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Sleep Apnea


Sleeping man

If you are experiencing symptoms such as loud snoring, daytime fatigue, or headaches upon waking, you may be suffering from sleep apnea. Many sufferers are unaware they have the condition but it can have detrimental effects on nearly every aspect of your life. A dentist can refer you to a sleep specialist for diagnosis. Then they can recommend treatment options, such as a customized oral appliance, to help you get a better night's sleep.

What Is Sleep Apnea?

Sleep apnea is a sleep disorder which involves an involuntary cessation of breathing throughout the night. There are three types of sleep apnea:

  • Obstructive
  • Central
  • Mixed

Obstructive sleep apnea (OSA) occurs when muscles in the throat relax, causing a blockage of the airway. Central sleep apnea results from an issue with the signals in your brain, while mixed is a combination of obstructive and central sleep apnea. The majority of individuals with sleep apnea have OSA.

Symptoms and Warning Signs

The most common, and obvious, sign of OSA is loud snoring. However, not all snorers have sleep apnea. Other symptoms of OSA include:

  • Episodes of reduced or absent breathing, known as apnea events
  • Daytime sleepiness or fatigue
  • Waking up with a dry mouth
  • Morning headaches
  • Decreased attention, concentration, motor skills, or memory
  • Gasping for air in your sleep
  • Frequent urination during the night
  • Teeth grinding

Man holding face in handsJaw pain is another common indicator of sleep apnea. This symptom is often caused by temporomandibular joint (TMJ) disorder, sometimes referred to as TMD. In some cases, when the throat begins to relax before an apnea episode, the jaw reflexively clenches to prevent a blockage of the airway. This excessive stress on the jaw can irritate the TMJs and eventually cause teeth to crack or become worn. Neck and shoulder pain can also result.

Often, your sleeping partner first recognizes signs of sleep apnea. They may mention chronic or loud snoring, or that you seem to stop breathing in your sleep and then gasp for breath without waking. If your partner has mentioned any of these symptoms, you should speak to a dentist.

Causes and Risk Factors of OSA

When your airway narrows or closes during sleep, your brain senses the lack of oxygen and sends signals to wake up and reopen your airway. For most patients, this awakening is so brief they do not remember it in the morning. Over the course of the night, you may waken 30 or more times every hour, resulting in a significant disruption of your sleep.

Sleep apnea can affect a variety of individuals, even children. There are certain factors which can increase your risk of OSA, including:

  • Excess weight or obesity
  • Large tonsils or adenoids
  • A thicker neck
  • A naturally narrow throat
  • Age
  • Family history
  • Use of alcohol, sedatives, or tranquilizers
  • Smoking
  • Nasal congestion

In addition, men are twice as likely to develop sleep apnea. However, the risk of sleep apnea can increase for women when they are overweight or after menopause.

How Do I Find out If I Have Sleep Apnea?

For many patients, their dentist is the first professional to become aware of their symptoms. If your dentist suspects you have OSA, they will recommend a specialist who can conduct a nocturnal polysomnography, or sleep study. Evaluations can often be made using take-home equipment but some patients may need to undergo the sleep study at a center.

Diagnosing Severity

A sleep specialist can generally diagnose mild, moderate, or severe sleep apnea based on the results of the study. The number of sleep apnea events you experience over the course of an hour determines the severity of your OSA. The condition is broken down into three categories:

  • Mild: Five to 14 apnea events per hour
  • Moderate: 15 to 29 events per hour
  • Severe: 30 or more events per hour

Depending on the severity, your doctor or dentist can determine the ideal solution to improve your sleep.

Oral appliance therapy can provide an inexpensive and effective treatment method for obstructive sleep apnea.

Treatment of Sleep Apnea

If you have moderate to severe sleep apnea, your dentist may recommend you speak to your primary care physician about a continuous positive airway pressure (CPAP) machine. However, for milder cases, oral appliance therapy can provide an inexpensive and effective treatment method. Your dentist can provide you with a custom sleep apnea appliance designed to bring your jaw forward and open your throat. This treatment can also provide relief for snoring. In rare cases, severe OSA does not respond to breathing devices and requires surgery to remove the obstruction of the upper airway.

Preventing the Condition

If you are concerned about developing sleep apnea, making some healthy lifestyle changes may help reduce your risk. Self-care techniques for OSA include:

  • Eating a heart-healthy diet
  • Aiming for a healthy target weight
  • Exercising regularly
  • Quitting smoking
  • Avoiding alcohol and medications with sedative effects
  • Taking nasal decongestants or using another method to keep your nasal passages clear at night

For some patients, sleeping on their side or abdomen, rather than their back, can help keep the airway clear. You can try sewing a tennis ball into the back of your pajama top to prevent yourself from sleeping on your back.

Ask Your Dentist about Sleep Apnea

Often, your dentist can screen for OSA before your primary care physician. Many of the symptoms of sleep apnea affect your oral health. In addition, oral appliance therapy for sleep apnea is often covered by dental insurance.

Sleep is a crucial aspect of whole-body health. If you suspect you may be suffering from this sleep disorder, schedule a consultation with your dentist today.

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