Sleep Apnea

It is estimated that 22 million Americans suffer from sleep apnea. 80 percent of the cases of moderate and severe obstructive sleep apnea are undiagnosed.

Left untreated it can lead to high blood pressure, chronic heart failure, atrial fibrillation, stroke, and other cardiovascular problems. It is also associated with type 2 diabetes and depression.

Don't worry! There are many solutions depending on your kind of sleep apnea and cause. We can help.

What is Sleep Apnea?

Sleep apnea is a common sleep disorder and much more than just snoring. During sleep, the patient’s upper airway becomes blocked by sagging tissues in the throat or the back of the tongue, and airflow ceases. The brain senses the lack of oxygen and it wakes the person to restart breathing. These interruptions can occur dozens of times every night without the person ever realizing it.

These disturbances can affect health including blood pressure, cardiovascular problems, type 2 diabetes, depression, weight gain and more. In addition most sleep apnea patients have a hard time staying awake during the day. This becomes a problem during work, play and especially when driving.
A diagnosis of sleep apnea can be confirmed with a sleep study. At Texas Sinus & Snoring we offer in home sleep studies.

Are There Different Types of Sleep Apnea?

There are different types of sleep apnea, defined by the causes.

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea (OSA) is the more common form, occurring when muscles in the throat relax, blocking airflow. These muscles support all of the surrounding tissues such as the tonsils and the side walls of the throat. When the muscles relax, the airway narrows or closes. Your brain senses this inability to breath and briefly wakes you from sleep to reopen the airway. These lapses in sleep can be so brief you don’t even remember them. These actions can involve a snorting, choking, or gasping sound and can repeat the pattern up to 30 times per hour all night.

Central Sleep Apnea (CSA)

Central sleep apnea (CSA) is caused when the brain doesn’t send proper signals to the muscles that control breathing.Consequently, you make no effort to breathe for a short period of time. You then awaken with shortness of breath or have difficulty even falling asleep.

Upper Airway Resistance Syndrome (UARS)

Upper airway resistance syndrome (UARS) differs from OSA in that there aren’t pauses in breathing or decreases in breathing. And patients with UARS simply require greater effort in breathing to get past obstructions.

Complex Sleep Apnea Syndrome

Another form of sleep apnea is Complex sleep apnea syndrome. This sleep apnea is categorized as a person having both OSA and CSA.

What Causes Sleep Apnea?

Most people don’t understand the difference between occasional snoring and sleep apnea. Snoring occurs when there is resistance to airflow when a person is sleeping. The resistance causes the noise.
When airway resistance increases to a complete blockage more than five times an hour, the patient has Sleep apnea. Dr. Cilento treats both snoring AND sleep apnea. Sleep apnea is a complex problem with complex solutions. In general, a person obstructs at three levels: The nose and sinuses, the soft palate, and the tongue base.

The Varying Causes of Sleep Apnea

  • Throat and tongue muscles that are abnormally relaxed
  • Enlarged tonsils or adenoids
  • Aging
  • Cardiovascular problems
  • Obesity
  • Chronic sinusitis and airway inflammation
  • Nasal congestion and blockage
  • Smoking
  • Family history


How Does Sleep Apnea Develop?

Several factors play a role in being more likely to develop sleep apnea. These are risk factors for obstructive sleep apnea:
  • Neck circumference — People with thicker necks often have narrower airways (men 17 inches and larger, women 15 inches and larger).
  • Obesity — Obese people have four times the risk of sleep apnea. Fat deposits around the upper airway can add to obstruction.
  • Narrowed airway — Some people simply have a naturally narrow throat, or have enlarged tonsils or adenoids.
  • Men — Men are twice as likely to have sleep apnea.
  • Age — Sleep apnea is more common in older adults.
  • Family history — Sleep apnea runs in families.
  • Smoking — Smokers are three times more likely to have OSA.
  • Alcohol or sedatives — These substances relax the throat muscles.

Common Sleep Apnea Symptoms

  • Loud snoring (more prominent with obstructive sleep apnea)
  • Daytime sleepiness or lethargy
  • Awakening with shortness of breath (central sleep apnea)
  • Episodes of breathing cessation witnessed by another person
  • Waking up with a headache in the morning
  • Excessive daytime sleepiness
  • Waking up with a dry mouth or sore throat
  • Difficulty staying asleep
  • Attention problems
  • Impotence or Erectile dysfunction
  • Irritability

You’ll need to complete a sleep history. Someone who shares your bed or someone in your household can usually help with this. We may refer you to a sleep disorder center, if it looks like you’re a good candidate. They will monitor you overnight as you sleep. You may also use a home test. This is a simplified version that measures your heart rate, blood oxygen level, airflow, and breathing patterns while you sleep.

Texas Sinus & Snoring on Great Day Houston with Deborah Duncan

Hear from Dr. Cilento and some of our sleep apnea patients on this segment with Deborah Duncan of Great Day Houston.

Can I Prevent or Stop Sleep Apnea?

Obstructive sleep apnea is sometimes limited by these prevention strategies. In any case making an appointment and seeing a professional about your sleep apnea is always the best plan of action.

