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Sleep Conditions & Treatments in Savannah, GA

Coastal Ear, Nose & Throat specializes in sleep treatment, such as sleep apnea and snoring. We partner with companies such as Watermark, Encore and Siesta Medical to diagnose and treat these conditions. Call us at (912) 355-2335 for more information or to make an appointment with Dr. Oliver

Conditions and Services

Sleep apnea is a disorder in which a person’s breathing stops and starts and they can’t get proper sleep. It is a potentially serious because sudden drops in the levels of oxygen in your blood can increase blood pressure and strain your cardiovascular system. It can also increase the risk of stroke. Sleep apnea can also cause daytime fatigue and as well as disturbing those around you causing them to become sleep-deprived.

Types of Sleep Apnea

  • Obstructive sleep apnea – a common condition that occurs when throat muscles relax.
  • Central sleep apnea – occurs when muscles that control breathing do not receive the proper signals from the brain.
  • Complex sleep apnea – is a combination of both obstructive and central sleep apnea.

Obstructive Sleep Apnea Treatments

When sleep apnea is suspected a physician can provide the appropriate tests and recommendations to treat the condition. Treatments include:

MILD CASES

Lifestyle changes – For mild cases of sleep apnea, changes that include weight loss and the cessation of smoking can provide significant benefit.

MODERATE TO SEVERE CASES

CPAP (Continuous positive airway pressure) – Utilizes a machine that supplies air pressure through a mask that is placed over your nose while you sleep. This opens up upper airway passages to eliminate snoring and the accompanying stopping and starting of breathing that interrupts sleep.

BiPAP – This is similar to CPAP but differs in that it uses a continuous positive airway pressure device to automatically adjust the inhaling and exhaling pressure while you are sleeping. Like CPAP, wearing a mask for sleeping is required.

Oral appliances – These are designed to keep your throat open by moving your jaw forward to alleviate snoring and some apnea.

Surgery – Surgery can be performed to remove tissue that vibrates causing snoring or to remove blockages that impede breathing. Procedures can include:

  • Uvulopalatopharyngoplasty (UPPP). This procedure removes tissue from the rear of the mouth and the top of the throat. Tonsils and adenoids can also be removed during this procedure. This surgery may be successful in stopping the structures in the throat from vibrating eliminating snoring. However, tissue farther down your throat may still block your air passage.
  • Maxillomandibular advancement. This procedure includes removing upper and lower parts of the jaw to enlarge the space behind the tongue and soft palate moving the jaw forward. This complex procedure can reduce the possibility of an obstruction and may require both an oral surgeon as well as an orthodontist.
  • Tracheostomy. You may need this form of surgery if other treatments have failed and if you have severe sleep apnea. In this procedure, an opening is made in your neck and a tube is inserted through which you breathe. The opening is kept covered during the day but uncovered at night to permit breathing without obstruction.
  • Tonsillectomies and adenoidectomies. These procedures can be performed to remove enlarged tonsils or adenoids and may reduce the snoring that contributes to or causes sleep apnea.
  • Nasal surgery. This surgery is used to remove polyps or to straighten nasal passages (deviated septum). It can help to improve breathing and contribute to the treatment of sleep apnea.

Central and Complex Sleep Apnea Treatments

  • Existing medical conditions. Better management of existing medical conditions that include heart or neuromuscular disorders.
  • Supplemental oxygen. Supplemental oxygen in various forms as well as different devices to deliver it is available to deliver additional oxygen to your lungs and may help with sleep apnea.
  • Continuous positive airway pressure (CPAP). This is the same approach used in obstructive sleep apnea and involves the use of a mask to deliver pressurized air to keep your airway from collapsing.
  • Bi-level positive airway pressure (BiPAP). This approach regulates the air pressure between breathing and exhaling and is like that used in obstructive sleep apnea.
  • Adaptive servo-ventilation (ASV). This more recently approved airflow device learns your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern to prevent pauses in breathing. ASV may be more successful than CPAP in treating central sleep apnea, however more study is needed.

Sleep apnea is a disorder in which a person’s breathing stops and starts. This can lead to increased blood pressure and strain your cardiovascular system. It can also increase the risk of stroke and fatigue. For serious cases of obstructive sleep apnea, surgery may be necessary. There are two forms of minimally invasive surgery to treat sleep apnea:

Hyoid Suspension

This procedure involves securing the very flexible hyoid bone by connecting it to the thyroid cartilage (adam’s apple) and moving around the tongue muscles and tissues surrounding it.  The procedure is done under general anesthesia and Dr. Oliver will make a small incision in the upper neck area, usually an easily concealable spot, detaches some muscle and tissue and inserts a device to help secure the hyoid bone.

Multi-Level Tongue Suspension

This procedure involves stabilizing the tongue using a suture loop within the tongue, anchored to a screw without having to create penetrations through the mucus layer of the tongue.

