What is Sleep Apnea?

Are you excessively tired during your day? Do you wake up often gasping for breath or with a choking feeling? Does your bed partner complain that you snore loudly or stop breathing in your sleep? If so, you may have Obstructive Sleep Apnea (OSA). Prevalence of OSA is very high at about 18 million Americans with the diagnosed condition. Many of these individuals are untreated and even more are undiagnosed. Sleep apnea is noted to be more common in men than women and progressively worsens with age and increasing weight.

Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep. 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 which results in insufficient oxygen levels in the bloodstream.

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 awake as they struggle to breathe which often accompanied by loud snoring or choking sensations. Because people with sleep apnea don’t always completely awake 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 which occurs when air cannot flow through the nose or mouth. This is caused by a collapse of the upper airway soft tissues against the back of the throat even though the body is still trying to breathe. Obstructive Sleep Apnea is far more prevalent and easily treatable by the dentist.

Risks associated with OSA

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop breathing numerous times per hour which can quickly turn into a deadly situation. Obstructive Sleep Apnea occurs when the soft tissue lying at the back of the patient’s 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 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.

Obstructive Sleep Apnea puts individuals at increased risk for hypertension, diabetes, depression, heart attack, and stroke. Stroke is the #2 cause of death worldwide and recent studies have shown that sleep apnea doubles the risk of stroke in men. In fact, the increased risk has been compared to adding 10 years to a mans age.

Symptoms of OSA

There are many common signs and symptoms of Obstructive Sleep Apnea. If you find these to be familiar to you, our office and facilitate testing and diagnosis with a board certified sleep doctor.

excessive daytime sleepiness
chronic snoring
gasping or choking sound during sleep
morning headaches
car accidents related to fatigue
depression
obesity
decreased sex drive or impotence
grinding of teeth during sleep
GERD

What does sleep apnea treatment involve?

There are essentially four different treatment modalities for Obstructive Sleep Apnea. Testing can be conducted with a wireless home sleep testing device or at a sleep clinic to determine exact diagnosis given by a board certified sleep physician. From there any of the following therapies or combinations can be prescribed:

Behavioral changes such as decreased consumption of alcohol and weight loss can significantly improve a patient's apnea and fatigue. Positional therapy to keep patients sleeping on their side instead of on their back also have a significant effect in improving the apneic condition of patients.
CPAP machines have traditionally been the "gold standard" of care to sleep apnea patients. This device forces air into the airway at a rate concurrent to how severe the apnea is. Although these machines work very well, they can be uncomfortable and cumbersome, and thus have only a 50% success rate.
Oral Appliance Therapy consists of a dental device that gently pulls the lower jaw forward. This brings the muscles and tissues of the airway forward, preventing the tongue from blocking the airway. These devices are generally easy to wear and help prevent unwanted surgeries.
Surgery is a more permanent solution and consists of sectioning the lower jaw in order to pull the bone holding the tongue forward slightly. This surgery has an impressive success rate and is performed by an oral surgeon.

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