Sleep Disordered Breathing (SDB) is a spectrum of breathing disorders that occur during sleep and range from Upper Airway Resistance Syndrome (UARS), which can be due to nasal obstruction, to OSA. Dr. Tamez’s approach to SDB is to focus on getting patients to breathe optimally through their nose (either through medication or surgery), which can cure UARS and improves quality of sleep. Once a patient is breathing great through their nose, then Dr. Tamez proceeds with ordering a sleep study, if necessary. He rarely recommends a sleep study prior to addressing any obvious or non obvious nasal obstruction. A significant number of patients have no idea they cannot breathe through their nose, because they have lived with the obstruction all their lives and know no different.
OSA is when the back of the throat/tongue closes off during sleep. OSA is very common and while it is true that very obese patients are more susceptible, most patients with OSA are not obese. While Dr. Tamez highly recommends weight loss, it is unlikely that weight loss alone will cure sleep apnea. The problem lies in the anatomy of the back of the throat and anatomy of the chin/neck. Not to mention, it is hard to lose weight if you are tired all the time. Non-surgical treatments for sleep apnea include CPAP (Continuous Positive Airway Pressure), which is a device used during sleep that prevents the back of the throat from closing off during sleep, which in turn, resolves snoring. Another option is use of an oral appliance which pulls the jaw forward and thus, prevents the back of the throat from closing off during sleep. The use of CPAP works optimally after a patient has been treated for nasal obstruction and can breathe well through the nose.
There are surgical procedures done to try and cure sleep apnea including: uvulopalatopharyngoplasty (UPPP); base of tongue reduction; hyoid suspension; and maxillomandibular facial surgery. However, many have high failure rates or are very invasive. Dr. Tamez usually reserves discussing these procedures for patients who fail more conservative management or for special circumstances.
- Computed tomography (CT) scan of the sinuses
- Sleep Study/Polysomnography
- Tubinoplasty/Submucous Resection of the Turbinates
- Functional Endoscopic Sinus Surgery (FESS)
- Continuous Positive Airway Pressure (CPAP) to treat sleep apnea
- Oral Appliance to treat sleep apnea or snoring
- Balloon Sinuplasty