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Sleep Surgeon Question 6

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Question 6 - CPAP vs. Surgery

From: Linda K..

Hi There, I'm a 27 yo single female. I'm 5'2 and weigh about 110-115lbs. I have moderate OSA and also have some other chronic health problems.

I was diagnosed with chronic Lyme Disease, and then hypothyroidism, mitral valve prolapse, athsma, and a heart arhythmia. I don't have allergies, but do have frequent mild congestion.

I had my first sleep study in Jan. 07 and was having 24 episodes/hr. Then I had a septoplasty and had another study using CPAP. The study showed that CPAP helped the apnea.

I'm getting ready to rent a CPAP machine, but I'd like to learn more about the efficacy of surgical and non surgical options that may be more appropriate for my lifestyle. I have a narrow jaw and small chin with a slight underbite. My dentist recommended a dental device, but I can't push my jaw forward enough to keep the tissues from touching.

I would love to correct the problem so that I don't need to worry about wearing a machine every night. I'm young and I'd like to be able to travel and to sleep on a bus, plane, or share a hotel room, without snoring, drooling and disturbing the people around me. I'd also like to get married and be able to cuddle with my husband without him feeling like he married Darth Vedor.

I know that these concerns are minor in the scheme of health, but I spend most of my waking hours focused on my health, and I would love to have a break at night. I look forward to your ideas. Thank you,

Answer Provided by Dr. Kasey Li
July 5, 2007

Generally, I don’t usually see many young women with moderate/severe OSA unless there is significant obesity or jaw deficiency that severely constricts the airway. Clearly, you are not obese, thus your moderate OSA is most likely due to your jaw structures, which constricts your airway. Although it is possible to have excess soft tissues in the throat such as large tonsils or soft palate that are also obstructing the airway, it would be much less likely since most women do not have lots of soft tissue excess as compared to men.

Since you have already planned to try CPAP, I would encourage your to use it to see if it helps you. If your airway constriction is mostly due to your jaw structures, maxillomandibular advancement is probably the best option. In general, I tend to recommend maxillomandibular advancement surgery in young patients such as yourself. This is because sleep apnea progresses with aging and young patients have a long life expectancy, thus OSA can become a problem again years later.

Good luck

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