Severe Sleep Apnea- Breathing Difficulties. Anatomical problems or other cause? (photo)

Every since I completed puberty, I have had trouble breathing at night, constantly waking up gasping for air. I feel a tension in my throat when I inhale, and feel dizzy and lightheaded during the daytime. My ortho previously told me that I have an overbite, unsure if this is relevant. 2 months ago, I woke up gasping and later collapsed.The ER doctor dismissed it as a panic attack. My gen. practitioner sent me to an ENT, who sent me to an pulmonologist, who is unable to diagnose issue

Doctor Answers 9

Sleep apnea and proper diagnosis

Sleep apnea is very under diagnosed.  It is difficult to get an assessment based on symptoms alone - usually the bed partner can identify the problem or witness the apneic events.  I would see a sleep medicine specialist and ask for a polysomnogram (sleep study).  This will give the most objective breathing, oxygen, and neurological information during your sleep.  It will also be able to tell if you have an obstructive or another cause to the events.  From the photo alone it doesn't appear you have a clear dentofacial cause, but it is a limited photo  - a proper CT scan or cephalogram would help your diagnosis as well from a surgical planning perspective.  Good luck.

Washington DC Plastic Surgeon
5.0 out of 5 stars 18 reviews

OSA (Obstructive Sleep Apnea)

Obstructive sleep apnea is a result of breathing being obstructed at night and it sounds like this is a possibility. As for fainting, it can have an impact on you during the day because you aren't getting the restorative sleep you need. Over time, this can have a major impact on your health. There are a lot of elements to consider in diagnosing sleep apnea and the only way to know for sure is to specifically request that you are screened for it.  There are a few different ways to do this. Sleep studies can be done at sleep clinics and where a mild or moderate case of OSA (obstructive sleep apnea) is suspected, patients may also be able to sleep at home with a device  that measures stats throughout the night  and provides those details to your doctor / dentist. An oral appliance can be crafted by a dentist for mild to moderate cases of sleep apnea. A CPAP machine may be recommended if you are diagnosed with a more severe case of sleep apnea. Good luck. 

Kathy Frazar, DDS, FAGD
Houston Dentist
4.6 out of 5 stars 10 reviews

Get a sleep test

The ONLY way to know if you have sleep apnea is from a sleep test, either a PSG (polysomnogram) or HST/OCST (home sleep test/outside center sleep test).  The PSG is best, but the others can shed some light (but may indicate you need to do the PSG).  Once we know what your sleep is like, advice is easier.

Lance Timmerman, DMD, MAGD
Seattle Dentist
4.3 out of 5 stars 6 reviews

Sleep apnea and your jaw

Consider getting a sleep study which is called a PSG from a sleep lab with a sleep physician.  If you have sleep apnea they may recommend a CPAP or refer you to a dentist trained in TMJ and sleep dental medicine to make an oral appliance to help you breath.  There are numerous reasons that you may have this problem.  It could be due to a deep bite and narrow dental arches.  This forces your tongue posteriorly which blocks the airway.  Another could be tonsilar blockage or possible enlarged turbinates which keep you from breathing through your nose.  Find someone to guide you from sleep studies to airway evaluation.  Good luck, its very important for your health.

Ronald Konig DDS
Houston Dentist
5.0 out of 5 stars 1 review

Sleep apnea and jaw

if you have had this issue and have been told you had an overbite then you might want to look into jaw advancement surgery. This would improve profile, bite, and more importantly your airway. Start by getting a sleep study first then contact a surgeon. 

Majid Jamali, DMD
New York Oral & Maxillofacial Surgeon
4.8 out of 5 stars 17 reviews

Severe Sleep Apnea undiagnosed

Did any of your physicians ever have you take a PSG (in-lab sleep test) or an HST (home sleep test)? That is the only way to diagnose sleep apnea.

Jay Neuhaus, DDS
New York Dentist

Severe sleep apnea and no diagnosis

If you have severe obstructive sleep apnea, then there are many treatments available to you. I would see a board certified sleep medicine specialist and get on CPAP. If CPAP doesn't work, then see a fellowship trained sleep surgeon who can diagnose and treat the level of obstruction that you're experiencing during sleep. 

Jose E. Barrera, MD, FACS
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

Sleep Apnea

you need to see an ENT that does sleep apnea testing and usually hooks you up to a machine for a  night and analyzes your heart rates and breathing for the entire night .  Then they can evaluate you better and rule out sleep apnea or give you an oral device tahat will help you breath better at night.  

Breathing issues

You are in a difficult situation as it is not a normal history and symptoms that is affecting you. I would continue to look for either a sleep physician or ENT that can help you get properly assessed and diagnosed. You may even benefit from seeing a dentist that does sleep appliances and uses a pharyngometer that is technology that uses sounds waves to map out your airway.
It may be anatomical, it may be muscle spasms or it could be something else. Even acupuncture would be an avenue to pursue.
I wish that I could be more helpful--don't give up. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.