sleep apnea and smoking risks - surgical sleep solutions

Smoking and Sleep Apnea: A Dangerous Relationship

In this day and age, it is common knowledge that smoking and using tobacco products is bad for your health. However, a number of studies have found that smoking and nicotine can be especially harmful to those who suffer from obstructive sleep apnea (OSA). In this article, we will take a closer look at the relationship between smoking and sleep apnea as well as explain why smoking cigarettes and having sleep apnea is a dangerous pairing.

5 Ways Smoking Aggravates Sleep Apnea

A 2001 sleep apnea study found that current smokers were 2.5 times more likely to suffer from OSA than non-smokers, independent of age, sex, weight, and other lifestyle behaviors. Why do smokers suffer from sleep apnea at a much higher rate than non-smokers? Here are five big reasons.

  • Smoking causes airway inflammation. Tobacco smoke can irritate your mouth, throat, and lungs, causing inflammation. This inflammation can make your airway smaller and make it more difficult to breathe.
  • Nicotine stimulates upper airway muscles. Nicotine doesn’t just stimulate your heart, it can also affect your airway muscles. Your contracted muscles can make regular breathing difficult.
  • Nighttime nicotine withdrawal causes sleep disturbances. A 2008 study found that smokers are four times more likely to report feeling unrested – and that smokers spend significantly less time in deep sleep. Researchers believe that this is because smokers  go through withdrawal at night. Sleep disturbances related to this withdrawal could exacerbate sleep apnea.
  • Smoking contributes to overall health issues.  Just like sleep apnea, smoking can affect almost all body systems. For example, smoking has been shown to affect the brain, lungs, heart, and immune system. These negative affects that smoking has on the body can in turn make a person’s sleep apnea worse.

Sleep Apnea Can Also Lead To Nicotine Addiction

One interesting recent study regarding sleep apnea, published in 2012, also found that those with obstructive sleep apnea may be more susceptible nicotine addiction. Perhaps those with sleep apnea turn to tobacco and smoking to deal with feeling tired during the day or to deal with anxiety related to daytime fatigue.

Improve Your Sleep Apnea By Quitting Smoking

Putting away your cigarette can improve many aspects of your health — and it may well help your obstructive sleep apnea symptoms. If you are looking for yet another reason to quit, you should know that those who stop smoking sleep more restfully, wake less often, and suffer from insomnia less frequently.

However, it is also important to note that sleep apnea is not often cured by stopping smoking – it is only made milder. To truly get full treatment for your sleep apnea, it is vital to speak to your doctor and find a plan that fits your lifestyle and needs.

Are you unsure if you suffer from sleep apnea? Fill out our questionnaire below to see if you are at high or low risk of suffering from obstructive sleep apnea.

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Do I Need a Sleep Study?

If you suspect that you or a loved one suffers from a sleep disorder, like sleep apnea, the first step is diagnosis.

A sleep test, whether conducted in your own home or in a sleep center, is the only way to properly diagnose or rule out a sleep disorder, and must be ordered by your physician.

There are two different kinds of sleep studies: diagnostic and titration studies.

The diagnostic study will diagnose or rule out a sleep disorder like sleep apnea. After having this study, your doctor can tell you, “Yes, you have sleep apnea,” or “No, you don’t have sleep apnea. Let’s look for other causes of your symptoms.”

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You can have a diagnostic sleep study in your own home (called a home sleep test, or HST) or in a sleep center.

You may choose one type of test over the other based on the type of sleep disorder you are suspecting, if you have other serious medical conditions and your insurance coverage.
In-center polysomnography (PSG) records your brain waves, heartbeat and breathing as you sleep in a sleep center.

It also charts your eye movements, limb movements and oxygen in your blood. PSG is also referred to as a diagnostic study, attended PSG, or fully attended overnight sleep study. PSG can diagnose or rule out sleep disorders such as obstructive and central sleep apnea, restless leg syndrome (RLS) and more. For more info on in center sleep tests, visit Advanced Sleep Medicine Services, Inc..

