Sleep Apnea

 

Self Test for Sleep Apnea

To see if you may have a concern for sleep apnea, please feel free to take this Self-Test for Sleep Apnea. Sleep apnea is a type of breathing disorder which is a serious, potentially life-threatening condition characterized by brief interruptions of breathing during sleep.  There are basically three types of apnea:

1. Central Apnea

The upper airway is open, but no oxygen is getting into the system. This occurs because the patient is not getting a chemical response from the brain to stimulate the lungs and the diaphragm to assist with breathing.

2. Obstructive Sleep Apnea (OSA)

The exact cause of OSA remains unclear.  The site of obstruction in most patients is the soft palate, which has no rigid structures such as cartilage or bone to hold the airway open.  During the night, muscles relax to a point where the airway collapses and becomes obstructed.  Therefore breathing tops ad the sleeper awakens to open the airway.  These arousals from sleep usually last only a few seconds, but they disrupt continuous sleep and prevent the person from reaching the deep stages of slumber, such as rapid eye movement (REM) sleep, which the body needs in order to rest and replenish its strength.  Once normal breathing is restored, the person falls asleep only to repeat the same cycle throughout the night.

In a given night, the number of involuntary breathing pauses or “apneic events” may be as high as 20 to 60 or more per hour.  These breathing pauses cause apnea episodes, although not everyone who snores has obstructive sleep apnea.
 
3. Mixed Apnea

This is a combination of central and obstructive sleep apnea.

Oral appliances are only indicated for use in patients suffering from obstructive sleep apnea (OSA). The signs and symptoms of OSA include snoring, excessive daytime sleepiness, gasping or choking during the night, non-refreshed sleep, fragmented sleep, clouded memory, irritability, personality changes, decreased sex drive, impotence, and morning headaches.

What are the risk factors?
The primary risk factors for OSA are obesity and age.  The accumulation of fat on the sides of the upper airway causes it to become narrow and predisposed to closure when the muscles relax.  Age triggers a loss of muscle tone that may be replaced with fat leaving the airway narrow and soft.

Men have a greater risk of OSA.  Other predisposing factors associated with OSA include:

  • Gender, male hormones cause structural changes in the upper airway.
  • Anatomic abnormalities, such as receding chin.
  • Enlarged tonsils and adenoids, the main causes of OSA in children.
  • Alcohol & sedatives relax the muscles in the surrounding upper airway.
  • Smoking causes inflammation, swelling, and narrowing of the upper airway.
  • Hypothyroidism, acromegaly, amyloidosis.
  • Vocal cords paralysis, post-polio syndrome, neuromuscular disorders.
  • Marfan’s syndrome, and Downs syndrome.
  • Nasal congestion.


What are the symptoms?

  • Loud snoring
  • Periods of not breathing (apnea)
  • Waking not rested in the morning
  • Daytime fatigue
  • Poor judgment
  • Personality changes
  • Excessive daytime sleepiness
  • Morning headaches
  • Weight gain
  • Limited attention
  • Memory loss
  • In addition, sleep apnea has been associated with high blood pressure, cardiovascular disease, stroke and sexual dysfunction.

    
A better quality of life.

Anyone who suffers from snoring should be well aware of the problem it poses.  Every day, no less than 1 in 3 men and 1 in 10 women experience sleep disturbance and broken sleep.  The effects are not restricted to snorers themselves.  The problem extends to everyone else around, notably to partners.

Have you considered a dental appliance?

Various oral appliances can be used to move the tongue or mandible forward.  These devises are used during sleep to prevent the collapse of the tongue and soft tissues in the ack of the throat so that the airway stays open during sleep.  These appliances promote adequate air intake and help provide normal sleep in people who snore as well as in patients with OSA who cannot tolerate positive airway pressure therapy (CPAP).

Appliances should only be considered for OSA patients who have been properly evaluated and diagnosed by a sleep specialist.  If you snore, please arrange for a private evaluation by one of our certified dental professionals.

Advantages of Dental Appliances

  • Easy to use
  • Few side effects
  • Comfortable
  • Reversible procedures
  • Non-invasive
  • Cost Effective



Children and Sleep Apnea

 


Children can also snore and suffer from obstructive sleep apnea. Often they are highly allergic and their airway is blocked due to enlarged adenoids, tonsils or swollen nasal mucosa. Clinical signs would indicate a turned up nose, allergic shiners under the eyes, mucous draining out of the nose, mouth breathing, and a nasal sound to the voice. Other signs are bed wetting, irritability, difficulty in concentrating at school, attention deficit disorder (ADD)  and hyperactivity

At the present time, obstructive sleep apnea is defined as a medical problem and the diagnosis must be made by a medical doctor or sleep physician (pulmonologist) who is specially trained in the area of sleep medicine.
 
The dental profession has an important role to play in the treatment of patients with snoring and sleep apnea. If 60% of men and 40% of women between forty and sixty years of age snore, this is a huge problem. Snoring is a serious social problem for the spouse, but obstructive sleep apnea can be a life threatening situation for the patient in that it can lead to irregular heartbeat, high blood pressure and strokes.

At the present time, obstructive sleep apnea is a medical condition that is being controlled and treated mainly by the medical profession. Despite the fact that in September 1995, the American Sleep Disorder Association finally endorsed oral appliance therapy as the third currently acceptable treatment method for snoring and sleep apnea, the vast majority of the medical doctors are not aware of the value of oral appliances.

As time goes on, the public is going to become more aware of the health risks associated with snoring and sleep apnea. It is the dental professionals responsibility to educate their members, the public and the medical profession about the important role that dentists and oral appliances play in the treatment of snoring and obstructive sleep apnea.