Sleep Apnea

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Snoring and Sleep Disorders Forms:

If you plan to or have scheduled an appointment for a Sleep Disorder such as Apnea or Snoring, please download and print the following forms and either mail them to us as soon as possible or bring them already filled out with you to your appointment:

Download All Sleep Disorder Forms In One Package

What causes Snoring?

Snoring is the sound made by the vibration of upper respiratory structures (the soft palate, tongue and uvula – the little “thing” that hangs down) caused by obstructed air movement during breathing while sleeping. The sound may be soft or loud and unpleasant. The cause may be any of the following: the tongue, soft palate, or uvula falling back into the airway, relaxed muscle tone in the structures of the upper airway, allergies (causing swelling), obstruction in the nasal airway, or fat build up around the throat.

What is Obstructive Sleep Apnea (OSA)?

Obstructive sleep apnea (OSA) is a debilitating sleep and breathing disorder defined as the cessation of breathing for at least 10 seconds or more (an apnea). During sleep, the body’s muscles relax, allowing the tongue and soft palate to collapse into the upper airway (back of the mouth and throat) and results in blocked breathing. When this occurs, the brain reacts by disrupting deep sleep just enough to start breathing again. These arousals may occur hundreds of times each night but do not fully awaken the individual who remains unaware of the loud snoring, choking, and gasping for air that are typically associated with OSA). OSA sufferers never get “a good night’s sleep” because repeated apneas and arousals deprive patients of REM and deep-stage restorative sleep, leading to chronic daytime exhaustion, mood alteration, and long-term cardiovascular stress.

What are the health implications of OSA?

OSA has a profound impact on an individual’s health. Over the long term, OSA is associated with the following symptoms: snoring, silence followed by a snort and jerk, not feeling rested upon awakening, daytime sleepiness, unclear thinking, emotional instability and depression, GERD (esophageal acid reflux disease), high blood pressure (hypertension), diabetes, heart disease and irregular heart beat (arrhythmias), stroke, and congestive heart failure. A major risk to us all is deadly motor vehicle accidents; in fact OSA has been implicated in the Exxon Valdez oil spill in Alaska.

Who suffers from OSA?

Some studies say that more than 50% of Americans who have OSA are undiagnosed. Because of the trend towards increased weight in the US, OSA cases are increasing at an alarming rate. If you or your partner wakes up in the morning not feeling rested, you or your partner may have OSA. Many times it is a sleep deprived bed partner who convinces the apneic patient to seek treatment, but often the apnea goes undetected by the patient and their partner. Some common associations/risk factors with sleep apnea are:

  • Neck size in men greater than 17 inches
  • Neck size in women greater than 15 inches
  • Overweight
  • Smoking
  • Hypertension and/or diabetes
  • Acid reflux disease
  • Endocrine or neuromuscular disorders
  • Snoring and/or tooth grinding (nocturnal bruxism) at night

OSA is typically medically diagnosed by having an overnight sleep study (polysomnagraphy) done at a sleep clinic where breathing, heart rate, oximetry, and brain waves are recorded.

Treatment of OSA

Treatment of OSA depends on the severity of the problem. Treatment can be life saving for moderate to severe cases. Lifestyle changes can help reduce OSA.

  • Weight loss – even small reductions in weight will be beneficial
  • Change sleep habits – for some, sleeping on their side instead of their back reduces apnea
  • Alcohol and drug use – Alcohol should not be consumed within 4 hours of sleep, and drugs and sleeping pills which cause relaxation and decreased muscle tone should be avoided
  • Nasal strips – over the counter nasal strips to open the nasal airway are helpful but this does not affect the mouth or tongue
  • Surgery – painful, 40% successful, but looses effectiveness with time
  • CPAP – a machine which pumps air via a mask worn at night which keeps the airway open is the most effective treatment and has saved many severe OSA patients lives, but CPAP compliance is typically low (only 40-55% compliance) so this leaves many severe apneics at risk.
  • Oral appliances – adjustable dental appliances made by a dentist with training in sleep dentistry have been shown to be effective treatment and are approved for moderate sleep apnea as an alternative to CPAP. These appliances are called Mandibular Advancement Splints or Mandibular Advancement Appliances and advance the position of the lower jaw at night and thus keep the airway open at night. They need to be “titrated” by a dentist to find the right position to be effective yet comfortable. Although sleep partners will typically report the cessation of snoring, successful appliance therapy is usually verified by repeating the sleep study.

Recently, the American Academy of Sleep Medicine has recommended oral appliances as an optional first line of treatment for snoring and mild to moderate sleep apnea. Non-compliant CPAP wearers, even those with severe apnea, could benefit from oral appliance therapy alone or with a combined CPAP/oral appliance treatment. This method of treatment allows for CPAP pressures to be lowered, giving superior comfort to patients. We are familiar in fabricating and adjusting many types of OSA appliances, such as the SomnoDent ®, TAP, and the OASYS.

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If you suffer from chronic snoring or obstructive sleep apnea talk to your physician and let us know. We are well trained and equipped to help you. It just may save your life!