Sleep should mean rest.

The faces most associated with sleep apnea

When the lower jaw, or both jaws, developed less, the tongue sits further back and the airway narrows, especially during sleep. These are the face types where it is seen most.

Class II faceOften it isn't the teeth. It's the base that holds them.Bimaxillary retrusive faceThe teeth may fit well. In the details, the face tells another story.Long faceWhen the face grows too much downward, the lips, the smile and breathing all feel it.

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Obstructive sleep apnea (OSA) happens when, during sleep, the upper airway narrows or closes for moments at a time. Breathing stops, the body reacts to restart it, and rest becomes fragmented, often without the person remembering it. That's why the person sleeping next to you usually notices it first: snoring, pauses, broken breathing. It's also common to wake up several times during the night, to be able to sleep only on your side or on your stomach because sleeping on your back becomes difficult, and to have reflux as well. During the day, tiredness, sleepiness or trouble concentrating can appear.

The upper airway isn't just the throat. It starts at the nose, in the nasal passages, and continues through the nasopharynx, behind the nose; then through the oropharynx, behind the palate and the tongue, and through the hypopharynx, down to the larynx. Its walls are largely made of muscle and soft tissue. The muscles of the palate and the tongue are anchored to the jaws and to the hyoid, a small bone in the neck, and they work as a unit: that's why the way the structure of the face grew has such an influence on the space available for air.

Sleep apnea always has several causes, but the structure of the face has a strong influence, making it more or less likely. When growth didn't leave enough functional space, the tongue and the muscles have less room, and so does the air. Orthognathic surgery restores the growth that was missing and, with it, that space: that's why it's so effective. When properly indicated, maxillomandibular advancement, which brings the upper jaw and lower jaw forward, often together with the chin, is the surgery with the greatest impact on obstructive sleep apnea. And because it changes the structure of the face, the change in the airway is permanent.

The diagnosis is made with a sleep study (polysomnography), which records how you breathe while you sleep, and other tests. On the maxillofacial surgery side, we add what we see in your face and in the CT scan, reconstructed into a virtual model: how the jaws grew, where the tongue sits and how much space there is for air. The airway is complex and can have different problems; when the case requires it, we work as a team with other specialties. There are also other treatments, such as CPAP, a machine used every night, and all the options are discussed at the consultation.

The images show how the space for air changed in one case; they are not a prediction. Every person is different, and what you can expect in your case is discussed at the consultation.