Sleep apnea is a prevalent condition affecting millions of individuals worldwide.  

Breathing during sleep is temporarily interrupted or diminished, leading to various health issues such as fatigue, difficulty concentrating, and heart problems.  

When seeking sleep apnea treatment in Lisbon, you should first understand the risk factors and explore the available treatment options. 

Understanding the Risk Factors for Sleep Apnea 

Several risk factors contribute to sleep apnea, including being overweight, smoking, excessive alcohol use, and ageing.  

Sleep deprivation caused by apnea increases the risk of heart attacks and strokes. Additionally, sleep apnea leads to problems like daytime sleepiness, difficulty concentrating, anxiety, depression, poor memory, and mood swings, significantly impacting one’s quality of life. 

Recognizing the Symptoms of Sleep Apnea 

The signs and symptoms of sleep apnea can include: 

• Snoring 
• Pauses in breathing during sleep 
• Morning and daytime sleepiness 
• Difficulty concentrating 
• Fatigue 

• Insomnia or trouble sleeping 
• Morning headaches 
• Memory and concentration problems 
• Irritability or mood swings 

If you experience any of these symptoms, it is crucial to consult a specialist for an accurate diagnosis and appropriate treatment.  

It is important to note that other health conditions may also cause these symptoms, so working with a specialist is necessary to determine the underlying cause. 

Diagnosing Sleep Apnea 

Polysomnography, a non-invasive sleep test, is a valuable diagnostic tool for sleep apnea. It records various sleep parameters, including eye movement, muscle activity, airflow, and blood oxygen levels. It aims to evaluate sleep quality and duration and identify disruptions like sleep apnea, characterized by breathing interruptions during sleep. 

Treatment Options for Sleep Apnea 

Fortunately, effective treatments for sleep apnea are available in Lisbon.  

It is crucial to approach treatment within a multidisciplinary team context involving medical specialists in pulmonology or neurology.  

The first-line treatment is usually positive pressure therapy, traditionally termed CPAP (Continuous Positive Airway Pressure). 

However, some patients may struggle to adapt to CPAP due to device discomfort or inability to adhere to the necessary treatment hours. 

What to Do When CPAP Isn’t Suitable? 

In cases where CPAP is not well-tolerated, the clinician may attempt to address the issue by adjusting the shape of the nasal/face mask, optimizing pressure settings for better comfort, or introducing a humidifier.  

Additionally, non-invasive or surgical alternatives may reduce or eliminate the need for CPAP. Alternative treatments should involve thorough discussions among the patient, pulmonologist/neurologist, and surgeon, supported by relevant examinations. 

Relevant Examinations 

In addition to polysomnography, other tests can be helpful, especially when considering a surgical option.  

Computed tomography (CT) can provide insights into anatomical defects that may obstruct the airway, such as a deviated nasal septum, facial skeletal disharmonies, or airway narrowing. However, in a CT scan, patients are awake, limiting the ability to interpret sleep-related factors.  

Cone beam computed tomography (CBCT) is a variant of CT with faster acquisition and slightly lower cost. Still, the patient is awake and standing, which poses an additional misinterpretation of the exam results.  

Drug-induced sleep endoscopy (DISE) is an endoscopic examination of the airway performed under sedation to simulate sleep conditions and identify sites of airway collapse and areas contributing to snoring. 

Non-Invasive Alternatives/adjuvant to CPAP 

There some devices can help to reduce CPAP pressure (adjuvant to CPAP) or even be the primary and only treatment needed (alternative to CPAP), such as: 

• mandibular advancement devices 
• Sleep positioners, when apneas predominantly occur in specific positions. 

Surgical Alternatives to CPAP 

As a specialized maxillofacial surgeon treating sleep apnea in Lisbon, I offer a range of surgical procedures, including: 

• nasal surgery 
• jaw surgery (orthognathic surgery, maxillomandibular advancement surgery) 
• palate surgery 

Collaborating with Otorhinolaryngology allows us to address other areas of the airway, such as tonsil and pharyngeal surgery. 

A special mention should be made of orthognathic maxillomandibular advancement surgery, considered a total airway surgery, as it affects all levels of the airway, including the nasal passage, palate, tongue, and jaw. By repositioning the jaws forward, maxillomandibular advancement surgery helps to enlarge the upper airway space, reducing the likelihood of obstruction during sleep. 

It changes the supporting skeleton of the airway, which is the most likely to be successful and curable in selected patients. 

Lifestyle Changes 

In addition to medical interventions, lifestyle changes such as weight loss and smoking cessation are crucial for successful sleep apnea treatment outcomes. It is important to remember that each patient is unique and may require different approaches tailored to their needs. 

Don’t Let Sleep Apnea Symptoms Persist! 

In conclusion, sleep apnea is a severe disorder affecting many Lisbon residents. 

If you have signs or symptoms of sleep apnea, consult a specialist for an accurate diagnosis and appropriate treatment. Treatment options include lifestyle modifications, positive pressure therapies, non-invasive CPAP alternatives and surgery.  

By working with experts in the field, you can find relief and improve your sleep