Sleep Apnea and Snoring
Sleep Apnea and Snoring
Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep. The term sleep apnea is derived from the Greek words meaning “without breath”. Breathing pauses can last anywhere from several seconds to minutes, and happen as often as 30 times or more per hour. 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 awaken 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 awaken during the episodes, they are often unaware they have a sleeping disorder and it can remain undiagnosed.
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 (OSA) 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 a qualified dentist.
Common signs of obstructive sleep apnea can include severe early morning headaches, sleepiness in the daytime, and insomnia. Fortunately, a dentist trained in Sleep Disordered Breathing 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 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 blood carbon dioxide levels to increase and blood 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 number of serious heart-related conditions, and should be investigated by the dentist and physician at the earliest opportunity.
What does sleep apnea treatment involve?
Initially, the dentist will want to conduct tests in cooperation with a physician in order to investigate, diagnose, and select a suitable treatment. A sleep study, either overnight in a Sleep Lab or using an at-home testing device, is essential for an accurate diagnosis.
The dentist can offer many different treatment options which depend largely on the exact diagnosis and the health of the patient. The dentist may advise the patient to halt some habits that aggravate sleep apnea such as smoking, alcohol consumption, and tranquilizer use.
Sleeping masks (CPAP) were traditionally used to keep patient airways open during sleep, but today there are less intrusive options. Dental devices that position 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 Appliance Therapy (OAT)
There are a number of dental devices that can be used to alleviate Sleep Apnea and Snoring. The goal of most of these devices is to separate the jaws and move the lower jaw slightly forward. This slight repositioning opens up the airway, and allows oxygen to flow freely again. Wearers of sleep apnea dental devices report that they stop loud snoring, feel more rested in the daytime, and are much more comfortable going to sleep. Sleep apnea appliances work best on patients who are not significantly overweight. They offer a viable alternative to Continuous Positive Airway Pressure (CPAP).
Dental Sleep Apnea appliances come in numerous designs. Dentists trained and experienced in Sleep Disordered Breathing choose the most appropriate appliance for each patient based on the patient’s individual circumstances. The considerations are as follows: Comfort, Bruxism (Teeth Grinding or Clenching), tongue size and shape, deep bite, missing teeth, nasal patency (nostrils open or closed), TMJ problems, appliance retention issues based on size and shape of the molar teeth, patient dexterity, and cost. Careful evaluation of each factor will enable the dentist to choose from nearly one hundred appliance designs to achieve the goals of each individual patient.
Nasal Surgery, for cases in which the problem is more nasal than oral airway obstruction.
UPPP (Uvulopalatopharyngoplasty), a procedure that removes excess tissue in the throat to make the airway wider. This sometimes can allow air to move through the throat more easily, reducing the severity of obstructive sleep apnea. The tissues that are removed may include the uvula, soft palate, tonsils, adenoids, and excessive throat tissue.
Hyoid Advancement, a surgery that alters the position of the Hyoid bone in the neck and helps pull the tongue forward slightly.
Tongue and jaw surgeries, both with the goal of permanently advancing the lower jaw to a more forward position.
For detailed information on these and more surgical options go to www.sleepapnea.org, the website of the American Sleep Apnea Association.