HST is a type of diagnostic polysomnography which is self-administered by the patient in his/her home.

It is used to diagnose sleep apnea by recording several channels of information: respiratory effort, pulse, oxygen saturation, nasal flow and snoring. HST is a convenient and cost-effective alternative to in-center sleep testing for many patients if it is highly likely that the patient has moderate to severe sleep apnea, and if the patient has no other significant medical issues such as pulmonary diseases, neuromuscular disease or congestive heart failure. HST cannot be performed on children and cannot diagnose other sleep disorders such as restless leg syndrome, periodic limb movement disorder or narcolepsy. These patients should be tested in a sleep center. For more information on home sleep tests, visit Advanced Sleep Medicine Services, Inc.

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If you have sleep apnea, you may require a titration study.

Even if you don’t expect to use PAP therapy to treat your sleep apnea, many insurances will require that you start with PAP therapy before they will cover the expense of any PAP alternatives.

A titration can be completed the same night as your diagnostic study if you’re testing in a sleep center. This type of combo-study is called a split night or 50/50 study. A split night begins with diagnostic polysomnography and switches to PAP therapy titration once the patient shows sufficient apnea events. This test is often ordered when sleep apnea is highly likely and can eliminate the need for a second night sleep study if the titration is successfully completed.

If your diagnostic test was done with a home sleep test (HST), your titration may be completed in a sleep center or in your home. Recently, many patients and insurance companies are opting for in-home titrations after a sleep apnea diagnosis is made using a home sleep test. This is called an auto-PAP titration. If you come into the sleep center for a full-night titration, you will use PAP therapy for the entire night and the technician will adjust the pressure settings to eliminate apneas.

For more information about different types of sleep studies and the sleep disorders they can diagnose, visit us at

Advanced Sleep Medicine Services, Inc. - Julia Guest article provided by:
Julia Steele Rodriguez, Vice President of Marketing and Operations at Advanced Sleep Medicine Services, Inc.

At Advanced Sleep Medicine Services, Inc., our mission is to empower sufferers of sleep disorders, like sleep apnea, to lead more fulfilling lives by improving their sleep. We believe that by caring for and educating our patients and diagnosing and treating their sleep disorders we can help them achieve better health.

With 20 locations across California, we are the leading provider of in-center and in-home (HST) sleep studies, PAP therapeutic devices, and replacement PAP supplies. We are contracted with more than 300 medical groups and commercial health plans. We partner with independent physicians who are at the forefront of the field of sleep medicine and together we provide high-quality, affordable, result-oriented and patient-centric diagnostic and therapeutic sleep medicine services. We strive to make all our interactions with patients, referring physicians, coworkers, and others courteous, caring and professional and we consider each interaction with our patients as an opportunity to live up to our commitment to the highest standards of patient care.

sleep apnea home test - surgical sleep solutions

Could sleep apnea home testing be right for you?

In past years, the only way to accurately diagnose obstructive sleep apnea (OSA) was through overnight observation in a sleep center. Today, though, some doctors are using an overnight sleep apnea home test to diagnose certain patients with the sleep disorder. Could sleep apnea home testing be right for you, and what are the pros and cons of this test over a more official in-clinic test?

How Sleep Apnea Home Testing Works

If you are being diagnosed through this method, your doctor will provide you with a sleep apnea home test kit along with detailed instructions on how to use it. Most of these test will measure your your heart rate, blood oxygen level, airflow and breathing patterns during a full night of sleep in your own bed. They do so through a belt that is around your chest, a blood-oxygen sensor on your finger, a data collection device strapped on your arm, and a breath sensor hooked over your ears and taped beneath your nose.

The Advantages of Sleep Apnea Home Testing

The major advantage of a home sleep apnea test is that it is more convenient for the patient: the person being tested is not required to travel to an overnight sleep clinic or to spend a night away from home. In addition, sleep apnea home tests are approximately ten times less expensive than in-clinic tests, which may make them a better especially when it comes to screening those in the transportation industry. Some people believe that sleep apnea home tests will help encourage people who have multiple symptoms of OSA to get diagnosed and treated when they might not otherwise take the step.

