Accessibility Tools

Sleep Apnea

Sleep Apnea

Sleep Apnea

“Sleep apnea is quite often undiagnosed. People with back pain or other major injuries are not going to get better if they’re not sleeping well. People come to me all the time saying, ‘My shoulder really hurts me and it’s waking me up every night.’ If you are not breathing while you sleep, of course your back or shoulder pain is going to get worse. We need to treat both your sleep apnea and your back or shoulder in order for you to completely heal.” – Dr. Romano

Sleep Apnea (SA) occurs when a person frequently stops breathing for short periods (10-30 seconds) during sleep. This can occur up to 400 times per night. It’s said that about twenty-five percent of the population has sleep apnea, with 80-90 percent of them going undiagnosed. This is particularly important when we perform any surgery such as hip replacements or knee replacements – studies show that undiagnosed / untreated sleep apnea can create more post-surgical complications and longer hospital stays, simply because the patient is not breathing well.

Obstructive Sleep Apnea (OSA) is the most common form of SA and occurs when the soft tissue in your throat narrows and repeatedly closes during sleep, preventing air from getting into the lungs. People with SA can suffer from fatigue and sleepiness, chronic headaches, depression, heart issues, high blood pressure, and more.

The causes of sleep apnea include obesity, drinking alcohol, smoking, sedative medication, a nasal obstruction (deviated septum), being over 40, high blood pressure, and many others. Chronic respiratory tract conditions, such as asthma, allergies, chronic bronchitis, and chronic obstructive pulmonary disease can be risk factors as well. You also have an increased risk of developing sleep apnea if you breathe through your mouth while sleeping or if you snore.

The use of a CPAP (continuous positive airway pressure) device, a very common form of therapy, keeps the upper airway open by providing a steady stream of air through a mask so you won’t stop breathing during the night. A specially fitted mouthguard is another form of treatment as it also keeps your upper airway open during sleep.

A lot of times people with sleep apnea or breathing problems also have balance problems and a host of other related complicating issues as well. That’s why we regularly screen for sleep apnea and, if diagnosed, recommend treatment.


What is Sleep Apnea

During normal sleep, your throat is clear and open, allowing air to flow freely to and from your lungs. Obstructive Sleep Apnea (OSA) occurs when the tissues at the back of your throat collapse and block airflow despite efforts to breathe. This causes tissues to vibrate, creating that all too familiar snoring sound. Most people with OSA are unaware of their constant struggle to breathe, making it impossible to get a restful night’s sleep.

How Can We Help?

If you believe you might be suffering from OSA, or have any of the warning signs listed here, please talk to us. We will do a series of tests to figure out the root cause of your problems and work with you to solve them.

Custom-Made Oral appliances help you breathe easier by positioning your jaw forward, thus opening your airway while you sleep. We do our best to solve your sleeping problems without the use of a CPAP (Continuous Positive Airway Pressure) machine, another primary treatment device for OSA.

Other secondary treatments might include using nasal sprays and washes and/or decongestants, using nasal strips or cones, regular exercise and weight loss, smoking cessation, avoiding medications indicated for sleep, and limiting alcohol use.

During your exam, we do a comprehensive review of your overall health and lifestyle. We also review your medical history, medications, and family history to determine the most appropriate treatment with the best possible outcome.

Incidence of OSA:

  • Up to 25% of population
    • 80-90% of it is unrecognized
  • In NFL study
    • 14% of current players
    • 34% of linemen
    • 52% of retired NFL player


  • Excessive daytime sleepiness
  • Frequent awakening at night
  • Poor concentration
  • Morning headaches
  • Moodiness or Irritability
  • Difficulty losing weight
  • Waking with shoulder or back pain
  • Falling asleep reading, watching TV, or driving

Causes and Risk Factors Are:

  • Male
  • Overweight or obese
  • High blood pressure
  • Family history of sleep apnea
  • Cigarette smoking
  • Alcohol use
  • Over age 50
  • Sedative medication
  • Menopause
  • Pregnancy
  • Asthma, COPD or Bronchitis
  • Gastroesophageal reflux, or GERD
  • Large neck size
  • Nasal obstruction
    • Deviated septum
    • Allergies
  • Enlarged tonsils or adenoids
  • Mouth breathing

Why Worry about OSA?

If left untreated, sleep apnea can result in a growing number of health problems, including:

  • High blood pressure
  • Diabetes
  • Depression
  • Headaches or Migraines
  • Worsening pain at night
  • Poor performance at work and school
  • Motor vehicle crashes
  • Academic underachievement
  • Worsening of ADHD
  • Irregular heartbeats, A-Fib
  • Heart failure
  • Heart attacks
  • Strokes
  • Early dementia
  • Erectile dysfunction

Children with OSA May Have:

  • Snoring
  • Learning disabilities
  • ADHD
  • Bedwetting
  • Teeth grinding
  • Mouth breathing
  • Night terror or sleepwalking
  • Frequent infections

Those with OSA at night also may have obstructive breathing during the day which causes:

  • Neck and back pain
  • Muscle weakness
  • Poor posture
  • Poor balance

Post-Op Patients with OSA:

  • 44% ↑ risk for complications
  • Pneumonia
  • Pulmonary embolism
  • Cardiac arrest
  • Stroke
  • Shock
  • Sudden death
  • ↑ Risk transfer to ICU
  • ↑ Hospital stay
  • ↑ Risk of drug complications
  • Narcotics
  • General anesthesia
  • Sedatives
  • Muscle relaxants

Getting Help:

Sleep apnea isn’t a condition to just ignore, and it has very serious implications for your health over time. Each case of sleep apnea is different, so it’s important so a individualized care plan to be implemented by your doctor. We’ll work with you to make sure that you, or your child who suffers from OSA, get the proper care, treatments, and technology to maintain your health.

Romano Orthopaedic Center

Request an appointment