Sleep Apnea Treatment NYC

man with cpap mask

Snoring is the body’s way of telling you that your sleep is not as efficient as it should be and something is not working correctly. It is often an indicator that you may be suffering from a serious medical condition called obstructive sleep apnea (OSA). Sleep apnea is a common sleep disorder that involves repeated breathing interruptions during sleep that may occur hundreds of times each night as a result of structural abnormalities or brain malfunctions.

If you believe that you may have sleep apnea, visit our NYC ear nose and throat practice for diagnosis and treatment. Dr. David Volpi is a board-certified otolaryngologist with over 25 years of experience performing the latest, minimally invasive ENT procedures to treat snoring, sleep apnea, and other ENT conditions in New York City. As one of the leading snoring and obstructive sleep apnea specialists in the country and the founder of eos sleep, a nationally-recognized sleep center, Dr. Volpi is highly qualified to diagnose and treat your sleep disorders. Learn more about sleep studies below, or request an appointment online.

Sleep Apnea

 

There are two main types of sleep apnea: obstructive and central. Obstructive sleep apnea is the more common form of this disorder and involves a blocked or collapsed airway during sleep that may result in breathing abnormalities. Central sleep apnea is less common and involves a malfunction in which the brain doesn’t send the proper signals to control breathing during sleep.

Patients who are overweight, have high blood pressure, are older, smoke or have a family history of sleep apnea may have an increased risk of developing obstructive sleep apnea, while those with heart disease or who have had a stroke are at an increased risk for central sleep apnea.

An estimated 90% of people with obstructive sleep apnea will go undiagnosed. As important as it is to get proper treatment, it is critical to understand the cause of your sleep apnea.

What Causes Sleep Apnea?

Obstructive sleep apnea occurs when an obstruction blocks the airway and air cannot easily flow through the nose or mouth during sleep.

At night, while the body tries to breathe, any airway obstructions cause turbulent air flow which causes vibrations of the soft tissue. As a result of these vibrations, a snoring sound is generated. Ongoing sleep apnea causes an imbalance in the bloodstream between the oxygen and carbon dioxide levels, as not enough oxygen is entering the body and not enough carbon dioxide is leaving the body. The brain senses an imbalance and sends a message to the body telling it to wake up; this can cause you to wake up completely or will bring you out of a deep level of sleep to a shallow level of sleep in order to start the breathing process.

The main factors that contribute to sleep apnea include:

Mouth structure

The soft palate extends from the roof of the mouth to the back of the mouth. The uvula, an extension of the soft palate, is the ball that hangs down in the back of the throat. If the soft palate is too thick, long, or floppy or if the uvula is enlarged, it can cause obstructions in your throat and narrow your air passages. Another source of obstruction that can cause sleep apnea is either a large tongue or large tonsils.

Nasal congestion

Congestion can narrow the nasal cavity and play a substantial role in sleep apnea. Enlarged turbinates, a deviated septum, enlarged adenoids or nasal polyps can all obstruct airflow and increase nasal congestion.

Being overweight

Excess weight may affect your breathing and impact sleep apnea. Extra weight around the throat and neck, particularly in people with a neck circumference of more than 17 inches, can narrow the airway and make it difficult to breathe.

Alcohol consumption and eating late at night

Drinking alcohol before bedtime and late-night eating can relax the throat muscles, making obstruction more likely and increasing the episodes of sleep apnea.

For many people, sleep apnea can be treated with minimally invasive procedures. As these procedures are routinely performed in an office setting, patients are able to return to normal activity within the same day. The treatment options will depend upon the site and source of your obstruction(s).

What are the Symptoms of Sleep Apnea?