The Disadvantages of Sleep Apnea Home Testing

The biggest disadvantage of sleep apnea home testing is that it is not as accurate as a sleep center test and may not detect all cases of sleep apnea. A nocturnal polysomnography tracks more of your body’s data, including your brain activity and your arm and leg movements. Therefore, it can result in more accurate and more meaningful results. A full sleep center test is also better at diagnosing mild sleep apnea and other types of sleep disorders. Finally, a test done in a sleep center is set up and observed by medical professionals, cutting down on the risk of errors. It is not uncommon for a doctor to recommend nocturnal polysomnography even after you have passed a home sleep apnea test.

Are You A Good Candidate For A Sleep Apnea Home Test?

Some people are better suited for a sleep apnea home test than others. You may be a good candidate for a home sleep kit if it is highly likely that you have moderate to severe sleep apnea and if you are otherwise in good health.

You may not be a good candidate for a sleep apnea home test if:

  • You may only suffer from mild OSA or are not at high risk for OSA.
  • You may suffer from sleep disorders other than sleep apnea, such as restless leg syndrome or narcolepsy.
  • You suffer from certain other health issues, such as heart disease, neuromuscular diseases, or congestive heart failure.
  • You are not confident that you can correctly use the home testing equipment.

Sleep Apnea Self-Evaluation at Surgical Sleep Solutions

If you believe you may need to be tested for obstructive sleep apnea, consider taking our online self-evaluation. If you have the signs and symptoms of sleep apnea or another sleep disorder, talk to your doctor about receiving a diagnosis and the proper treatment for your condition.

sleep apnea and womens hearts : new study

New Study: Sleep Apnea and Heart Failure in Women

A new sleep apnea study has determined that obstructive sleep apnea (OSA) may be more harmful to women’s heart health than to men’s heart health. The study, published in the American Heart Association’s medical journal Circulation, found that while a large range of heart conditions are associated with OSA in both men and women, only women with OSA had a significant increase in heart conditions after researchers accounted for other risks (such as weight, blood pressure, and age).

Sleep Apnea Heart Failure Study Methods & Details

The study followed 737 men and 879 women over the course of fourteen years. All participants in the study were screened for obstructive sleep apnea and none of the participants showed signs of cardiovascular disease at the beginning of the study.

Throughout the duration of the study, the men and women were tested for their level of troponin T, a protein in the blood that is associated with cardiovascular disease. In addition, researchers tracked all instances of:

  • Coronary artery disease
  • Heart failure
  • Death from cardiovascular disease or other causes.

Because sleep apnea is associated with other conditions that can lead to heart disease, such as obesity and diabetes, the scientists corrected for these factors when analyzing data.

Sleep Apnea Heart Failure Study Conclusions

During the 14 years of the study, 46 percent of the men and 32 percent of the women either developed heart health issues or died. Women with moderate to severe OSA had more than a 30 percent higher risk of heart problems than women without sleep apnea, while men with moderate to severe OSA did not have a higher risk for heart disease when correcting for other factors. Additionally:

  • Obstructive sleep apnea was associated with increased levels of troponin T in women but not in men.
  • Obstructive sleep apnea was associated with heart failure in women but not in men.
  • Obstructive sleep apnea was associated with death in women but not in men.
  • Obstructive sleep apnea was associated with an enlarged heart (another risk for cardiovascular disease) in women butnot in men.

The study’s lead author, Dr. Amil M. Shah is an assistant professor of medicine at Harvard. He stated that the study shows that obstructive sleep apnea may be more harmful to women’s hearts than to men’s hearts – and that even some women in the study who did not develop cardivascular disease showed signs of health conditions associated with heart failure.

Treatment For Women With Obstructive Sleep Apnea

Another one of the study’s authors, Dr. Susan Redline, added that the study’s conclusion “highlights the importance of sleep apnea screening and treatment for women, a group who often are not routinely screened for sleep apnea.” Redline, who is a sleep specialist at Brigham and Women’s Hospital in Boston, was referring to how women can reduce their risk of developing heart problems by getting their OSA diagnosed and treated as soon as possible.

