Treatment options for sleep apnea

What is sleep apnea?

Sleep apnea is a condition when your breathing stops during your sleep, sometimes occurring 20-30 times per hour. Each time you stop breathing, the lack of oxygen available to supply to the brain causes you to wake up to restart the breathing process. The continuous process of wake-sleep, wake-sleep cycles prevent you from achieving deep sleep and causes you to feel constant drowsiness and fatigue during the day.

What are the risk factors?

Sleep apnea can occur with any age and gender. However, it is more common in males over age 40. There is higher risk for individuals with obesity, smoking, drinking, and family history.

Should it be treated?

Sleep apnea should be treated immediately. If left untreated, it can lead to high blood pressure, risk of heart failure, and stroke. It interferes with sedation and surgical recovery. Due to unintentionally falling asleep during the day, it negatively affects work and school. It also leads to higher risk of injury while operating heavy machinery.

How is sleep apnea treated?

Treatment for sleep apnea depends on the severity and type of apnea. Basic treatments involve behavior management, such as instructing patients to lose weight, stop smoking, stop drinking, and sleep on their side instead of their back.

Intervention treatment may include an oxygen machine. A medical device called a CPAP machine (Continuous Positive Airway Pressure) is commonly used to treat moderate to severe sleep apnea. It delivers a continuous stream of oxygen to the patient, and has been proven to lower blood pressure and reduce heart problems [Source: WebMD].

Many people find that the machine works effectively at delivering air flow. However, the drawbacks include wearing a face mask that can be cumbersome and uncomfortable, and the mask can cause sore spots and irritation to the skin. The machine can be noisy, which can wake a person up at night. It is also an expensive machine. Some patients find themselves waking up at night to take the oxygen mask off.

An alternative treatment is oral appliance therapy. The oral device works best for mild and moderate cases of sleep apnea and avoids the drawbacks of an uncomfortable machine. The treatment involves fabricating and fitting a custom-made appliance to position the mouth open and unobstructed in order to maintain an open airway. This appliance is fabricated by an orthodontist and is used to prevent throat blockages. The oral appliance must fit comfortably so that it does not cause sore spots and the person can breathe comfortably.

In some severe cases, surgical treatment may be required to permanently change the position of the jaw. The mandible can be advanced to open the airway. The maxilla can be widened with a palatal expander in order to widen airway spaces.

If you or someone you love suffers from sleep apnea, talk to your physician to be referred to a sleep apnea specialist. The specialist may conduct a sleep study to diagnose the extent of the problem and recommend the appropriate treatment. If you are diagnosed with obstructive sleep apnea (OSA), you can schedule a consultation with an orthodontist to see if oral appliance therapy may be helpful to treat your sleep apnea. We can custom create an oral device for you to help open your airway and improve breathing.

If you find this blog helpful, let us know. Dr. Nancy Phan and the team at Care Orthodontics want you to have a beautiful and healthy smile. We create beautiful smiles with Care!

Sources and Citations:

1. http://www.progressivebraces.com/sleep-apnea-appliance-snore-appliance
2. http://www.dentistryiq.com/articles/2013/11/using-oral-and-dental-devices-to-treat-snoring-and-sleep-apnea.html
3. http://www.webmd.com/sleep-disorders/sleep-apnea/continuous-positive-airway-pressure-cpap-for-obstructive-sleep-apnea

What is the difference between snoring and sleep apnea?

What is snoring?

Snoring occurs when you make hoarse sounds during sleep. It is caused by the vibration of the soft palate. It presents due to narrowing and laxity of airway tissues. Snoring does not restrict the airway and it does not cause sleep disturbances.

Studies estimate that 30% to 50% of the U.S. population experience snoring. Light snoring can be a minor annoyance. Excessive, loud and habitual snoring can disturb your loved one. Snoring does not cause breathing or sleep disturbances. However, it can progress into upper airway resistance syndrome, which causes sleep disturbances and becomes sleep apnea. Snoring can be a sign of sleep apnea. Snoring can increase a person's risk for stroke. [Source: Lee et al.]

In summary, as long as there is no airway restriction, then the term “snoring” is used. It is important that you recognize the differences between snoring and sleep apnea.

What is sleep apnea?

Sleep apnea is a condition when your breathing stops during your sleep, sometimes occurring 20-30 times per hour. Each time you stop breathing, the lack of oxygen supply available to the brain causes you to wake up in order to restart the breathing process. The continuous process of wake-sleep, wake-sleep cycles prevent you from achieving deep sleep and causes you to feel constant drowsiness and fatigue during the day.

Sleep apnea is defined as restriction of the airway passage for a minimum time leading to oxygen saturation drop. Apnea is a complete or almost complete blockage of the airway for a certain time.

What are the signs of sleep apnea?

Snoring is one symptom of sleep apnea. However, snoring does not always indicate sleep apnea. It may be a social inconvenience but may not cause cessation of breathing, and may not require immediate treatment. Currently, 1.2 million Americans suffer from sleep apnea.

To diagnose sleep apnea, look for these symptoms:

• Choking or gasping that follows loud snores at night
• Breathing cessation episodes
• The need to wake up frequently with shortness of breath
• Sore throat and dry mouth after waking
• Insomnia or difficult sleeping
• Headaches, drowsiness, and irritability upon waking in the morning
• Falling asleep unintentionally during the day

What are the different types of sleep apnea?

The types of sleep apnea are usually diagnosed by a sleep apnea specialist in a sleep lab.

There are 3 types of sleep apnea:

1. Obstructive sleep apnea (OSA) is the common type. It occurs due to a physical blockage, typically caused by the tongue, uvula and soft palate, which collapse and block the airway in the back of the throat.
2. Central sleep apnea (CSA) is a less common type. It occurs due to lack of proper signals from the brain sent to the breathing muscles.
3. Complex sleep apnea is a less common type. It is a combination of obstructive and central sleep apnea. [Source: Dental IQ]

 

Medical and dental conditions associated with sleep apnea

• People who have high blood pressure, frequent heartburn and hypothyroidism have high associations with sleep apnea.
• People who have heavy clenching, grinding, bruxing, temporal mandibular joint symptoms and frequent headaches have high associations with sleep apnea. [Source: Health checklist]

If you have these conditions, along with disruptive sleep patterns, you should see your physician to get diagnosed with sleep study tests to rule out sleep apnea.

Should it be treated?

A light snoring can be a minor annoyance to your spouse or family member but may not need treatment. Severe snoring can be a sign of sleep apnea and should be diagnosed and treated. Sleep apnea should be treated immediately. If left untreated, sleep apnea can lead to high blood pressure, risk of heart failure, and stroke. It interferes with sedation and surgical recovery. Due to unintentionally falling asleep during the day, it negatively affects work and school. It also leads to a higher risk of injury while operating heavy machinery.

In the next post, Dr. Nancy Phan will discuss different treatment options for sleep apnea.

If you find this blog helpful, let us know. Dr. Nancy Phan and the team at Care Orthodontics want you to have a beautiful and healthy smile. We create beautiful smiles with Care!

1. http://www.dentistryiq.com/articles/2013/11/using-oral-and-dental-devices-to-treat-snoring-and-sleep-apnea.htm
2. Lee SA, Amis TC, Byth K, et al. Heavy snoring as a cause of carotid artery atherosclerosis. Sleep 2008, 31:1207-1213
3. Bruce, Dan. Health history checklist for sleep-related breathing disorders. Dental Economics 03 2015, 80-84