Many patients with sleep apnea may not be aware that they have this condition, as breathing interruptions are not usually remembered upon waking. However, patients with sleep apnea may experience:

  • Excessive daytime sleepiness
  • Snoring
  • Trouble concentrating
  • Irregular heartbeat
  • Restless sleep
  • High blood pressure
  • Waking up with a dry mouth or a sore throat
  • Morning headaches
  • Gasping or choking during sleep

Most people suffering from sleep apnea are not aware of their nightly episodes because they don’t attribute their daytime symptoms with what’s happening to them at night. Those suffering from this sleep condition are often made aware of their snoring or sleep apnea episodes at night because of the effect it can have on their bed partner.

How do you diagnose sleep apnea?

To diagnose and treat your condition, Dr. Volpi may recommend a sleep study if he suspects you are suffering from obstructive sleep apnea. After an initial consultation, we offer a comfortable, convenient and less expensive option for patients who meet the criteria for an at home sleep study.

Sleep testing with CPAP or BiPAP enables Dr. Volpi to properly assess your condition. A monitor measures activity while the patient is sleeping, and a CPAP (continuous positive airway pressure) or BiPAP (bilevel positive airway pressure) device is used. The CPAP delivers pressured air at a constant rate, while the BiPAP delivers pressured air at a higher pressure while inhaling and a lower pressure while exhaling. It is the air pressure that aids in keeping the breathing passages open.

Whichever device you are given is connected to a mask that is placed over the mouth, the nose or both. It will automatically adjust the amount of air pressure needed to breathe during sleep without causing apnea. For accurate test results, you must sleep for at least two hours on the night of your sleep testing.

The next morning, the polysomnogram is over. Once the results have been interpreted, Dr. Volpi can create a customized treatment plan for your individual condition.

What are the Treatments Options for Sleep Apnea?

There are many different treatment options available for sleep apnea, depending on each patient’s individual case, including oral appliance therapy, mandibular repositioning and tongue-retaining devices, nasal sprays, and surgery.

Many patients can experience significant results from continuous positive airway pressure (CPAP) machines or adjustable airway pressure devices, which are used while sleeping. Connected to a tube and a mask that covers the nose, the pressure generated by the CPAP splints the structures in the back of the throat, holding the airway open during sleep.

While treatment often begins with conservative techniques, many patients require surgery in order to effectively treat their condition. Surgery for sleep apnea aims to remove the blockage in the nose or throat that causes this condition. This can be done through procedures such as:

CPAP

CPAP, also known as the continuous positive airway pressure (CPAP) mask, is a non-invasive treatment that sleep specialists typically prescribe as the first therapy method to treat airway obstruction(s) which cause snoring and sleep apnea. At night, the machine works to increase air pressure in the throat, allowing the airway to remain open when you breathe.

Oral Appliance

These devices fit like a sports mouth guard or orthodontic retainer and are used at night to prevent the collapse of the tongue and soft tissues in the back of the throat; often they are prescribed to treat airway obstructions(s) which cause snoring and sleep apnea.

Balloon Sinuplasty

This minimally invasive procedure opens blocked sinuses, relieving pressure and pain associated with chronic sinusitis. It is a safe, gentle and highly effective treatment option for those suffering from sinus-related snoring and sleep apnea. The recovery is fast and easy.

Palate Coblation

The palate coblation procedure is performed in a single office visit under local anesthesia. Using radio frequency energy, the ENT surgeon stiffens the soft palate to reduce vibrations and snoring intensity. This minimally invasive procedure treats mild to moderate sleep apnea.

Pillar Procedure

Through the insertion of small implants, the Pillar Procedure effectively stiffens the soft palate and thus reduces the intensity and loudness of snoring. This procedure is highly effective with very little discomfort and most patients experience a fast and easy recovery.

Coblation Turbinate Reduction

This procedure reduces the size of nasal turbinates using radio frequency energy and it is an effective treatment option for those suffering from sinus-related snoring and sleep apnea. Patients experience continued relief from nasal airway obstruction.

Laser-assisted Uvulopalatoplasty

Using laser technology, this procedure shrinks the size of an enlarged uvula and is used to treat mild to moderate sleep apnea. As the treatment area heals, patients experience a significant reduction in snoring intensity.