Sleep apnea is more prevalent in men – and there is a misconception that women do not suffer from the condition. We hope that this study increases awareness of OSA in women as well as awareness that untreated OSA is associated with heart health issues in women.

Sleep Apnea Treatment At Surgical Sleep Solutions

We offer a permanent surgical solution for both men and women with moderate to severe obstructive sleep apnea. To learn more about our sleep apnea surgery, or to schedule a consultation, please call us today at (855) 560-7378. This is not a solution for all and if you are happy with your CPAP excellent, if you need help getting started to see if you suffer from sleep apnea please start by filling out our questionnaire below.

bimaxillary advancement surgery - surgical team - surgical sleep solutions

Bimaxillary Advancement Surgery is 98.8 Percent Effective

Another study has found that bimaxillary advancement surgery, also know as maxillomandibular advancement surgery (MMA), is a highly effective treatment for those suffering from obstructive sleep apnea (OSA). The sleep apnea study, which was conducted by the David Geffen School of Medicine at UCLA, also determined that the upper and lower jaw surgery is even more effective on those with moderate to severe sleep apnea.

Overall, the study found that bimaxillary advancement surgery is 98.8 percent effective.

Sleep Apnea Surgery Study Methods and Details

For the study, which was published in the November 25, 2015 issue of Otolaryngol Head Neck Surgery, researchers looked at 45 different studies regarding bimaxillary advancement surgery and a total of 518 different patients that underwent the procedure. Those included in the study met the following criteria:

  1. All patients were adults who underwent bimaxillary advancement surgery as treatment for OSA.
  2. None of the patients also had adjunctive surgeries (including tonsillectomy, uvulopalatopharyngoplasty, and partial glossectomy).
  3. The outcome recorded preoperative and postoperative quantitative outcomes for both the apnea-hypopnea index (AHI) and/or respiratory disturbance index (RDI).
  4. The study included data regarding individual patients.

To find the studies used, researchers looked at databases in all languages using a variety of keyword searches. Databases included The Cochrane Library, Scopus, Web of Science, and MEDLINE.

Bimaxillary Advancement Surgery Study Results

Of the 518 patients studied, 512 showed significant improvement in their apnea-hypopnea index (AHI) and/or respiratory disturbance index (RDI). Significant improvements were also seen in the mean (SD) postoperative oxygen saturation nadir and in the Epworth Sleepiness Scale score. In other words, 98.8 percent of patients improved their sleep apnea symptoms and many also improved their oxygen intake and sleepiness levels. The average apnea-hypopnea index score decreased by 80 percent after surgery and the average respiratory disturbance index score decreased by 65 percent.

In addition to determining the overall success of maxillomandibular advancement surgery (MMA), the study also determined that the surgery had the biggest benefit for those with severe sleep apnea, while those with more mild sleep apnea symptoms saw more subtle changes.

The scientists concluded that this study will help optimize patient selection for MMA surgery, while further study will likely provide additional insight.

Sleep Apnea Bimaxillary Advancement Surgery At Surgical Sleep Solutions

Researchers continue to find that MMA surgery is the most effective option for many patients with moderate to severe obstructive sleep apnea. Are you ready to find out if this treatment option could be the right solution for you? Contact Surgical Sleep Solutions today to schedule your consultation.

Learn more about our unique delivery model, see if surgery is the right option for you, or let us help guide you to the right solution.

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sleep apnea and gout flares

The Connection Between Sleep Apnea and Gout Flares

Obstructive sleep apnea has been tied to a large number of other health problems, including heart disease, obesity, and stroke. Now a new sleep apnea study has strengthened the tie between OSA and one more health condition, gout. The results of the study don’t explain why sleep apnea may be a factor that causes gout flares, but it does suggest that treating sleep apnea could prevent attacks of gout in some people.

What is Gout?

