Can MMA Knock Out Sleep Apnea?

I have found very few treatments for sleep apnea that can be considered true cures. CPAPs, mandibular advancement devices, and Inspire implants all work as long as you wear them or turn them on.

The underlying sleep apnea is still there if the device isn’t used. However, where the cause is anatomical, there are a number of surgeries that can successfully and permanently resolve sleep apnea. I was interested in finding out more.

What is maxillary mandibular advancement surgery?

One of these surgeries is called the maxillary mandibular advancement or "MMA" surgery. This involves repositioning the bones of the upper and lower jaws to create more airway space. I was lucky enough to have an opportunity to speak to Sydney Avis, who has recently undergone successful MMA surgery.

A dynamic father-daughter duo

Sydney has her dad, Dr. Victor Avis, helping to guide and advise her through her health journey. Dr. Avis, a dentist, was learning more about airway health as part of his professional studies. Dr. Avis says, “I realized in the course of my further education in orthodontics that my daughter, Sydney, was suffering the ill effects of having a compromised airway right under my nose.”

Airway documentary

The Avis father-daughter team decided to record Sydney's journey in a documentary film called Airway. They have been recording all the steps leading up to and including Sydney’s MMA surgery. Their goal with the documentary film is to spread awareness and hope to other people suffering because of restrictions in their airways. 

They have also established a non-profit called The Airway Revolution Foundation with goals including educating medical and dental professionals to work collaboratively on airway health and providing funding assistance to patients unable to afford the care they need.

Before Sydney's MMA surgery

Maxillary mandibular advancement is major surgery, and both Sydney and her Dad wanted to be sure to have exhausted all the other options.  As Dr. Avis says, “We wanted to do our due diligence to make sure we had followed all the necessary steps and diagnostic procedures before deciding on surgery.”

Sydney had a DISE (Drug-Induced Sleep Endoscopy) procedure. This involved an anesthesiologist recreating the stages of sleep and an endoscope showing where the airway was collapsing. The DISE results showed Sydney’s airway collapsing in 4 different places.

Going beyond the diagnosis

Dr. Avis explained that sometimes he doesn’t think diagnoses are particularly helpful. Sydney was diagnosed with narcolepsy first and later with mild sleep apnea. Despite these diagnoses, Dr. Avis could tell Sydney’s issue was that her airway was not wide enough and was collapsing at night. 

Therefore, it didn’t really matter to him what this was officially called. The definition of sleep apnea has to involve a 10-second pause in breathing; a person pausing breathing for 9 seconds might not receive a formal diagnosis but is still going to suffer ill effects and poor sleep.

To Sydney and her Dad, the specific diagnosis wasn’t the most important thing; widening her airway and resolving Sydney’s sleep problems were paramount.

Previously unsuccessful on CPAP and MAD therapy

Before embarking on the MMA surgery, Sydney tried a mandibular advancement device (MAD) and then a continuous positive airway pressure (CPAP) machine. She did not tolerate either of these treatments well. Having ruled out alternative treatment, Sydney decided to proceed with the MMA surgery.

MMA surgery and recovery

The surgery involves several different stages. First, the palate is expanded to make space for the surgical incisions. Then, the surgery involves moving both jawbones forward and rotating upwards.

It’s a substantial recovery period followed by more braces. Sydney explained that her lengthy recovery was tough going and involved months without any solid food. “It was tough. My family was eating spaghetti, and I could only drink and not enjoy solid food. It was so hard.”

An MMA success story

Now Sydney is 5 months post-surgery, and she is sleeping much better. She says, “I had never slept well before the surgery, and now I sleep 8 hours a night with no problem. It’s amazing.”

I am inspired that Sydney and her dad decided to use their unique position to help others by sharing Sydney’s journey. I very much look forward to watching the Airway documentary when it’s complete and seeing what this dynamic father-daughter team does next with their non-profit to improve understanding and treatment of airway issues.