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SleepApneaMightbeRobbingyouofMorethanaGoodNightsSleep

Fatigue, a “foggy” mind, and irritability are all signs you’re not getting enough sleep—and neither might your sleeping partner from your continuous snoring. You might have a common form of sleep-related breathing disorder (SRBD) known as obstructive sleep apnea.

Sleep apnea occurs when the airway becomes obstructed (usually by the tongue), resulting in a lack of oxygen. The body rouses from sleep just enough to correct the obstruction. This can occur and interrupt deep sleep several times a night, causing the aforementioned problems as well as personality changes, high blood pressure or increased stomach acid reflux. If the problem persists, sleep apnea could also become a long-term factor in the development of heart disease, diabetes or other serious conditions.

Fortunately, we can do something about it. While some may require more invasive intervention, most cases of sleep apnea can be alleviated through continuous positive airway pressure (CPAP) therapy. In this therapy, an electrical pump supplies pressurized air into a face mask worn while sleeping. The increased air pressure helps to keep the airway open.

For some patients, however, CPAP can cause discomfort like claustrophobia, nasal congestion and dryness. If that’s a concern for you, you might want to consider an oral appliance provided by your dentist.

Customized to your own individual mouth contours, this appliance is usually a two-part hinged device that draws the lower jaw and the tongue forward to open the airway. Easily adjustable, these appliances are usually more comfortable to wear than a CPAP and don’t require electricity or have the attendant noise of a CPAP pump.

They do, however, have a few drawbacks: they can disrupt saliva flow, causing either too much or too little; they may result in some morning soreness; and they can stimulate unnecessary tooth or jaw movements. For most, though, these side effects are minor compared to a better night’s sleep.

If you suspect you may have some form of SRBD, you’ll need to have it confirmed through a physical examination and possibly sleep lab testing. If it is sleep apnea, your physician and dentist can work together to help you find the right therapy to regain the benefits of a good night’s sleep.

If you would like more information on sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

By Dr Henry Lee
May 14, 2014
Category: Oral Health
Tags: sleep apnea   snoring  
FrequentlyAskedQuestionsAboutObstructiveSleepApnea

Q: What is sleep apnea, and how common is it?
A: Obstructive sleep apnea is a type of sleep-related breathing disorder (SRBD) in which the airflow to the lungs is restricted — or even cut off completely — during sleep. This condition is usually caused by the collapse of soft tissues in the back of the throat, and is potentially deadly. Sleep disorders, including SRBD, are thought to affect tens of millions of people in the United States. They have been blamed for several catastrophic accidents, including the 2014 Metro-North train crash in New York, and the 1989 Exxon Valdez oil spill in Alaska.

Q: How can I tell if I might have sleep apnea?
A: Everyone has trouble sleeping sometimes. But if you constantly snore, wake up feeling irritable, and experience sleepiness and diminished performance during the day, it may mean you suffer from this condition. After a while, SRBDs can trigger depression, confusion, memory loss, and other personality changes. Medical professionals note that a person with SRBD tends to be obese; to show enlargement of the tongue, tonsils, or uvula; to have nasal polyps or congestion; and possibly, to exhibit other signs.

Q: How is sleep apnea treated?
A: There are various treatments for sleep apnea, depending on the severity of the problem and its likely cause. These include oral appliance therapy (wearing a retainer-like device in the mouth at night); orthodontic treatment and/or oral surgery; and using a CPAP (constant positive airway pressure) machine to help facilitate breathing at night. Each has advantages and disadvantages that should be discussed with a healthcare provider who has experience in the area of sleep disorders.

Q: What does all this have to do with dentistry?
A: Dentists are, of course, extremely familiar with the anatomy of the mouth. We sometimes notice signs of potential sleep problems before they become life-threatening. What’s more, we may be able to successfully treat the problem with oral appliance therapy. We can properly fabricate, fit and adjust an oral device that helps keep your airway open at night. Because it is inexpensive, removable, and relatively comfortable, an oral appliance may be a good remedy to try before moving on to more complex treatments, such as a CPAP machine or surgery. So if you think you might have SRBD, maybe it’s time to make an appointment and talk to us about it.

YourDentistMayHavetheSolutiontoYourSnoringandSleepApnea

Your snoring isn’t just an annoyance to other members of your household — it could indicate a serious health issue. Fortunately, there are treatments, some of which your dentist might be able to provide.

Snoring is the result of soft tissue structures in the back of the throat, including the tonsils, the uvula, the tongue or fat deposits, collapsing on each either and obstructing the flow of air into your lungs. The obstructions produce a vibration that is the source of the snoring.

These obstructions could lead to a serious condition known as Obstructive Sleep Apnea (OSA). As the name implies, the obstruction causes a complete cessation of airflow for several seconds. As oxygen levels drop, the body responds by waking for one to three seconds (known as “micro-arousals”) to restore airflow. These disruptions can occur several times a night, as much as fifty times an hour. The depletion of oxygen and resulting low quality of sleep can contribute to high blood pressure, a higher risk of heart attack or stroke, and the possibility of accidents caused by lower alertness during the day.

You can help reduce the effect of OSA by losing weight and exercising. You may also be a candidate for Continuous Positive Airway Pressure (CPAP) therapy, which utilizes a device that delivers pressurized air into the airway while you sleep.

Depending on the exact cause and extent of your OSA, you might also benefit from treatments provided by your dentist. We can develop a custom-fitted oral appliance, similar to an orthodontic retainer or sports mouthguard, which you wear while you sleep. These devices work by repositioning the lower jaw forward, thereby maintaining an open airway by also moving the soft tissue of the tongue forward. For more advanced conditions, certain surgical procedures that realign the jaw or remove excess tissue, the tonsils and adenoids, or parts of the uvula or soft palate could be considered.

To know your best treatment course, you should schedule a complete oral examination to determine the exact cause of the obstruction, and possibly a polysomnogram, an overnight study performed in a sleep lab. And as your dentist, we might be able to provide the key for a better night’s sleep and a healthier tomorrow.

If you would like more information on how we can address your problems with sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Snoring & Sleep Apnea.”

By Dr Henry Lee
April 03, 2012
Category: Oral Health
Tags: sleep apnea   snoring  
FiveFAQsAboutSnoringandSleepApnea

Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”