHS causes a wide variety of symptoms including snoring, excessive daytime sleepiness, morning headaches, chronic fatigue, impotence, and obesity. If untreated, moderate to severe OSAHS can lead to poorly controlled hypertension, stroke, heart attacks, and increased risk of motor vehicle accidents. The diagnosis of OBAHS is confirmed on a polysomnogram (sleep study) that is ordered if OSAHS is suspected.

Dr. Smith is board eligible in sleep medicine and is a member of the American Board of Sleep Medicine. We receive many outside referrals from other physicians to read sleep studies and diagnosis and manage their patients with sleep apnea. Utilizing video endoscopy to study the air passages and polysomnograms (sleep studies) to evaluate the patient’s night-time sleep, our doctors are uniquely qualified to diagnosis and treat sleep disorders.

In moderate or severe OSAHS, the first line of treatment recommended is usually a device known as nasal CPAP (Continuous Positive Airway Pressure). CPAP, usually delivered through the patient’s nose and or mouth while they sleep, creates an internal air splint that keeps the airway open and allows the patient easy access to needed air. One of the keys to tolerating CPAP is an excellent pressure adjusting and fitting session. This is usually done in the form of a titration (adjusting the pressure levels) sleep study. At the Institute, we work with area sleep labs to ensure our patients receive careful and complete titrations with custom fittings of their CPAP units.

Some patients come to us unable to tolerate CPAP. Many times we find that patients fail initial nasal CPAP because of chronic nasal obstruction. Often patients treated in the Institute for this obstruction, sometimes needing surgical correction of the nose or sinuses, can often become successful CPAP users.

Services we Provide:

• Overnight sleep screenings (nocturnal pulse oxymetry)
  
• Sleep studies (polysomnograms) with physician interpretation
  
• Nasal CPAP and BIPAP
  
• Video endoscopy of air passages (in office)
  
• CT scan of sinus passages (in office)
  
• Coblation treatment of palate and nasal tissue
  
• Palatal implants (Pillar Procedure System)
  
• Nasal surgery to relieved nasal obstruction
  
• Advanced palatal and tongue procedures