Gout is a type of arthritis caused by high levels of uric acid in the bloodstream. The uric acid crystallizes and collects in the joints, most commonly affecting the big toe. Gout is more common in men and postmenopausal women. It is also more common in older people, African-Americans, and people who have a parent who suffered from gout.

Symptoms of gout include:

  • The quick onset of pain, swelling, and extreme tenderness in a joint.
  • Redness and warmth in a joint.
  • Attacks that last for hours, days, or even weeks.

Risk factors for gout include:

  • Obesity or excessive weight gain.
  • High blood pressure.
  • Alcohol use.
  • Abnormal kidney function.
  • Hypothyroidism.

The best way to prevent a gout attack is to stay hydrated, limit alcohol intake, and maintain a healthy weight. Gout may also be prevented through avoiding foods rich with purine, which is converted into uric acid in the body during digestion. Eating dairy products may also reduce levels of uric acid in the blood.

Recent Study: Sleep Apnea and Gout Flares

Scientists at Boston University recently conducted a study that found a significant connection between sleep apnea and gout flares. Published in the most recent volume of  Arthritis & Rheumatology, the study examined 9,865 suffering from sleep apnea and compared their health to 43,598 people who did not have sleep apnea. The study corrected for sex, age, and obseity – three factors that affect the likelihood that you suffer from both gout and sleep apnea.

The study found that people were 50 percent more likely to have gout flares if they had been diagnosed with sleep apnea. While the study does not conclude that sleep apnea affects uric acid levels in the blood, and while the study does not explain why sleep apnea increases incidences of gout, it does suggest that treating sleep apnea could help prevent attacks of gout.

The lead author of the study, professor of medicine Yuqing Zhang, stated that the results call for further studies regarding uric acid, OSA, and gout.

Sleep Apnea Surgical Solutions

Treating your sleep apnea can improve your overall health in multiple ways. If you are looking for treatment alternatives to the CPAP device, or if you believe sleep apnea surgery may be the right choice for you, please contact us below to set up an in office or virtual consultation or call (855) 560-7378.

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sleep apnea during pregnancy - surgical sleep solutions

Developing Sleep Apnea During Pregnancy

Whether you develop sleep apnea during pregnancy or whether you are planning a pregnancy after being diagnosed with obstructive sleep apnea (OSA), it is vital to understand both how sleep apnea can affect your pregnancy and how your pregnancy can affect your sleep apnea. Let’s take a closer look.

Why Do Some Pregnant Women Develop Sleep Apnea?

In some cases, women who have never before suffered from OSA will begin to show symptoms of sleep apnea during their pregnancy. In other cases, someone with mild sleep apnea will see a worsening of symptoms as their baby grows and develops. While scientists do not fully understand the connection between sleep apnea and pregnancy, researchers believe that OSA may appear or worsen due to:

  • Sleep position. Sleep apnea may become worse when a sufferer sleeps on her back. Women in their second and third trimesters of pregnancy are restricted to sleeping on their side or back due to their growing belly. Women who switch to a back position may see OSA symptoms appear or become more severe when they are in certain sleeping positions.
  • Weight gain. Women with healthy pregnancies will gain between 20 and 40 pounds in nine months – and a significant number of women in the United States will gain even more than that. While the baby is directly responsible for some of these extra pounds, much of the weight appears in other parts of the body. In some cases, this excess weight can make obstructions in the throat and mouth worse.
  • Hormonal changes. Pregnant women go through a number of significant hormonal changes, especially after the baby’s placenta grows. These hormonal changes could affect their sleep, including their sleep apnea. Hormonal changes will continue after the baby’s birth as the mother nurses her baby.
  • Shifts in internal organs. As the uterus grows, many of the organs in the abdominal cavity are pushed upward. This, paired with hormonal changes, can cause issues like acid reflux. Physicians also believe that this could contribute to OSA.

Sleep Apnea Symptoms During Pregnancy

Could you be suffering from sleep apnea during pregnancy? Common symptoms include:

  • Snoring.
  • Long pauses between breaths while sleeping.
  • Gasping, choking, or coughing during sleep.
  • Daytime drowsiness and fatigue.
  • Dry mouth or sore throat upon waking.
  • Headache upon waking.

