Continuing our discussion concerning the health connection between the mouth and the body, we will review the condition known as Obstructive Sleep Apnea, its common symptoms and what can be done to minimize the potentially devastating effects of this disease.

Obstructive Sleep Apnea or OSA is a potentially serious sleep disorder in which patients repeatedly stop and restart breathing during sleep. The throat muscles intermittently relax during the sleep cycles, and the airway becomes  temporarily blocked.  The muscles normally support the soft palate and tongue. When these muscles relax, the airway either narrows or closes as a breath is taken, and the flow of air is blocked. As a result the blood level of oxygen is reduced, the nervous system thereby senses impaired breathing and awakens the patient so that an open airway is restored. These events can occur as many as forty or even more times each hour throughout the night. The end result is an inability to reach the normal, deep, restful and necessary phases of sleep.  This lack of quality sleep results in sleep deprivation.

People with sleep apnea usually snore (often loudly), may wake during the night with  gasping or choking, or may seem to stop breathing periodically according to their bed partners. OSA is most commonly seen in middle-aged and older adults and people who are overweight.  Men are more frequently affected, but women and children may also exhibit symptoms of Sleep Apnea.

Common signs and symptoms of obstructive sleep apnea include:

• Snoring (often loudly)
• Episodes of interrupted breathing during sleep
• Abrupt  awakenings during the night
• Daytime drowsiness
• Dry mouth or sore throat in the morning
• Morning headaches
• Mood changes including depression or irritability insomnia

In addition, certain factors increase the likelihood of a patient’s having Obstructive Sleep Apnea.  Those with one or more of these signs are urged to speak with their primary care physician about the need to be tested for OSA. These factors include:

• Being overweight
• Having a neck size greater than 17 inches for men and 16 inches for women
• Having high blood pressure especially if resistant to medications
• Having a narrow airway possibly due to enlarged tonsils and/or adenoids
• Chronic nasal congestion
• Diabetes — type I or 2
• Family history of sleep apnea
• Smoking
• Frequent use of alcohol

If a patient is unaware of their Sleep Apnea condition or if is left untreated, a variety of complications may develop.  Conditions associated with OSA include:

• Cardiovascular problems including high blood pressure, coronary artery disease, heart attack, as well as heart failure and stroke and heart arrhythmias.
• Daytime drowsiness, fatigue and irritability as well as difficulty concentrating.
• Children with OSA may have problems in school and commonly have attention or behavior disorders.
• Sleep deprived partners — commonly bed partners may choose to sleep in a separate room.

In addition to seeking the advice of your doctor, there are steps that you can take to at least minimize the effects of OSA.

• Try to sleep on your side
• Avoid drinking alcohol close to bedtime
• If you are drowsy, avoid driving or using machinery
• If you are overweight  lose weigh
• Exercise regularly
• Quit smoking
• Use nasal decongestant

If you are diagnosed as having Obstructive Sleep Apnea, there are three traditional therapies which are used to control this condition.   The first is positive airway pressure in which a device called a CPAP is worn over the nose and/or mouth while you sleep.   It employs a steady stream of air to maintain an open airway.

Continuous Positive Air Pressure (CPAP)

The second is a dental appliance which is designed to hold the jaw in a downward and forward position.  In this position, the tongue and soft tissue at the back of the mouth are held  to effectively maintain an open airway. These devices are also used to minimize or eliminate snoring.

Third, there are various surgical procedures which may be appropriate for some patients.

If you have any questions about obstructive sleep apnea or the oral appliances which are used to treat this disease, please call us at 908.359.6655 or via our website at www.DesignsForDentalHealth.com