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How much do you know about Sleep Apnea?
Sleep Apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea or hypopnea, lasts long enough so one or more breaths are missed, (a pause of 10 seconds or more) and such episodes occur repeatedly throughout sleep (5 to 30 times per hour or more).
Sleep apnea, often referred to as Obstructive Sleep Apnea (OSA), is often accompanied with the following symptoms:
- Heavy snoring
- Gasping for air during the night
- Excessive daytime sleepiness
- Morning headaches
- Clouded memory
Although OSA affects between 5-10% of the population worldwide, it is unfortunately a misdiagnosed condition. As many as 80% of people with sleep apnea do not know it. As the symptoms usually develop gradually over time, most people suffering from this condition are not even aware that OSA can be the cause of their deteriorated physical and psychological wellbeing.
What about snoring?
Aside from being the subject of much teasing, snoring can be a huge problem and many couples are not sleeping together because of it (estimates run as high as 23% of all couples experiencing this problem). Although all people who snore do not have sleep apnea, 96% of all sleep apnea people do snore.
Spouses are often the person aware of a loved one’s snoring. We have also observed spouses can accommodate to the snoring bed partner and are not aware of the underlying problem. We have a bed partner questionnaire to help you and us determine if a sleep study may be indicated.
For many years, we have been helping people suffering from snoring and OSA issues.
Call us today. Get some peace back into your bedroom and add some good quality years to your life!
What are sleep apnea treatment options?
For those who are aware of their condition, the gold standard for treating OSA has long been an oral appliance called the CPAP machine. Although very effective, many people find the CPAP to be very uncomfortable and cumbersome. In fact, it is well known after one year 67% of CPAP users are no longer use the machine. In many cases, sleep apnea sufferers may benefit from and prefer a more comfortable jaw-aligning oral appliance. The purpose of this device is to reposition the tongue forward and out of the throat to allow for a clear airway. Delivering more oxygen to the body allows you to wake up feeling more rested and energetic.
What can the dentist do for me?
We custom fit a sleep appliance for you. This device is worn on your upper and lower teeth. The reason it works is because it pulls the bottom jaw forward. When the jaw is positioned forward, so is the tongue. The tongue is the largest obstacle to airway flow. We are simply opening the airway to provide you with the oxygen you need for a restful sleep.
What is a sleep study?
As you know, the only way to rule out high blood pressure is to take a measurement, so it is with sleep apnea. You cannot assume that you have or do not have sleep apnea without a test – called a sleep study.
This can be done in your own bed or at a Sleep Centre.
There are different levels of severity and increased severity means a higher risk of disease or death but all levels carry risk and in general sleep apnea worsens with time, age and weight. AHI (Apnea-Hypopnea Index) or RDI (Respiratory Disturbance Index) is the standard method of scoring and determining the level of sleep apnea.
AHI or RDI:
- <5 Normal
- 5-15 Mild
- 15-30 Moderate
- >30 Severe
What are the dangers of sleep apnea?
Your health is in jeopardy in several ways. If you have sleep apnea, every time you go to sleep you start to suffocate over and over again and your emergency stress system has to save you or you will die. When your emergency stress system gets switched on repeatedly, when it should be turning down during normal sleep, your health starts to suffer. Not only is your sleep fragmented and of very poor quality, you may develop:
- Memory and mood changes
- Feeling tired or sleepy
- Not waking refreshed
- High blood pressure
- High cholesterol
- Heart attack
- Weight gain
- Difficulty losing weight
- Neck pain
- Macular degeneration
- Many people with Alzheimer’s Disease have sleep apnea
- And many other health consequences
Sleep apnea is a serious medical condition with serious health outcomes. 80% of people with mild to moderate sleep apnea do not know it.
What causes OSA?
OSA is a uniquely human problem and can be considered a price we pay for our ability to talk. We use our throat in at least three different ways. We use it to form words when we speak, to propel food when we swallow, and to serve as a passageway for air when we breathe.
We are stuck with a single tube that must be flexible and collapsible so we can talk and swallow, but must stiffen up to resist collapse when we suck air into our lungs. The solution to this design problem is a complex group of muscles that change the shape of our throat when we talk and swallow, but also stiffen and dilate the passageway when we breathe in.
These muscles work well when we are awake, but like all muscles they relax become less active when we are asleep. If our airway is abnormal in its size or shape or “stiffness”, for example if it is too small because of excess tissue in or around it, then the muscles responsible for holding it open during sleep are unable to do their job. The airway collapses so no air gets to the lungs.
The effect of gravity on the tongue and other structures surrounding the upper airway can narrow it when sleeping on your back.
So OSA is caused by conditions that narrow this passageway, the upper airway, or make it more collapsible. Chief among these is obesity, especially obesity with a large neck, although other conditions such as having touching tonsils or a relatively small jaw also can promote upper airway collapse. Certain diseases such as hypothyroidism are also associated with OSA.
Drinking alcohol near bedtime can make the airway more collapsible.
Is OSA a chronic disease or can it be cured?
For the vast majority of people with OSA their condition is a chronic disease. If you have OSA it will likely last your lifetime. It can be successfully managed, but it will not be cured. OSA is like other chronic diseases such as diabetes or high blood pressure. In highly selected patients surgical cures of OSA have been reported. Management of OSA with changes in lifestyle and the addition of a medical device have proven to be very effective. Loss of weight and neck size is very important as a first lifestyle change. Use of a medical device like a MRD (mandibular repositioning device) with a dentist or with CPAP from a sleep physician will likely help.