What is sleep apnea?
by Numpol Dejtiranukul
Sleep apnea means “lack of breath” or “no breath”. Millions of Americans as well as others around the world suffer from this life threatening condition in which a person stops breathing for a period of time during their sleep. This happens infrequently in patients that have mild obstructive sleep apnea, to very frequently in those that have severe obstructive sleep apnea.
At night time while the body is at rest and we are in a reclined position, most muscles in our bodies are relaxed except for our vital functions such as our diaphragm to keep us breathing. Many muscles in the airway also become lax and more susceptible to collapse. Studies deduce that the airway is very complex and it’s ability to stay open and collapse are controlled by our muscles as well as brain signals and receptors that provide feedback to our brains. It is the combination of these two that causes a person to stop breathing at night time.
What is snoring and how does it relate to sleep apnea?
Snoring is when the air you are breathing passes through a narrow area very quickly. One area in particular which causes snoring is where the uvula or soft palate is. An unusually relaxed soft palate which decreases in muscle tone at night can flap back and forth as a person tries to take in a breath. This in turn causes the characteristic snoring sound. There are other conditions that cause snoring as well such as nasal congestion, broken nose, deviated septum among other things. Very loud snoring could be a risk factor for sleep apnea because it indicates that the airway is more relaxed
What is the harm with sleep apnea?
Studies show positive correlations between sleep apnea and hypertension, obesity, diabetes and congestive heart failure. Blood oxygen levels can dip below average which can put stress on the body. Patients that have untreated sleep apnea report fatigue, moodiness, daytime sleepiness and lack of concentration and focus on work.
What is the treatment for sleep apnea?
A CPAP machine which stands for Continuous Positive Airway Pressure is the golden standard for the treatment for sleep apnea. This device is either is worn as a nose piece or a full face mask and delivers a constant pressure to help to keep the airway open. This device is a remarkable achievement for sleep apnea patients but compliance is a concern. Many CPAP patients do not wear their devices for the full night. Complaints I often hear at the office are that they are uncomfortable, fall off in the middle of the night, and leak.
Are there alternatives to a CPAP machine for sleep apnea?
Severe OSA (obstructive sleep apnea) can be treated surgically with a variety of different procedures. Patients with mild to moderate sleep apnea may respond well to Oral Appliance Therapy. A dentist can make an oral appliance that helps to move the jaw in a certain position that will in effect increase the size of the airway for regular breathing. Not all patients will be candidates. A sleep study must be reviewed, as well as a thorough sleep history, dental history, and medical history. According to the 2006 Practice Parameters for the Treatment of Snoring and Obstructive Sleep apnea with Oral Appliances, “Oral appliances are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP and should be completed by a Dentist with advanced training in sleep medicine.
Dr Dejtiranukul is a Dentist in O’Fallon, Missouri