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Posts for tag: sleep apnea

By John Sartorio, D.M.D.
May 22, 2017
Category: Oral Health
Tags: snoring   sleep apnea  
DontLetSleepApneaRuinYourSleep-orYourHealth

Sleep apnea is more than an annoyance. This chronic condition not only interferes with your alertness during the day, it may also contribute long-term to serious issues like cardiovascular disease.

Sleep apnea occurs when your airway becomes temporarily blocked during sleep. Of the possible causes, one of the most common is the tongue, which as it relaxes may cover and block the back of the throat. This lowers the body's oxygen level, which in turn alerts the brain to wake you to clear the airway. You usually go immediately back to sleep, unaware you've wakened. This can happen several times a night.

Although older people are at higher risk, anyone can have sleep apnea, even children with enlarged tonsils or adenoids. If you or a loved one regularly experiences fatigue, brain fog, irritability or loud snoring, sleep apnea could be the culprit. You'll need a complete medical examination to properly diagnose it.

If you do indeed have sleep apnea, there are a number of ways to treat it depending on its severity. One prominent way is with a Continuous Positive Airway Pressure (CPAP) machine that produces a higher air pressure in the mouth to force the tongue forward and keep the airway open.

While CPAP is effective, the pump, hose and face mask you must wear may become uncomfortable while you sleep. We may, however, be able to supply you with a less cumbersome device: a custom-made oral appliance you wear while you sleep. Similar to a retainer, this appliance mechanically pulls and holds the lower jaw forward, which in turn moves the tongue away from the airway opening.

This oral appliance won't work with all forms of sleep apnea, so you'll need an examination to see if you're a candidate. With more advanced conditions, you may even need surgery to reshape the airway or remove soft tissue obstructions around the opening.

Whichever treatment is best for your situation, it's well worth reducing your sleep apnea. Not enduring these nightly incidences of airway blockage will help ensure you're getting a good night's sleep — and enjoying a higher quality of health and life.

If you would like more information on treating sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “If You Snore, You Must Read More!

SleepApneaandBehavioralProblemsinChildrenHowYourDentistCanHelp

We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).

The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.

What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.

Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.

There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.

If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”

By John Sartorio, D.M.D.
September 23, 2013
Category: Oral Health
Tags: snoring   sleep apnea  
FiveThingsYouShouldKnowAboutSleepApnea

Sleep apnea, a form of sleep-related breathing disorders that is estimated to affect some 22 million Americans, is sometimes thought of as the “quiet culprit” lurking behind many other maladies. But ask anyone who sleeps alongside a sufferer, and you'll get a different response: It isn't quiet at all! Instead, it's often marked by loud snoring and scary episodes where breathing seems to stop. If you've ever worried that you or someone you care about may have this condition, here are five facts you should know.

1) Sleep apnea is a potentially deadly disease

For one thing, it leads to chronic fatigue that can make accidents far more likely — a special concern in potentially dangerous situations, like operating machinery or driving a vehicle. It also appears to be related to heart conditions such as high blood pressure, irregular heartbeat, coronary artery disease, and even stroke. Plus, it can lead to weight gain, depression and mood disorders.

2) People with sleep apnea may wake hundreds of times every night

These “micro-arousals” may occur 50 or more times per hour, and may keep a person from getting any relaxing sleep — even though they retain no memory of the episodes. That's why people who suffer from sleep apnea often go through their days on the verge of exhaustion. And they aren't the only ones who suffer: Their bed partners may also be kept up throughout the night, becoming anxious and irritable.

3) Persistent snoring can be a symptom of sleep apnea

Snoring is caused when breath being drawn into the lungs is obstructed by soft tissue structures in the upper airway. Most everyone snores sometimes… but chronic loud snoring is a common symptom of obstructive sleep apnea (OSA) — and the louder and more frequent the snoring, the greater the likelihood of OSA. To confirm a diagnosis of sleep apnea, a sleep study using special monitors may be conducted in a clinical setting, or an at-home test may be used.

4) Your dentist may be able to help diagnose and treat sleep apnea

What does dentistry have to do with sleep apnea? For one thing, sleep apnea is a disease that involves structures in the oral cavity — an area dentists are quite familiar with. Sometimes, fatigued folks who suffer from OSA begin snoring when they recline in the dental chair, showing their symptoms firsthand. But even if their patients don't fall asleep, dentists with proper training are recognized by the American Academy of Sleep Medicine (AASM) as being able to provide first line therapy for mild to moderate sleep disorders.

5) An oral appliance is a good step to try before more invasive treatments

If it's appropriate in your situation, your dentist can custom-fabricate an oral appliance that may alleviate sleep-related breathing disorders. This device, worn while you're sleeping, helps to maintain an open airway in the throat and to reduce breathing problems. With a success rate of around 80%, in many cases it's comparable to the more complex CPAP (continuous positive air pressure) machines, but people often find it easier to wear. Plus, it's a non-invasive treatment that can be explored before deciding on a more involved treatment, such as surgery.

If you would like more information about dentistry and sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”

By John Sartorio, D.M.D.
May 15, 2013
Category: Oral Health
ShaquilleONealsSlamDunkAgainstSleepApnea

You may think snoring is a minor problem, but it can be a lot more than that. Just ask hoops star Shaquille O'Neal, whose rambunctious snoring bothered his girlfriend enough for her to suspect a health problem. Her observations eventually led to Shaq's diagnosis of moderate Obstructive Sleep Apnea (OSA), which occurs when the soft tissue structures at the back of a person's throat, including the tongue, partially close off the upper airway and prevent air from moving into the lungs during sleep. Sometimes airflow can be blocked completely for 10 or more seconds.

When air flow is reduced, blood oxygen levels drop. This leads to brief waking episodes known as “micro-arousals,” which can happen sometimes more than 50 times an hour. The sleeper might not even be aware of this, even while gasping for air. Micro-arousals prevent the person from ever reaching deep, restful sleep.

Besides suffering from excessive daytime sleepiness, studies show sleep apnea patients are at higher risks of heart attacks, congestive heart failure, high blood pressure, brain damage and strokes. People with sleep apnea also have a higher incidence of work and driving-related accidents.

OSA can be treated in a few different ways. On the advice of his doctor, Shaq opted for a Continuous Positive Airway Pressure (CPAP) machine, which generates pressurized air delivered through a face mask worn while sleeping. The force of the pressurized air opens the airway (windpipe) in the same way as blowing into a balloon does.

For people with milder OSA, or who find they can't tolerate wearing a mask during sleep, an oral appliance supplied by a dental professional might be the answer. Oral appliances are worn in the mouth and are designed to gently reposition the jaw and move the tongue forward away from the back of the throat. Success rates of 80% or more have been reported using oral appliances, depending on the severity of the OSA.

If you would like more information on sleep apnea, please contact us or schedule an appointment for a consultation. You can learn more about sleep apnea by reading the Dear Doctor magazine article “Snoring & Sleep Apnea.” Dear Doctor also has more on “Sleep Disorders & Dentistry.”