Hyderabad: Rajesh, a 32 -year-old businessman, suffered from severe snoring, daytime fatigue and frequent morning headaches. His wife noticed that he often had to wake up in distress to take heavy, deep breaths.After consulting an ENT specialist, he was diagnosed with obstructive sleep apnea.Sleep apnea is a serious sleep disorder where breathing repeatedly stops and starts during sleep. It can lead to major health problems if left untreated. People with sleep apnea experience repeated drops in oxygen levels, which put a strain on the heart. Over time, this increases the risk of high blood pressure, heart disease, stroke, and even sudden cardiac death. Poor sleep quality also affects the brain, leading to memory issues, difficulty concentrating, and a higher chance of depression and anxiety.Sleep apnea also increases the risk of accidents. People who do not get restful sleep may feel sleepy during the day, leading to road traffic accidents and committing blunders at the workplace.According to studies, nearly 10 lakh people worldwide suffer from obstructive sleep apnea, with at least 40 per cent of cases remaining undiagnosed. In India, around 13 per cent of men and six percent women suffer from moderate to severe sleep apnea, though many cases go undetected due to lack of awareness.The main causes of sleep apnea include obesity, blocked nasal passages, and weak throat muscles. However, in Rajesh’s case, it was found that the obstruction in his airway was because of nasal blockage due to a narrow upper jaw. Experts have pointed out that the structure of the face, jaw, and airway also plays a major role.“Dentists and oral and maxillofacial surgeons play a crucial role in treating sleep apnea because the shape and position of the jaw affect breathing. Small or receding lower jaw called retrognathia, pushes the tongue backward, making it harder to breathe at night. A high-arched palate or narrow upper jaw reduces space for airflow in the nose and increases nasal resistance. Teeth grinding or bruxism is often a sign that the body is struggling to open the airway during sleep,” said Dr Sukhvinder Bindra, oral and maxillofacial surgeon.“From an ENT perspective, the common causes include nasal blockages: a deviated nasal septum, swollen nasal tissues, or chronic sinus problems can make it difficult to breathe through the nose. Enlarged tonsils or adenoids can block the throat, especially in children, leading to breathing difficulties during sleep. Over time, weak muscles in the throat collapse more easily, blocking the airway and causing snoring and choking episodes during sleep,” said Dr. Seemab Shaikh, senior ENT surgeon.ENT specialists often recommend treatments like nasal surgeries, tonsil removal, or palate surgeries to improve airflow and reduce sleep apnea symptoms. “The solution that dental surgeons come up with is to widen the narrow upper jaw. This helps in improving nasal airflow and reducing airway obstruction. This is particularly beneficial for younger patients and those with skeletal constrictions,” Dr. Bindra said.In Rajesh’s case, a collaborative approach involving an ENT surgeon and an oral and maxillofacial surgeon and orthodontist was taken. While the ENT surgeon corrected his nasal obstruction, the maxillofacial and orthodontist team provided a maxillary expander to widen the upper jaw. His symptoms improved gradually and restored his sleep quality and overall health.“In select cases where surgery is not an option, mandibular advancement devices (MADs) help reposition the lower jaw and tongue, keeping the airway open. In severe cases, maxillomandibular advancement (MMA) surgery is performed to enlarge the airway by repositioning the upper and lower jaw, offering a long-term solution for patients with severe sleep apnea,” said Dr. Gayatri Moghe, a paedodontist.
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