Sleep apnea is one form of a series of disorders involving breathing during sleep. The overarching term is sleep-disordered breathing; here at Nathanson Dental, we use sleep apnea because that’s the term with which people are most familiar. Sleep apnea is just one type of sleep-disordered breathing. It is a limitation, or sometimes a complete stopping, of breathing while a person sleeps, and as you might imagine, if you’re not breathing you’re not getting oxygen, and that’s really dangerous.
Sleep apnea has been linked to all different kinds of disorders, most notably high blood pressure and cardiovascular disease — just about any disorder where having a lower level of oxygen in the blood can be a danger.
Types of Sleep Apnea
There are several different kinds of sleep apnea. The most common is obstructive sleep apnea (OSA); as the name implies, it is a result of obstruction of our breathing apparatus. Many things can cause OSA, but usually it’s because the structures at the back of the throat fall against the back of the airway. Usually it’s the base of the tongue, but it can also be the soft pallet or tonsils.
Central Sleep Apnea is another type of sleep apnea, though it is less common. CSA is a neurological disorder. Our brain tells our body what things it needs to do to keep us alive, but with CSA, the brain is not telling the body to breathe properly when we sleep. With OSA, a person can’t breathe, and with CSA, a person won’t breathe.
Symptoms of Sleep Apnea
The single most common symptom of sleep apnea is snoring. Snoring is caused by the rattling of the tissues in the back of the throat. The reason the tissues rattle is that the air can’t get through all the way. Usually there’s a partial obstruction causing the rattling in the throat. If a person’s snoring, it is very indicative of sleep apnea. It’s been estimated that about 70% of loud snorers have sleep apnea.
Other considerations include:
- Tiredness/excessive daytime sleepiness
- Neck size/flexibility
- High blood pressure
- Cardiovascular disease
- Age: sleep apnea can often occur in older men and post-menopausal women
While there are some generalizations that can be made, there really isn’t a “typical” sleep apnea patient. The only way to know for sure if you are at risk for developing sleep apnea is by scheduling an appointment at our Hunt Valley dental office.
Sleep Apnea Diagnosis
After a person is screened, and we can predict the likelihood of a person having sleep apnea, the only way to get a diagnosis is to get a sleep test. Whether it’s in-lab or at home, a sleep test can be performed one, two, or three nights, and should be performed by a certified sleep physician. Once complete, the sleep doctor will review the results of the sleep test and give a diagnosis. From there, Dr. Nathanson can help with treatment. He is a member of the American Academy of Dental Sleep Medicine and is currently going through the process of getting Diplomate status with them, which means he is qualified to provide sleep apnea treatment with dental appliances.
Sleep Apnea Treatment
The most common treatment for sleep apnea is the CPAP (continuous positive airway pressure). The machine generates air pressure, the patient wears a mask or nasal device, and the machine blows air into the airway and keeps the airway open so the person can breathe.
The CPAP is 100% effective when it’s worn consistently. The problem is that a lot people can’t or won’t use them. They find the masks uncomfortable, sometimes they just don’t like the feeling of the air blowing in the throat, some don’t like the sound of the machine, or the bed partner doesn’t like the sound of the machine. Even though the CPAP is a very effective treatment, it’s estimated that 40%-50% of CPAP users don’t use it.
The next step to consider would be an oral appliance. At our Hunt Valley dental office, we use the TAP appliance, which consists of two parts: a top and bottom. The top part has an adjustable hook that most patients adjust at home a half turn a couple times per week to move the hook forward. The hook then fits into the slot on the lower portion, moving the lower jaw forward and encouraging the tongue to be raised away from the back of the throat. This allows the patient to breathe better.
What should I do if I suspect that someone in my family suffers from sleep apnea?
Call Dr. Nathanson for an evaluation, and he can refer you to a sleep physician for a sleep test. If the results indicate sleep apnea and a custom oral appliance is recommended, we can create one for you.