Treating Sleep Apnea

Our sleep disorders team works closely with experts in other specialties to provide the best treatment options tailored to each patient’s unique needs.

This multidisciplinary approach combines the efforts of sleep medicine, otolaryngology, sleep dentistry, plastic/maxillofacial surgery, cardiology, endocrinology and bariatric surgery to diagnose and treat patients with sleep apnea.

We offer several surgical and non-surgical options for treating sleep apnea and our sleep disorders team will help you decide which option is best for you.

 

Non-Surgical Options

• Continuous Positive Airway Pressure (CPAP) therapy uses a machine to help patients with obstructive sleep apnea breathe more easily during sleep. A CPAP machine sends a constant flow of air pressure to the throat to ensure the airway stays open during sleep.

• Automatic Titrating Continuous Positive Airway Pressure (Auto-PAP) therapy is set within a high- and low-pressure range determined by need. The machine automatically detects how much pressure a patient needs with each breath. The auto-PAP machine increases automatically as needed to allow normal breathing during sleep.

• Bi-level Positive Airway Pressure (Bi-level PAP) therapy delivers two different levels of pressure: one for inhaling, the other for exhaling. These pressures are pre-set (based on a prescription by a sleep specialist) and alternate just like a person’s breathing pattern.

• Non-invasive Ventilation (NIV) therapy is designed to alleviate sleep apnea and to improve ventilation. Our sleep laboratory has significant expertise in treating disorders of sleep hypoventilation with NIV. NIV titration is performed with simultaneous monitoring of breathing, blood oxygen levels and carbon dioxide (CO2) levels.

Mandibular advancement devices (MADs) can help treat obstructive sleep apnea by moving the jaw and tongue forward during sleep. Pushing the lower jaw forward helps expand the airway, thereby reducing the number of breathing pauses. MADs look similar to sports mouth guards or retainers and are adjustable. A sleep dentist sets the position of the jaw for maximum effectiveness.

Our sleep laboratory is one of the few that works closely with experts in sleep dentistry to assess whether a mandibular advancement device will be successful or not.

In our sleep laboratory, we are able to perform an overnight oral appliance titration using a temporary, one-time use, custom-fitted oral appliance made by the sleep dentist. If this sleep study demonstrates successful treatment of obstructive sleep apnea, the sleep dentist will proceed with making a more durable MAD.

Some people have sleep apnea primarily when sleeping on their back (the supine position). This is called positional sleep apnea. In positional sleep apnea, breathing returns to normal once a person is on their side. To treat positional sleep apnea, positional therapy is used. This may involve wearing a special device around the waist or back to maintain a person on his or her side.

Surgical Options

Obstructive sleep apnea patients who cannot tolerate positive airway pressure therapy may benefit from nerve stimulation or upper airway surgery.

Performed by Zhen Gooi, MD, surgical treatments include hypoglossal nerve stimulator treatment to relieve obstructions at the tongue base and palate. Other surgical options involve relieving obstructions at the level of the nose and upper and lower throat.

Otolaryngologists / head and neck surgeons at UChicago Medicine provide comprehensive airway assessments to personalize your surgical treatment for an airway obstruction.

Performed by craniofacial surgeon Russell Reid, MD and orthodontist Michael Stosich, DMD, maxillomandibular advancement surgery can be an effective treatment for obstructive sleep apnea.

In this procedure, the upper and lower jaws are moved forward to eliminate airway obstruction. Maxillomandibular advancement surgery enlarges the airway in both the palate and tongue regions.

Phrenic nerve stimulation is a treatment option for adults with moderate to severe central sleep apnea. An implantable device stimulates the phrenic nerve in your chest to send signals to the diaphragm to activate breathing. The treatment starts and stops on its own and does not require you to wear anything on your face. No equipment is needed at home.

The phrenic nerve stimulator device is implanted during a minimally-invasive outpatient procedure by Hemal Nayak, MD, a cardiologist who specializes in electrophysiology.

Read a Q&A with Dr. Nayak and Dr. Mokhlesi to learn more about central sleep apnea.

Weight Loss Options

A strong correlation exists between obesity and the development of obstructive sleep apnea. Bariatric surgery can be an effective treatment for obesity and related conditions like sleep apnea.

Endoscopic therapy uses flexible scopes that do not require an incision.

Our endoscopic gastroenterologist Christopher Chapman, MD, works with patients who struggle with weight issues to provide them with a non-surgical program to facilitate or enhance their weight loss.

The Chicago Weight program helps adults manage their weight and medical conditions associated with excess weight.

Silvana Pannain, MD and the team at Chicago Weight treats obesity and coordinates care for patients with obesity-related diseases like obstructive sleep apnea.

Our experts take a specialized approach centered on promoting weight loss and improving metabolic and cardiovascular health.