Sleep Apnea

Cosmetic Dentistry Directory

leep apnea is a health-threatening condition that you may have without realizing it. If you habitually snore, and if you tend to struggle with drowsiness during the day, you might be waking at night to gulp air down and then falling back asleep.

The term apnea comes from a Greek word meaning without breath. A person with sleep apnea stops breathing many times each night, perhaps hundreds of times, and perhaps for as long as a minute each time. This interferes with sleep to the point of endangering your health.

The airway, called the trachea, is a relatively wide tube between the throat and lungs and as it enters the lungs, it divides and sub-divides into thousands of smaller tubes. Each little tubule gives up its oxygen and receives waste products. That “dirty” air then makes its way through ever-larger tubules until it reaches the trachea again and is breathed out.

Obstructive Sleep Apnea

Of the three types of sleep apnea, Obstructive Sleep Apnea (OSA) is the most common. It is caused by a blocked airway. The soft tissue in the throat collapses against the airway, blocking it either partially or completely. This causes the sound of snoring. However, not every snorer has OSA.

There are two other types of sleep apnea, both less common:

• Central Sleep Apnea – where the airway is open but the brain stops signaling the muscles to breathe; and
• Mixed sleep apnea – a combination of the other two types.

Each occasion when you stop breathing is called an apneic event. At some point you wake up briefly, long enough to resume breathing, and fall back asleep only to wake again shortly to repeat the same cycle. This makes for very restless and disturbed sleeping. When you have hundreds of apneic events each night, the blood becomes depleted of oxygen and its waste products build up.

Sleep Apnea Symptoms

When sleep apnea continues untreated, it can cause a variety of uncomfortable and even dangerous symptoms. Some of them are evident when you wake in the morning, such as headaches and a dry throat. Others are:

• Chronic fatigue
• High blood pressure
• Cardiac problems
• Weight gain
• Problems with memory and attention span
• Impotence
• Depression and irritability
• Habitual snoring

Chronic fatigue can lead to other dangers such as poor job performance and careless driving. Studies have established a link between sleep apnea and likelihood of being in a car accident.

Who is Most Likely to Have Sleep Apnea?

According to the National Institutes of Health, about 12 million Americans are thought to have sleep apnea and over half of these people are overweight. The excess fatty tissue around the throat falls against the airway when muscles relax during sleep. Other people at increased risk for sleep apnea are:

• People over 65
• Middle-aged men
• Hispanics, Pacific Islanders, and African Americans
• People with small airways, either because of genetics or from the congestion of an allergy
• Children with enlarged tonsils
• Smokers
• People with high blood pressure
• People with other family members suffering from sleep apnea

Diagnosing Sleep Apnea

Doctors and neuromuscular dentists can both diagnose sleep apnea. A medical history is taken, and a family history. Doctors will do a physical exam and dentists will do a bite exam and a sleep study will be done.

The sleep study has traditionally been done in a sleep clinic where you spend a night being monitored. Now it can also be done at home by wearing a device strapped around your chest. At $300, this is far less expensive than going to a sleep clinic and just as reliable.

You can pay out of your pocket for use of this diagnostic device for one night and for a report on its findings. That is simpler than going through a health insurance company or Medicare, with all the attendant paperwork and perhaps unnecessary questionnaires, lab work, or testing. Home sleep-testing devices have been commonly used in other countries – Australia, Canada and European countries – for many years.

These devices have some sensors that record any pauses in your sleep breathing. You bring the device back to your dentist’s office and he or she will be able to advise you about your sleep apnea and how severe it is. You can then discuss treatment options.

Sleep Apnea Treatment

There are no drugs to treat sleep apnea. For some people, one or two lifestyle changes are enough:

• Stop using any alcohol or sleeping medications at bedtime
• Lose weight
• Use nasal sprays to help keep the nasal passages open
• Use special sleepwear that prevents you from lying in a supine position (on your back)

CPAP (Continuous Positive Airway Pressure)

CPAP does not work very well for most people who try it. It uses a vacuum pump connected by a breathing tube to a mask worn over the nose and face. The pump’s air pressure is set just strong enough to keep your airway open.

Sleep is difficult with CPAP because of the pump’s noise, the mask’s discomfort, and the movement limitations imposed by the breathing tube. About 75 percent of people prescribed a CPAP system abandon it and go without sleep apnea treatment.

MAS (Mandibular Advancement Splints)

An alternative approach offered by many dentists is a custom appliance worn during sleep. Each one is made to fit closely over the upper and lower teeth. The term “mandibular” refers to the lower jaw, the mandible, and these appliances hold it in a slightly forward position, slightly advanced.

This prevents throat tissue from collapsing back against the airway and ensures a sound night’s sleep. Some are designed a little differently and hold the tongue slightly forward rather than the jaw. All must be obtained through your dentist or doctor. A popular brand is the SomnoMed but there are many others.

Surgery

Some sufferers of sleep apnea experience no help from the above options and need surgery to give them a clear airway during sleep. Depending on the cause(s) of your sleep apnea, you might be advised to have:

• A tonsillectomy – removal of the tonsils or adenoids (pharyngeal tonsils), which are masses of soft tissue at the back of the throat
• Septoplasty – straightening or centering the nasal septum that separates the nostrils. If it is deviated from the center, breathing becomes more difficult when you lie on the opposite side, as one nostril is too narrow.
• Somnoplasty – shrinking any excess tissue around the throat or in the nasal cavities by using radio waves.
• LAUP (Laser Assisted Uvula Palatoplasty) – using a laser to vaporize unneeded soft tissue around the airway.
• Surgery to pull the tongue forward, preventing it from collapsing against the airway. It repositions the muscle used to stick the tongue out (the genioglossus muscle), drawing it further forward.

Each case of sleep apnea is individual. If you suspect that you or your loved one suffers from sleep apnea, it is important for your health’s sake to be checked as soon as possible. You can find a qualified sleep apnea dentist near you by contacting us today.