Sleep Apnea

Sleep Apnea

Bona Notti silk sleep masks

OVERVIEW:
Sleep apnea is a potentially serious sleep disorder characterized by repeated episodes of interrupted breathing during sleep. This can happen hundreds of times throughout the night. As a result, the brain and the rest of the body don’t receive the proper amount of oxygen. If you snore loudly at night and feel tired the next day after a full night’s sleep, you may have sleep apnea.

Although, sleep apnea is most common in adults, in rare cases, children may suffer from this condition as well. This disorder is a progressive condition that gets worse as you get older and should be addressed as soon as possible.

The three types of sleep apnea:

  • Obstructive sleep apnea (OSA) is the most universal of three types. OSA takes place when relaxation or collapse of the throat muscles causes airway blockage.
  • Central sleep apnea (CSA) happens as a result of the brain failing to send proper signals to control the breathing muscles. CSA is does NOT involve blocked airways.
  • Mixed sleep apnea combines both OSA and CSA.

Who is at risk?

  • If you are male
  • If you are overweight
  • If you are over forty years old
  • If you have a large neck size (men and women)
  • If you have large tonsils, a large tongue, or a small jaw bone
  • If sleep apnea runs in your family
  • If you have acid reflux disease
  • If you have allergies and/or other sinus problems

Symptoms and warning signs

  • Loud snoring
  • Waking up with a dry mouth
  • Morning headaches
  • Disorientation upon awakening
  • Daytime drowsiness and fatigue
  • Frequent urination throughout the night
  • Insomnia
  • Excessive perspiration while sleeping
  • Gasping, snorting or choking during the night
  • Chest retraction in young children while sleeping
  • Decreased attention span and concentration
  • Problems with memory
  • Poor work performance
  • Irritability
  • Anxiety
  • Depression
  • High blood pressure
  • Accelerated weight gain
  • Heartburn
  • Diminished libido

The symptoms may be mild, moderate or severe in nature.

Effects of Sleep Apnea
Untreated sleep apnea can lead to the following health problems:

  • High blood pressure
  • Stroke
  • Impotence
  • Diabetes
  • Obesity
  • Depression
  • Arrhythmia (irregular heart beats)
  • Heart disease
  • Heart attacks
  • Heart failure

Additionally, this sleep disorder may cause poor performance in work and school and an increase in everyday accidents, including car crashes.

How do you know if you have Obstructive Sleep Apnea?
There are two types of painless tests called polysomnograms to diagnose sleep apnea.

The first type of polysomnography is administered overnight in a sleep lab. This test monitors your brain waves, muscle activities, eye movements, heart rate, blood oxygen level and monitors audio for snoring and gasping.

The second kind of polysomnography is a home monitoring test. After taking home a computerized polysomnograph, a Sleep Technologist will connect you to electrodes and explain how to record your sleep data. You bring back the machine and data the morning.

TREATMENT:
There are nonsurgical and surgical options for the treatment of sleep apnea.

NONSURGICAL OPTIONS

Behavioral Modification
Mild sleep apnea can usually be corrected by implementing changes in your behavior and habits, such as:

  • Starting a weight loss program
  • Staying away from alcohol
  • Avoid taking sleeping pills
  • Altering sleep positions to restore proper breathing
  • Quit smoking
  • Using nasal sprays and breathing strips to clear nasal congestion
  • Not sleeping on your back

Dental Devices
You can purchase oral devices designed to keep your airway open. They work to improve your breathing and diminish snoring in three different ways.

  1. Move the jaw forward
  2. Lift the soft palate
  3. Prevent the tongue from falling back and blocking the airway

If necessary, you can also have these devices custom made by dentists who specialize in the area of sleep apnea.

Sleep ApneaModerate and severe sleep apnea is generally treated with C-PAP (continuous positive airway pressure). This C-PAP machine uses a face mask to deliver a continuous flow of air pressure, opening the airway and keeping it unobstructed.

A Bi-level (Bi-PAP) machine is used for more severe apnea. The Bi-level machine blows air using two separate pressures. A higher pressure is used for when a person is inhaling and a lower pressure is used for exhaling.  A sleep doctor “prescribes” your particular pressure and the machine is set up by a home health care company that also gives training in its use and maintenance.

Surgical Options
Surgery may be necessary if you have any of the following issues causing sleep apnea as a result of an abnormally narrow throat:

  • A deviated septum
  • Enlarged tonsils
  • A large tongue
  • A undersized lower jaw with overbite

Correcting a deviated septum and removing tonsils, adenoids or polyps may help to unblock your nasal passageways. Usually, it’s children that have their tonsils and adenoids removed.

Here are the most common surgical procedures used to remedy sleep apnea:

  • Pillar palatal implant: A procedure that uses implants to stiffen the soft palate and stop snoring.
  • Nasal surgery: Corrects a deviated septum and other nasal obstructions.
  • Uvulopalatopharyngoplasty (UPPP): Removes uvula and tissue in the throat, therefore widening the airway opening.
  • Mandibular maxillar advancement surgery: Corrects specific facial malformations or obstructions to the throat that cause sleep apnea.
  • Laser assisted uvuloplasty (LAUP): Removes the uvula and tissue that surrounds the airway behind the palate. 
  • Radio frequency (RF) procedure and somnoplasty: Both of these procedures correct chronic snoring, nasal obstruction and OSA with the use of radio waves to shrink tissue in the air passages.

Be sure to use a doctor who has a lot of experience in these procedures and is very knowledgeable in the area of sleep apnea. Always do your research and ask tons of questions!

Resources:
For more information on dental devices: http://www.ihatecpap.com/oral_appliance.html
For more CPAP information: http://www.stanford.edu/~dement/equip.html


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