Sleep Apnea

Sleep Apnea and Dentistry

Sleep apnea is a common and potentially life-threatening medical disorder that happens when your regular breathing is interrupted during sleep.

This most commonly occurs when tissue in the back of the throat collapses and blocks the airway, reducing the amount of oxygen delivered to organs including your heart and brain.

Sleep apnea can affect anyone at any age, although men are more likely to develop the disorder.

Two main types:

  • Obstructive sleep apnea – The more common form, it is the result of blocked airflow during sleep, usually when the soft tissue at the back of the throat collapses while you sleep. Health factors, such as obesity may contribute.
  • Central sleep apnea – Results from a problem with how the brain signals the breathing muscles. The airway is not blocked; instead the brain fails to signal the muscles to breath. Dentists do not treat this rarer type of sleep apnea which can occur with conditions such as heart failure, brain tumors, brain infections and stroke.

When to see a doctor
People with obstructive sleep apnea usually do not remember waking up during the night.

Symptoms may include:

  • Loud snoring
  • Sleepiness or lack of energy during the day
  • Recurrent awakenings or insomnia
  • Morning headache
  • Awakening with a dry mouth or sore throat
  • Waking from sleep with a choking sound or gasping for breath

Consult a medical professional if you experience shortness of breath or excessive daytime drowsiness.

Diagnosis required
Based on your signs and symptoms, your physician may schedule an evaluation, or refer you to a sleep disorder physician or a dentist trained in sleep disorders. At a sleep disorder center, a sleep specialist may recommend a nocturnal polysomnography or home sleep test to measure heart rate, blood oxygen level, airflow and breathing patterns during
sleep.

Test results show a drop in oxygen level if obstructive sleep apnea is present, and a physician can prescribe an appropriate therapy. Proper diagnosis and treatment should involve a joint effort between a physician, sleep disorder physician and dentist trained in
sleep disorders.

Treatment options
Treatment options for obstructive sleep apnea vary depending on the severity of the disorder. Lifestyle changes may be recommended to treat milder cases such as losing weight, quitting smoking, avoiding alcohol or altering the sleeping position.

For moderate or severe obstructive sleep apnea, other treatments, including continuous positive air pressure (CPAP) or oral appliances, are available. CPAP is a device which improves breathing while you sleep. It supplies air through the nasal passages to keep the airway open.

Oral appliance for obstructive sleep apnea look similar to an athletic mouthguard. They are designed to reposition the jaw and tongue to improve airflow. Dentists with training in oral appliance therapy are familiar with the various appliances and, in consultation with a patient’s physician, can determine, design, construct and fit an appliance to meet
a patient’s individual situation and condition.

This therapy could take several weeks to months to complete. It will include monitoring by the dentist to evaluate the response of the teeth and jaws to the treatment. In more  complex cases, surgical procedures performed by an oral and maxillofacial surgeon may be necessary.

If left untreated, obstructive sleep apnea can result in a number of health problems including:

  • High blood pressure
  • Stroke
  • Heart failure, irregular heartbeat and heart attack
  • Diabetes
  • Depression
  • Worsening of ADHD

A confirmed diagnosis is required from a physician before any treatment can be  administered by a dentist. Because obstructive sleep apnea ca be a silent condition, it
can go undiagnosed for several years. Talk with your physician if you have experienced symptoms to ensure your condition is identified and properly treated.

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