Sleep Disordered Breathing

Sleep disordered breathing (which includes snoring and obstructive sleep apnea among other more complex conditions) is very common and is estimated to affect more than 25 million Americans.  Obstructive sleep apnea is a debilitating condition that is defined by episodes of stoppage of breathing or shallow breathing throughout the night.   It is a situation in which air flow stops because the entire upper airway is blocked.  Snoring is a condition that develops when air passes through an airway that is too small to allow unobstructed flow and it is often accompanied by shallow breathing that is tied to obstructive sleep apnea as well.  In some cases, snoring presents without sleep apnea.

Snoring and sleep apnea are caused by the same thing:  a narrow airway that collapses.  Snoring may often lead to sleep apnea and can be a symptom.   In fact, it is the most common symptom, followed by excessive daytime sleepiness and high blood pressure.  Someone who snores should be evaluated for sleep apnea.

What is the big deal about sleep apnea?  Sleep apnea results in many episodes of breathing cessation at night.  This greatly increases the risk of development of high blood pressure , heart attack and stroke and increases the risk of death  if left untreated.  The good news is that with treatment these risks decrease.  When someone dies, sleep apnea is almost never listed as the cause of death, although it can be the underlying reason as severe derangements in our nervous system controls due to sleep apnea and lack of oxygen can cause an unstable heart rhythm and/or stoppage of the heart rhythm that can be lethal .  It increases the risk of heart attack and stroke, more than any other factor, including smoking.  It leads to daytime tiredness, which results in more accidents and reduced work production.

 In short, it is a very serious problem.

What causes sleep apnea?  Weight gain is one factor.  Your genetics play a role and anatomy of the face and oral cavity are other factors that can contribute to the development of sleep apnea.  Childhood obesity and nasal allergies can cause anatomical changes in a school age child or teenager that result in sleep apnea as an adult and need to be addressed.  There are also many other factors that can cause an obstructed upper airway, both medically and dentally related.  These are best discussed with a physician and dentist who work in the area of sleep disordered breathing.   

What are treatments for sleep apnea and snoring?   For mild and sometimes moderate cases, a dental appliance can be a very good option.  It opens the bite and moves the jaw forward, resulting in a more open airway.   Palatal expansion, particularly in teenagers, can result in benefits beyond orthodontic issues.  It can greatly reduce the risk of developing sleep apnea.  For severe cases, the gold standard is a C-PAP (Continuous Positive Airway Pressure) machine.  This works by pushing continuous air pressure through the nose and into the throat.  This pushes back the tongue and other tissues and opens the airway.  The C-PAP machine works wells but some patients find it difficult to use.   In those cases, a dental appliance that opens the airway is a good alternative.  Surgical options also can be used in rare circumstances, mainly in people with certain facial abnormalities.

Anyone suffering from sleep disordered breathing should be evaluated by a sleep specialist.   Getting treatment for sleep apnea will improve your health, life expectancy, relationships, and work productivity.

Oral Appliance

 

    CPAP                                                                                                                                                                                                                                                                                  

 

                                       

Dr. Richard Janis DDS can be reached at: http://www.dr-richardjanis.com

Dr. Parham Gharagozlou can be reached at: http://www.healthysleepcare.com/