  • Treat Sinusitis and Allergies — Many people have ongoing allergy and chronic sinus issues that cause breathing difficulties and nasal obstruction. This may progress to snoring and even sleep apnea if left untreated.

  • Exercise — Moderate activity, such as brisk walking for 30 minutes a day can relieve some symptoms.

  • Lose weight — Even a slight weight loss can relieve constriction in your throat. Getting to your ideal, healthy weight may be all you need to do to open up your airway.

  • Avoid alcohol, sleeping pills, and tranquilizers — These all relax the muscles in the back of the throat, allowing the sagging that leads to sleep apnea.

  • Sleep on your side or abdomen, not your back — Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat, blocking your airway. There are some commercial devices that vibrate when you roll onto your back in sleep.

  • Don’t smoke — Smokers are three times more likely to have OSA.

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Sleep Apnea Treatment in Spring, TX

Understanding the Cause of Your Sleep Apnea

Understanding the cause of your sleep apnea determines our course of action. This could include breathing systems such as a CPAP, Inspire Sleep Therapy, an Oral Appliance, AIRLIFT or Sinus Surgery. Lifestyle changes like losing weight, limiting alcohol consumption, or quitting smoking can also help.

Some patients have sleep apnea AND a nasal obstruction. A CPAP can't do its job if your nose doesn't work correctly. Balloon Sinuplasty, and nasal procedures can help restore normal nasal breathing.

What is CPAP?

Continuous Positive Airway Pressure (CPAP) is the most popular treatment for obstructive sleep apnea. It uses air pressure to keep the upper airway passages open. The patient wears a mask over his or her nose during sleep. The mask delivers air pressure that is somewhat greater than the air pressure in the bedroom. This difference in pressure keeps the airway passages open, preventing snoring and apnea.

Inspire Sleep Therapy

Inspire Therapy is a new approach. Dr. Cilento implants a device that the patient turns on when he or she goes to bed. The device delivers a mild stimulation to key airway muscles to help keep them open while sleeping. The person doesn’t feel a thing, but the airway stays open, allowing uninterrupted sleep.

Oral Appliance Therapy

Oral appliance therapy uses a device similar to a sports mouth guard or an orthodontic retainer. Worn only during sleep, the oral appliance supports the jaw in a forward position to help maintain an open upper airway.


AIRLIFT™ is a simple and effective implant treatment for Obstructive Sleep Apnea and alternative to CPAP. It helps open and stabilize the airway.

Kinds of Surgery for Sleep Apnea

As a premiere sinus and sleep surgeon in Houston, Dr. Cilento has a methodical approach to tackling even the toughest of snoring problems. He will perform a comprehensive physical exam and history at your first visit. We assess all patients for the presence of reversible causes of nasal obstruction. Even if a patient wishes to use CPAP, a working nasal airway is a must. Dr. Cilento offers many surgeries to help maximize nasal airflow:

  • Nasal Valve Reconstruction — The nasal valve stenosis is caused by narrowing of critical structures in the nose. Cartilage on each side of the nose may weaken and collapse on one or both sides when a person is breathing in. This is known as nasal valve collapse. Nasal Valve Reconstruction surgery corrects this problem and returns proper airflow.
  • Turbinoplasty- The turbinates are the radiators of the nose and are responsible for warming and moistening of the air we breathe. They also react to allergens, irritants and bacteria and viruses and swell to block the nose. Removal is not a good idea so we have several ways of shrinking the size of these structures permanently.
  • Septoplasty — The septum is the structure in the nose that separates the two nostrils. For some patients, their septum can become crooked or misaligned, making one nostril larger than the other. This can inhibit proper airway function. Septoplasty evens out both nostrils by repositioning the septum. This places both nostrils in the proper position and improves airflow.
  • Balloon Sinuplasty- The presence of Chronic sinusitis can cause severe and persistent nasal obstruction. For those who qualify, balloon sinuplasty may be required to help open blocked sinuses and nasal airflow outtracks.

Severe Sleep Apnea Treatment

Once the nose is maximized, attention is turned to the area of the Palate and oropharynx. If a patient’s sleep apnea is moderate to severe and is impacting their quality of life adversely, Dr. Cilento offers several surgeries to improve the airflow in this area. Surgery is usually an option if other sleep apnea treatments have failed to improve the patient’s symptoms.


  • UPPP/Uvulopalatopharyngoplasty — This surgical procedure removes excess tissue in the throat, widening the airway. UPPP also seeks to improve the movement of the soft palate to help the airway remain open during sleep. Outcomes are improved if the patient still has their tonsils for removal with the palate trimming.
  • Snoreplasty — If a patient does not have sleep apnea but still has a considerable amount of snoring, it is possible to trim the palate and stiffen the palate enough to stop the noise.
  • Hyoid Suspension — The hyoid bone is located just above the adams apple and connects all the tongue muscles together. If we suture it to the adams apple below and stabilize it, the patients breathing is improved.
  • Tongue Base Coblation — sometimes the tongue base is stiffened and reduced in sized by locally applying energy to help shrink it.
  • Oral Appliance — Sometimes the answer to tongue base contributions to sleep apnea is simple. We will often discuss sleep appliances to help move the tongue base forward. These appliances can be custom made to help position the lower jaw forward, thus pulling the tongue out of the way.