The Siesta Medical Encore Suspension System

The company we’re partnered with is Siesta Medical. Their Encore device is one of two approved tongue suspension systems in the United States. Encore is equipped to do either procedure, or both if necessary.

Recovery from Sleep Apnea Surgery

Recovery – Many patients need 1-2 days of supervised recovery. 
Pain Management – There is some pain associated with this surgery and so you will be prescribed medication. Pain goes away usually two weeks following the surgery.
Ear, Jaw and Throat Symptoms – You may notice discomfort or swelling in the ear, throat and jaw.
Sleeping Habits – Your sleeping habits may need to change after this surgery for a few days. This includes elevating your head while sleeping.
Nausea and constipation – It’s very common to experience these symptoms after the surgery

According to The American Academy of Otolaryngology, about 45 percent of adults snore occasionally. Though snoring can affect anyone, it is most common in men and people who are overweight. Snoring once and awhile is perfectly normal, but snoring on a regular basis can disrupt both your sleep patterns and the sleep patterns of those around you.

Snoring is caused when air cannot flow through the back of the throat and the nose freely. The obstruction causes the noisy, vibrating sounds of snoring. The air flow can be obstructed for a variety of reasons, such as:

The Anatomy of your Mouth – Anatomical reasons, such as a low palate, poor muscle tone in the throat, poor muscle tone in the tongue and narrow airways can cause snoring.

Obstruction of Nasal Airways – About 20 percent of people who snore only snore during allergy seasons or when they have a cold or sinus infection. Having a deviated septum, swollen turbinates or nasal polyps can also cause the nasal airway to have an obstruction.

Alcohol Consumption – Drinking alcohol before sleep can relax your throat muscles and decrease your defenses against airway obstruction.

Obstructive Sleep Apnea – OSA is the most serious cause of snoring. Obstructive Sleep Apnea is when airway obstruction during sleep results in short periods of time where the snorer stops breathing. OSA is often linked to sleep deprivation, heart attack, irregular heartbeat and high blood pressure.

Oral Appliance Therapy to treat Snoring

The FDA recognizes this method to treat snoring. It involves putting a custom-fitted device in your mouth at night to help open up your airways naturally overtime, restricting the tongue from collapsing by holding the lower jaw. We are partnered with 1st Line Medical’s Somnoguard. The device is in two pieces and is adjustable to be custom fit to any patient. It brings the lower jaw forward which brings the tongue and muscles surrounding it to move forward as well, opening up your airway.

Pillar Procedure to treat Snoring

The Pillar Procedure is only 20 minutes and is done under local anesthesia. It aims to stiffen the soft the pallet, which is believed to be the source of snoring for 80% of people. This is done by placing small implants into the pallet which strengthens it overtime, reducing the vibration of the tissue that causes snoring. It’s a good alternative for people who don’t want to wear equipment to bed. Watch the video below to learn how the Pillar Procedure works: 

Dr. David Oliver diagnoses sleep apnea by testing your sleeping habits in the comfort of your home. There are a few variations to sleep studies; Multiple sleep latency test (MSLT) which measures how long it takes you to fall asleep. It also determines whether you enter REM sleep.
Maintenance of wakefulness test (MWT) which measures whether you can stay awake during a time when you are normally awake. The last test is a Polysomnogram which records internal body functions during sleep.

What is being Recorded for a Home Sleep Test?

There are many factor that contribute to sleeping issues. The most valuable pieces of information include brain activity, blood oxygen saturation, pulse rate, airflow, snoring levels and eye movement. There’s no way for you to know these pieces of information while you sleep, so taking a test may be crucial for diagnosing your sleep apnea or other relates issues.

How is this Information Recorded?

Coastal Ear, Nose & Throat partnered with Watermark Medical and use the Apnea Risk Evaluation System (ARES™). The device is equipped to read this information. For instance, a nasal cannula which you place in your nose is connected to a pressure transducer, an accelerometer detects movements during the night and an acoustic microphone can detect snoring volume. The device is highly technical and can capture all the information needed to detect obstructive sleep apnea. You can see how you put the ARES device on.

Radiofrequency Ablation (RFA) is a minimally invasive procedure to tighten the base of the tongue to help cure snoring and sleep apnea. It helps treat loose tongue muscles, enlarged tongues and sleep apnea caused by those two conditions.

The RFA Procedure

The doctor uses a non-invasive device to direct targeted radiofrequency energy to the base of the tongue. As the tongue heals, it gradually shrinks and tightens. The procedure we perform uses the Olympus Celon technique.

Benefits of Radiofrequency Ablation

Safety – The device has fail safe measures to eliminate the possibility of over-treatment. 
Low risk bleeding – The mucus layer of the tongue stays in tact during the procedure, so for the most part you won’t experience any bleeding
Fast procedure – Each lesion (tissue that’s being treated) only takes 6-10 seconds to treat
Minimally invasive – Due to the minimally invasive nature of the device, there is very little discomfort and the procedure only uses localized anesthesia.