Laser-assisted Tonsil Ablation

In order to open up the airway and treat snoring and sleep apnea caused by enlarged tonsils, the laser-assisted tonsil ablation reduces the size of the tonsils using laser technology. Wielding state-of-the-art laser technology, Dr. Volpi can minimize damage to surrounding tissue in the throat which results in faster recovery times for patients.

Endoscopic Sinus Surgery

An outpatient procedure, this surgery aims to remove small amounts of bone or tissue blocking the nasal passages and treat sinus-related snoring and sleep apnea. You can expect an easier and faster recovery with less scarring than traditional sinus surgery

Septoplasty

The septoplasty procedure corrects a deviated septum and provides relief from impaired breathing as well as snoring and sleep apnea symptoms.

Genioglossus Advancement

This surgery makes it less likely that the tongue will collapse in the airway and obstruct breathing during sleep. It aims to treat snoring and sleep apnea caused by weak tongue muscles or an enlarged tongue.

Hyoid suspension

Similar to the Genioglossus Advancement procedure, this surgery opens the airway and helps prevent the tongue from blocking it. The hyoid suspension treats snoring and sleep apnea caused by an enlarged tongue or weak tongue muscles.

Tonsillectomy

A tonsillectomy opens up the airways through the removal of enlarged tonsils. It is performed on patients with enlarged tonsils to treat snoring and sleep apnea.

Dr. Volpi will determine which treatment plan is best for your individual condition. Patients can take certain steps to handle symptoms of sleep apnea on their own, including losing excess weight, sleeping on your side and using a saline nasal spray to keep your nasal passages open at night.

Can I treat my sleep apnea without surgery?

Yes, a number of non-invasive treatment options for sleep apnea are available, including continuous positive airway pressure (CPAP) masks and oral appliances. Many patients schedule an appointment with Dr. Volpi in hopes of finding an alternative option to the CPAP mask; they find the mask uncomfortable and bothersome to use.

At Dr. Volpi’s practice, we offer a variety of minimally invasive procedures that can treat sleep apnea. Treatment could be as simple as a 30-minute in-office procedure. For milder cases of sleep apnea, we also recommend lifestyle adjustments and activity modifications that may improve your symptoms.

The following recommendations may help your sleep apnea:

  • Clear your sinuses – Before your nasal congestion or allergies become too severe, seek treatment to clear any nasal obstructions.
  • Avoid alcohol, eating late at night and sleep aids – If you have trouble sleeping at night, it may help to increase your activity rate during the day.
  • Sleep on your side – Sleeping on your back can cause your tongue to fall back into the airway and cause obstruction to your breathing.
  • Diet and exercise – By shedding extra body weight, many people improve their symptoms.

Am I a candidate for a minimally invasive, in-office procedure?

If you do not see a positive effect on your sleep apnea symptoms from the recommendations outlined above, then you are most likely a candidate for a minimally invasive procedure.

What are my alternative treatment options to the CPAP mask?

Depending on the severity of your symptoms and the site of your airway obstruction(s), a myriad of alternative treatment options exist. Although the CPAP mask is still the gold standard for treating sleep apnea, it is not always the best option. Dr. Volpi will tailor a treatment plan to address the root cause or causes of your unique problem.

Is sleep apnea life-threatening?

Strong medical evidence suggests that obstructive sleep apnea increases the risk of high blood pressure, heart attack and stroke; it can also increase your risk of dying early.

What doctor is best for treating sleep apnea?

The best doctor for treating snoring is an otolaryngologist (ear, nose and throat doctor) who specializes in treating patients with snoring and sleep apnea conditions. Dr. Volpi is a board-certified otolaryngologist and has over 25 years of experience treating sleep patients. Not only will he provide you with the most comprehensive treatment options, he will tailor a treatment plan that will address the root cause or causes of your problem.

Our sleep apnea treatment options are designed to ensure the best possible results. Schedule an appointment with Dr. Volpi and let us help you get a better night’s sleep!