Sleep apnea requires a sleep study to diagnose. Speak to your primary care doctor or OBGYN if you are displaying symptoms of OSA.

Sleep Apnea During Pregnancy: Complications & Connections

It is difficult to understand how sleep apnea affects pregnancy and vice versa. This is complicated by the fact that both sleep apnea and pregnancy are associated with a number of other health issues, painting a complex picture. However, researchers have conducted a number of studies that have connected sleep apnea, pregnancy, and the following issues:

One way to prevent these issues, for both mother and baby, is to successfully treat OSA before and during pregnancy.

Treating Sleep Apnea During Pregnancy

The best treatment for obstructive sleep apnea during pregnancy depends upon the factors of the case, such as whether the patient had sleep apnea before pregnancy and how severe the sleep apnea is. To learn about the best treatment for you, before, during, or after pregnancy, speak to a health professional today.

To learn more about whether you may display the symptoms of sleep apnea, take our sleep apnea self-evaluation below.

sleep apnea surgery pre op - surgical sleep solutions

Obstructive Sleep Apnea Treatment: Oral Appliances, Surgery or Something Else?

After a patient has been diagnosed with obstructive sleep apnea (OSA), they have a very important healthcare decision to make with the guidance of their physician: what OSA treatment is right for them? Many have the misconception that there is one ideal treatment for everyone or that a continuous positive airway pressure (CPAP) device is the only effective option. This is not the case. In truth, there are a variety of different therapies, treatments, and devices available for use and finding the right one depends on a number of factors.

4 Questions to Ask Before Choosing An OSA Treatment

It is vital to review several considerations before deciding upon an OSA treatment, including the severity of the apnea, the cause of the apnea, and the personal preferences and habits of the patient. Let’s take a closer look at four questions patients should explore with their doctor before taking action:

  • What is my Apnea Hypopnea Index (AHI)? Your AHI is the best way to understand the severity of your OSA. Very simply, your AHI measures how many apnea events you have each hour during sleep. Those with mild sleep apnea have fewer than fifteen apneas per hour, while those with moderate sleep apnea have an AHI between 15 and 30. Those with severe OSA have an AHI of 30 or higher. Patients with an AHI index of 15 or lower may find adequate treatment through an oral device, positional therapy, or lifestyle changes. Those with higher AHIs may consider CPAP or surgery, sometimes in tandem with an oral device.
  • What are the possible root causes of my OSA? As with so many other diseases, your treatment should reflect the cause. In the case of OSA, it is important to discover what is obstructing your breathing and what could remedy the situation. For example, if your sleep apnea is caused by or made worse by a deviated septum or a high BMI, those issues should be addressed. If your sleep apnea is simply caused by a narrow airway, that issue needs to be addressed.
  • Do I have other significant health concerns? Sleep apnea often exists alongside other health concerns, such as asthma, obesity, heart disease, diabetes, and arrhythmia. In many cases, sleep apnea can be made more severe by these health conditions and in many cases, sleep apnea can make these health conditions more severe, too. If you have serious health problems besides OSA, surgery may not be a possible solution for you. However, if your sleep apnea is causing other health problems, it is vital you find a working treatment that effectively treats the issue.
  • Will compliance be an issue? Some sleep apnea treatments are effective, but only if the patient uses them correctly and consistently. Unfortunately, compliance with CPAP devices is very low, with a large number of users taking the device off in the middle of the night or only using it occasionally. Likewise, some patients are not able to consistently wear their dental appliances. It is key to understand that your sleep apnea symptoms will return if you do not choose a treatment that you can commit to and use correctly for the rest of your life.

An oral appliance may be the right choice if…

  • You have an AHI of 15 or lower.
  • You only suffer from mild OSA.
  • You have health issues that prevent you from having OSA surgery.
  • You have a remaining AHI between 5 and 15 after your OSA surgery.
  • You are not able to use your CPAP device consistently.
  • You can’t use a CPAP device due to a side effect or health issue.

