Snoring, Sleep Apnea and Dentistry

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.

sleep_apnea

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)

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.

                                      Sleep Appliance
                                              Somnodent Sleep Appliance

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

 

 

 

Free Sleep Apnea Screenings Offered in November

Again this year, we are offering free Obstructive Sleep Apnea (OSA) screenings during the month of November. This is our way of giving thanks for all the blessings which we have received during the year, and it is our hope that we may potentially save a life by providing this service.

 Sleep apnea is a serious condition with potentially life-threatening side effects. Most people are not at all aware of this condition and certainly do not think that it affects them.  People who have Obstructive Sleep Apnea are at risk for various medical conditions including:

  •  Adult onset diabetes (the #1 growing disease currently in the US!)
  • High blood pressure (especially when resistant to treatment)
  • Anxiety and depression
  •   Daytime sleepiness
  •  Heart attacks and strokes
  •   Gastro-esophageal reflux disease (GERD)

In addition, OSA patients are prone to daytime sleepiness which places them at risk when driving. Also, these patients may struggle with diet-resistant weight gain.  Such patients frequently lose significant weight when treated for their sleep apnea condition.

If you have any of the above symptoms or conditions, or have been told that you snore or stop breathing while asleep – or you just sleep poorly – perhaps finding out if sleep apnea is the problem may be the prudent thing to do. The screening is very quick and easy. It involves a history form and a brief examination, after which a preliminary diagnosis can immediately be made.

This offer is available to all of our patients as well as their friends, family, and coworkers. Please take advantage of this service! The first step is to determine if you are at risk for sleep apnea.   Once a diagnosis is established, there are various ways to control the condition, allow you to sleep better, live healthier and feel great!

Call us at 908.359.6655 or visit our website at www.DesignsForDentalHealth.com to schedule your free screening.

Have a wonderful holiday!

Richard M Nadler DMD, FAGD and the Designs For Dental Health Team

Happily Ever After: A Snoring Appliance Leads to Love

Editors Note: This story is from a peer of ours who attends our same post-doctoral institute. We all know about the dangers of drunk driving; but, in fact, sleepy drivers are perhaps more dangerous and more common!  The patient described in this story realized he needed a snoring appliance for just that reason.  In the end, it helped him far more than for just getting a restful night’s sleep to drive safer…

I will never, make that NEVER, forget the second “snoring device” I ever made was for a guy sitting in the next operatory. He overheard me as I was describing the first snoring device I had ever made.  He came into the room and said, “I have to have one of those!  I just fell asleep during a red light on my way over here!”

This was 1984-5 and this was a “Snoring Appliance”.  I was, to indulge in some understatement, blithely unaware of all the health-related issues that this entailed.

While discussing his problem at the appointment the next day, he looked at me in that vulnerable, sleepy-eyed, basset hound way and said words to this effect: 

“Doc, I am serious about a woman. We have both been married and divorced, and have been dating for a couple of years. We think it is the real thing and we want to get married. We really love each other. So, we took the trip of a Lifetime together to Hawaii. It was a wonderful trip except………

 

the first morning I woke up and there was a note on her pillow:

 

Dear XX,

I love you dearly.  But, I cannot marry you and sleep in the same bed with you because of your snoring. I am in room #201, call me to discuss this.

 

Doc, can you help me?”

Well, I made him the appliance that I knew at the time. And it, luckily, stopped him from snoring. I got a call from the newly wed Mrs. XX, who called and said, graciously, “Thank You”. She also shared with me what a dilemma she faced when confronted for the first time as an adult sleeping with a freight train sound next to her. And that this crazy device saved their relationship and they got married after all!

THE END

True story.  And because it happened so early in my efforts, I have always believed we can help, at least in some way or another.