Sleep Apnea Treatment

Many people feel sluggish during the day.  But if you or someone you know is constantly fatigued after getting a full night’s sleep it may be a sign of an underlying medical condition.

Sleep disordered breathing is estimated to affect 80 % of the population.  The most common being Obstructive Sleep Apnea and insomnia.   OSA is a medical condition where the airway relaxes during sleep and the natural tissues in the back of the throat relax and block the flow of air.  When this happens our sleep architecture is disrupted and we are aroused out of our deep sleep state ( REM ).  Some patients will wake up gasping, others will continue to stay asleep but cycle into lighter sleep to prevent a lack of oxygen.  This lowering of the oxygen levels in our blood can have considerable toll on our vital organs.  The heart pumps harder to raise blood pressure to increase the limited supply of oxygen to our oxygen starved organs.   OSA can increase your chances of stroke and heart disease.  

Did you know that waking up multiple times in the night to urinate  ( Nocturia) is a common sign that you may have a sleep related breathing disorder?    A lack of breathing causes the reflexive autonomic nervous system to initiate.  

How does apnea cause nocturia? Researchers explain that during episodes of sleep apnea, the soft structures in the throat relax and close off the airway, setting into motion a chain of physiological events. “Oxygen decreases, carbon dioxide increases, the blood become more acidic, the heart rate drops and blood vessels in the lung constrict,” says Umlauf. “The body is alerted that something is very wrong. The sleeper must wake enough to reopen the airway. By this time, the heart is racing and experiences a false signal of fluid overload. The heart excretes a hormone-like protein that tells the body to get rid of sodium and water, resulting in nocturia.”

Almost just as common as OSA is insomnia.  Insomnia is a medical condition where people have trouble falling asleep or staying asleep.  This condition can be incident related, or a chronic condition.  As always we recommend seeing a sleep medicine physician to diagnose what is causing your poor sleep. 

The different types of sleep disorders

Although people who can’t sleep complain that they’re always tired and accordingly are looking for a sleep disorder treatment that will cure them, it’s also important that they understand that a continuous lack of sleep can negatively affect the body so much that it makes it hard to perform even the most basic functions.

Three of the more common types of sleep disorders include:

 Obstructive Sleep Apnea:  OSA is a serious sleep disorder associated with loud snoring and pauses in one’s breath during sleep (due to the tongue and soft tissues blocking the airway).

Snoring: Snoring is a very common disorder and a problem for many people.   It  also occurs when the muscles in your throat relax and vibrate as air passes over them.  Unlike OSA the airway does not occlude and there are no pauses in breathing. 

Insomnia: Insomnia is a sleep disorder in which people have trouble falling asleep and/or staying asleep, and is usually not dental-related.

Many people currently looking for a sleep disorder treatment are surprised to find out that many sleep problems can be helped with an oral appliance.

It’s important to figure out what the exact cause of your sleep disorder is in order to find the best sleep disorder treatment.  We always recommend seeing your physician and having a sleep study done.   A sleep study or Polysomnogram ( PSG) is a test ordered by a physician to diagnose your sleep condition.  Typically you will sleep overnight at a sleep center, however if you are healthy they may order a home sleep study.   You’ll need to first set up a consultation with your physcian to find out why you’re not sleeping well and then the best course of treatment can then be discussed with you.

Are you having trouble being compliant with wearing your CPAP?   Are you suffering more now that you are wearing the CPAP machine?  Do you hate your CPAP?  A CPAP (Continuous Positive Air Pressure) is a device which provides a steady stream of oxygen via a tube attached to a mask worn when sleeping.  The CPAP is standard treatment for patients diagnosed with obstructive sleep apnea.  However Patients that are diagnosed with OSA and cannot use a CPAP may be candidates for a Mandibular advancement appliance.   A MAD is a dental appliance, similar to a retainer, that keeps the lower jaw forward and prevents the airway from occluding.  

Even though the gold standard of care for sleep related breathing disorders is a CPAP, the effectiveness of the device is significantly compromised by patient compliance.   Many people either don’t wear the machine or only wear it for the beginning part of the night when they take it off to use the restroom and neglect to put it back on.

A MAD is a dental appliance that keeps the lower jaw in a more forward position during the night.   It is worn as a top and bottom appliance.  Many people are able to use a MAD as an alternative to CPAP.  Patients get more rested sleep because their soft tissues are supported and their airway is open, but also because they are not tied to a machine and mask.  

The fact that some of these sleep disorders can have a dental solution is a great news!   Having a dentist trained in Oral Appliance Therapy is the key to success.   Dr Sudikoff is a member of the American Academy of  Dental Sleep Medicine and is an accredited Dentist.  Working towards her Diplomate status she dedicates  many hours of her continuing education to treating OSA with Oral appliances.  

Snoring and Dental Oral Appliances:

 An oral appliance can also help decrease the amount of snoring a patient is making.  The oral appliance will help open the airway and increase the  stability of the upper soft tissues.   Many patients ask the question “if I snore do I have sleep apnea?”   The only true way to know is to have a sleep study done.  Simple snoring may be annoying but it is not life threatening.  Obstructive sleep apnea however is a very serious health concern.  It is important to get correctly diagnosed.  A good screening tool is the Epworth scale.  The Epworth scale asks questions directly related to how tired you are.  A moderate to high score on the Epworth Scale correlates with obstructive sleep apnea and other sleep breathing disorders

Is an oral device right for me?

The first place to start is with a sleep consultation.  Dr Sudikoff will examine you, discuss your concerns and see if you are a good candidate for an oral appliance.  We will discuss different appliances and answer any questions you have.  As a member of the American Academy Of Sleep Dentistry, Dr Sudikoff is knowledgeable in sleep medicine and can coordinate care with your physician. Please call our office at (704) 632-9922 and set up an appointment today.