Sleep apnea surgery (bimaxillary advancement surgery) may be the right choice if…

  • You have an AHI higher than 15.
  • You suffer from moderate to severe sleep apnea.
  • You have issues with oral device compliance.
  • Your have tried other interventions, such as oral devices, CPAP, and lifestyle changes.
  • Your OSA is caused by a narrow or blocked airway.
  • You are not able to use your CPAP device consistently.
  • You can’t use a CPAP device due to a side effect or health issue.
  • You are looking for a permanent, lifelong solution to your OSA.

Consulting with Doctors & Dentists

The single best way to find an effective and appropriate sleep apnea treatment is to speak to sleep apnea medical professionals. A sleep apnea surgeon can help patients better understand the severity and cause of their OSA as well as the best possible treatment plans for the individual’s needs. A dentist can help patients determine whether an oral device may be helpful, either on its own or in conjunction with another treatment. A dentist can also make certain your dental appliance fits correctly.

Contact Surgical Sleep Solutions with additional questions.

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Bimaxillary advancement surgery - surgical sleep solutions

Bimaxillary Advancement Surgery for Obstructive Sleep Apnea

Although oral appliances can greatly benefit many patients with mild to moderate obstructive sleep apnea (OSA), dental devices may not be a sufficient treatment for those with a severe form of the sleep disorder. In these cases, continuous positive air pressure (CPAP) therapy or surgery may be more effective routes for patients to stop snoring, decrease apneas, and get a better night’s rest.

Bimaxillary Advancement Surgery Basics

Until relatively recently, many sleep apnea surgeries have suffered from low rates of efficacy, daunting side effects, and long recovery times. However, in the past few years, more and more surgeons around the country have found success with bimaxillary advancement surgery, also known as maxillomandibular advancement (MMA) surgery.

Unlike sleep apnea surgeries of the past, which in large part cut away parts of the inner mouth and throat in order to increase airflow, bimaxillary advancement surgery takes an innovative approach to the issue of blocked airways. During the procedure, the surgeon moves both the upper and lower jaw forward as much as an inch, opening the airway simply by restructuring the pathway and literally giving patients room to breathe.

  • Before the surgery. Before the procedure, the OSA patient will meet with a surgeon, anesthesiologist, and orthodontist to make certain that he or she is a good candidate for the surgery and to make sure that their bite is stabilized. The preoperative evaluation includes 3D Cone Beam CT scans and specialized airway and facial skeletal software that allows the medical team to diagnose the obstructive and maximize airflow improvement during the surgery.
  • During the surgery. The patient is given a general anesthetic while the surgeon makes incisions in the inner mouth, mobilizes the upper and lower jaw, and moves both forward. The jaw is then fixed into place using titanium plates and screws. In some cases, the teeth may be stabilized by braces, arch bars, or rubber bands for several weeks during the healing process.
  • After the surgery. Full patient recovery can take 8-12 weeks, although the vast majority of our patients spend only one night away from home in a hospital or recovery center and return to work in 7 to 10 days. A liquid diet is required for 3-5 days after the procedure before a soft chewing diet can begin. Swelling and pain are controlled with liquid medications. Most patients report being able to breathe more easily and sleep better immediately after surgery.

Advantages and Disadvantages of Bimaxillary Advancement Surgery

At Surgical Sleep Solutions, over 95 percent of our sleep apnea surgery patients are cured of their OSA symptoms.


While a small minority of patients may still need or prefer the assistance of a CPAP machine or oral device, most have found a permanent solution to their sleep apnea and no longer need to treat their disorder with the help of a device. This is especially good for those who travel for work, those who have difficulty with compliance, and those who suffer side effects from CPAP therapy.


Like all surgeries, bimaxillary advancement surgery comes with a small number of risks and the chance of complications. The procedure may be expensive for those without the appropriate health insurance or for those who have difficulty taking paid time off of work. Finally, bimaxillary advancement surgery may not be a good option for those with other health problems or those with very high body max indexes (BMIs).

