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Sleep Apnea

Sleep apnea is a sleep breathing disorder that is characterized by interruptions of breathing during sleep. It is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep. The term sleep apnea is derived from the Greek etymology meaning “without breath”. Sleep apnea occurs when breathing is suspended for periods of 10 seconds or longer. Breathing pauses can last anywhere from several seconds to minutes and occur 5 times or more in an hour during sleep. Ongoing disrupted breathing causes an imbalance between the carbon dioxide and oxygen levels in the bloodstream, as not enough carbon dioxide is exiting and not enough oxygen is entering the body. Sensing this imbalance, the brain sends a message to the body, telling it to wake up to restart the breathing process. People with sleep apnea will partially awake as they struggle to breathe, and this is often accompanied by loud snoring or choking sensations. Because people with sleep apnea don’t always completely awake during the episodes, they are often unaware they have a sleeping disorder and it can remain undiagnosed.

Doctors estimate that 9.1% of men and 4% of women have sleep apnea. That translates to 18-25 million Americans (1 in every 15) living with sleep apnea. Possibly as few as 5% have been diagnosed, or have taken a sleep study. A person afflicted with untreated obstructive sleep apnea (OSA) is up to 4 times more likely to have a stroke, as well as 3 times more likely to have heart disease. Approximately 50% of all patients who have hypertension, or high blood pressure, are also afflicted with obstructive sleep apnea. People suffering from OSA are as much as 6 times more likely to be involved in a car crash than those without sleep disorders. This is due to the fact that they are drowsy from lack of sleep.

Even though sleep apnea can affect anyone regardless of age, weight, and gender, these factors indicate a higher likelihood of having sleep apnea: mouth breathing, excess weight, neck size, family history, use of alcohol or sedatives, smoking, being a MALE, Age, narrowed airway, enlarged tonsils or jaw structure.  

Sleep apnea is measured by the number of times you stopped or reduced breathing per hour. Together, these events are counted and known as the Apnea-Hypopnea Index (AHI). A sleep study will measure your AHI as well as the drop in your blood-oxygen levels to help determine the severity of the disease. If you have obstructive sleep apnea, your sleep study results will indicate mild, moderate or severe sleep apnea.

There are two main types of this disorder; central sleep apnea which occurs when the brain fails to send important signals to the breathing muscles, and obstructive sleep apnea which occurs when air cannot flow through the nose or mouth even though the body is still trying to breathe.  Obstructive sleep apnea is far more prevalent and easily treatable by the dentist.

Common signs of obstructive sleep apnea can include severe early morning headaches, sleepiness in the daytime, and insomnia. Fortunately, the dentist is equipped with the necessary technology and expertise to treat sleep apnea in several different ways.

Reason for treating sleep apnea

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop breathing numerous times per hour, and this can quickly turn into a deadly situation. Obstructive sleep apnea occurs when the soft tissue lying at the back of the patient’s throat collapses into the airway. The tongue then falls towards the back of the throat which tightens the blockage and prevents oxygen from entering the lungs.

The problem worsens when the chest region, diaphragm, and abdomen fight for air. The efforts they make to obtain vital oxygen only cause a further tightening of the blockage. The patient must arouse from deep sleep to tense the tongue and remove the soft tissue from the airway.

Because sleep apnea causes carbon dioxide levels to skyrocket in the blood and oxygen levels to decrease, the heart has to pump harder and faster to compensate for the lack of oxygen. Sleep apnea patients can technically “die” many times each night. Sleep apnea has been linked to a series of serious heart-related conditions, and should be investigated at the earliest opportunity.

What does sleep apnea treatment involve?

Sleep apnea treatment involves maintaining an open airway during sleep and preventing the airway from collapsing. Sleeping masks were traditionally used to keep the patient’s airways open while they slept, but nowadays there are some less intrusive options. Dental devices that gently tease the lower jaw forward are very effective in preventing the tongue from blocking the main air passage. These dental devices are gentle, easy to wear, and often help patients avoid unwanted surgeries. Oral Appliances are placed in the mouth and are worn much like an orthodontic appliance or sports mouth protector. Worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat, oral appliances promote adequate air intake and help to provide normal sleep in people who snore and have sleep apnea.

C-PAP (continuous positive air pressure applied through a nasal mask) is the most common and standard form of treatment of obstructive sleep apnea (OSA). The C-PAP machine consists of a face or nasal mask that is connected to a pump, providing a positive flow of air into the nasal passages in order to keep the airway open. This pressure ensures that the airway does not’t collapse during sleep. C-PAP is recommended as the first line of treatment for patients with severe obstructive sleep apnea. Patients with mild-to-moderate sleep apnea can usually choose which therapy they would prefer.

The American Academy of Sleep Medicine recommends oral appliances as the first-line therapy for patients who have been diagnosed with mild-to-moderate obstructive sleep apnea, or severe obstructive sleep apnea that cannot tolerate their prescribed CPAP. They can also be used in conjunction with other therapies such as continuous positive air pressure (C-PAP). Determination of proper therapy can only be made by joint consultation of your sleep physician and a qualified sleep medicine dentist.

While not considered as the first line of treatment for snoring or sleep apnea, surgery may be an effective option for patients who cannot tolerate C-PAP or oral appliance therapy. With many surgical options available, it is up to the surgeon to find where the obstruction is in the patient’s upper airway or nasal passage and determine what the best solution is. 

If you feel you may benefit from sleep apnea treatment, contact our practice today.