Sleep apnea is a temporary cessation of breathing during sleep that can last anywhere from a few seconds to over one minute. There are three types of sleep apnea: obstructive (due to a physical collapse of the airway), central (brain does not signal muscles to allow breathing), and mixed (combination of obstructive and central). While central and mixed apneas are not rare, the majority of sleep apneas are obstructive.
During an apneic event there is great strain on the heart and the reduction of oxygen in the body leads to a somatic chain of events that can result in a myriad of symptoms ranging from relatively benign excessive nighttime urination to fatal cardiac arrest. The brain responds to this oxygen desaturation by attempting to physically move the body in order to dislodge the soft tissues blocking the airway as well as disturbing your progression through the natural and necessary stages of sleep, resulting in excessive daytime fatigue.
The consequences of sleep apnea can be life threatening. An apneic individual is at much higher risk for a long list of serious conditions, such as heart attack, stroke, hypertension, and diabetes. Moreover, sleep apnea places an individual at much greater risk for depression, impaired cognition, gastric reflux, weight gain, and fatal auto accidents.
What happens during an apneic event?
In an obstructive apneic event, breathing either stops completely (apnea) or is shallow (hypopnea), most often due to a collapse of the soft tissues of the airway. Commonly, breathing is blocked at the back of the throat because your muscles relax while sleeping and your lower jaw can sink backward. The tongue follows the jaw and, along with other soft tissues, causes the airway to collapse. While choking, the body’s oxygen saturation drops and the brain does not readily distinguish between being underwater or simply laying in bed not breathing. Your brain may cause your arms and legs, or whole body, to jerk in order to wake you. Additionally, it may attempt to remove the tongue from the throat by moving the lower jaw, which may result in aggressive night time clenching and/or grinding of the teeth. There is also a hormonal response, which can lead to a variety of negative effects internally, ultimately and over time resulting in disease. Once your brain successfully wakes you to end the choking, sleep resumes and you repeat this process again and again. For some, this cycle may occur hundreds of times per night.
Signs & Symptoms of OSA
Because obstructive sleep apnea (OSA) occurs during one’s sleep, it is not always easy to recognize. Each patient is unique but if you recognize a combination of the following symptoms in yourself or a loved one, please consider contacting our office for a sleep medicine consultation:
“It’s just snoring!” Or is it?
Snoring is not simply a nuisance for bed partners. Research has shown that regular snoring – even mild snoring – increases one’s risk for carotid artery atherosclerosis and stroke. One should not dismiss snoring (particularly loud snoring) as a benign condition to be ignored. If you are a loud snorer, there is clinical justification to seek out a therapeutic remedy and/or delve deeper into whether you are suffering from a sleep breathing disorder.
How can we help you?
Our clinic specializes in oral appliance therapy in the treatment of obstructive sleep apnea. While a CPAP (“continuous positive air pressure”) machine is the gold standard in apnea therapy, many prefer the comfort and convenience of a custom fabricated oral appliance. As an oral wellness clinic and not simply a general dentistry, we approach your healthcare from a holistic patient-centric perspective, focusing on your overall wellness and not solely on your teeth.
Our custom-made appliances will help prevent your airway from collapsing during sleep by holding your lower jaw in place so that your tongue and soft tissues are less able to obstruct your breathing. While the concept is simple, to adjust your appliance properly and determine clinical efficacy requires multiple visits to our clinic and a series of sonar and sleep testing because a two-millimeter difference in adjustment across two axes can mean the difference between a more open or closed airway. While our oral appliance will also treat your snoring as a side-effect, getting you breathing again is the goal of oral appliance therapy. We are not simply making a snore guard. We are utilizing state-of-the-art technology and best-practice standards of clinical care to ensure that you are properly treating your potentially life-threatening apneic condition.
While an initial consultation or dental visit can assess risk factors, only a sleep study reviewed by a physician can determine for sure whether an individual has a sleep breathing disorder. The physician diagnosis combined with our in-office diagnostics and patient education will help determine which therapy is right for you. The process can be confusing, but our dedicated sleep medicine coordinator will help guide you through it all. If you are concerned or suspect you might have a sleep breathing disorder, contacting our office to schedule an appointment for an initial consultation is a good first step.
There are two types of sleep studies. The first type is an in-lab study but while the data is comprehensive, patients may find the experience to be uncomfortable. The patient must be wired from head to legs and will sleep in a laboratoty or hotel bed under the scrutiny of a technician. The second option is a study done at home in one’s own bed, using a portable device worn on the head only. As part of our initial consultation, both options will be reviewed and explained by our dedicated sleep medicine coordinator so you are able to make the best choice to suit your preferences.