Sleep Apnea Surgery at Surgical Sleep Solutions

Surgical Sleep Solutions has been perfecting a unique delivery model for bimaxillary advancement surgery for over eleven years and have taken great pleasure in watching our patients begin their new lives without suffering from the symptoms of sleep apnea. We encourage everyone who believes they may be suffering from OSA to speak to their doctor about getting a diagnosis and getting help. You can also take this self evaluation to see if you are at high or low risk as well.

Please note that before surgery we recommend trying CPAP for a minimum of three months.

Contact us for more information or to setup a consultation today.

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obstructive sleep apnea and the mediteranean diet

The Connection Between Sleep Apnea & The Mediterranean Diet

Many patients suffering from obstructive sleep apnea (OSA) who also have a high body mass index (BMI) are asked by their doctors to lose weight through exercising and eating a more nutritional diet. This is because sleep apnea can be negatively affected by excess pounds and because sleep apnea has been tied to obesity and obesity-related heath issues including heart disease, high blood pressure, and stroke. Studies have shown that for overweight patients, losing weight can reduce the number of apneas or, in cases of mild OSA, stop the problem entirely. But how should OSA patients go about their weight loss journey and choose a diet that works for them?

Study: A Mediterranean Diet Vs. A Prudent Diet

When it comes to losing weight and combating obstructive sleep apnea, are all diets created equal? A sleep apnea study conducted in 2011 and published by the European Respiratory Journal found that a Mediterranean diet may be more effective than a “prudent diet,” defined as a a diet low in fat and calories. The study involved 40 obese patients with moderate to severe OSA. Twenty of the participants were placed on the Mediterranean diet for 6 month, while 20 followed the prudent diet. Both groups exercised. The results found that those on the Mediterranean diet had a greater reduction in their sleep apnea symptoms than the prudent diet group. In addition the Mediterranean diet group had a greater reduction of their waist circumference.

Following a Mediterranean Diet

What is a Mediterranean diet? The diet is based on the cultural foods of the Mediterranean, consisting of Greece, Southern Italy, and Spain. It originated after researchers linked the diet with smaller waistbands and better overall health. How can you follow a Mediterranean diet? Here are the loose parameters:

  • Base meals on multiple servings of brightly color fruits and vegetables.
  • Focus on olives and olive oil for fats instead of butter or margarine.
  • Get lots of proteins from seeds, nuts, and beans.
  • For another source of protein, eat small, sensible portions of fish and eggs.
  • Limit red meat consumption to a few times per month and small portions.
  • Limit refrained carbs and dairy products.
  • Dairy products should be limited to small portions of yogurt and cheese.
  • Limit alcohol to small amounts of red wine.
  • Limit sodium by using larger amounts of herbs and spices.

Generally, the diet focuses on healthy fats, lots of fiber, whole grains, and low amounts of sodium and red meats. Researchers believe that the lack of saturated fats, paired with how filling the meals can be due to the large volumes of fruits and vegetables, is the reason the diet can result in weight loss and smaller stomachs.

In addition to what you eat, the Mediterranean diet also examines how you eat. Proponents of the diet suggest that you eat socially, like many Mediterranean cultures, which can slow down consumption and take the focus off of your food. In addition, health experts recommend that exercise is paired with the diet for the best health results.

Other Benefits of the Mediterranean Diet

According to the Mayo Clinic, the Mediterranean diet has been tied to reductions in the risk for heart disease, cancer, Parkinson’s disease, and Alzheimer’s disease. Heart disease and cancer are two health issues that are also associated with sleep apnea, although scientists are still not certain of how these health problems are connected.

Treatment options for Obstructive Sleep Apnea (OSA)

At Surgical Sleep Solutions, we understand that finding relief from sleep apnea is vital, but that different people will find success with different treatments. Some overweight OSA sufferers with mild to moderate sleep apnea may benefit from following a Mediterranean diet, positional therapy or CPAP for example while some with more severe OSA may need to consider surgery as an alternative to CPAP. To learn more about your treatment options, or to speak with a doctor, please call our offices today: (855) 560-7378.