Unlike snoring, sleep apnea is a potentially life threatening disorder in which you either slow or completely stop breathing while you sleep. These episodes can last from a few seconds to a few minutes and may occur many times throughout the night. The risks of undiagnosed sleep apnea include heart attack, stroke, high blood pressure (hypertension), decreased libido and daytime drowziness. A sleep apnea diagnosis of mild, moderate, or severe depends on exactly how many times per hour an episode occurs. Common signs of sleep apnea are snoring, and gasping or choking sounds during sleep.
Am I at risk for sleep apnea?
Anyone can develop sleep apnea. An estimated 18 million Americans suffer from this condition. That means that 1 out of every 15 people have sleep apnea. Sleep apnea is more commonly found in men and individuals who snore, are overwieght, have high blood pressure, and are over the age of 50. Some studies suggest hereditary may also be a factor. Take this quiz to find out if you may be at risk!
What are the causes of sleep apnea?
There are a number of potential causes of sleep apnea. Obstructive sleep apnea is usually caused by structural problems that close off your airway and interrupt or stop your breathing while you sleep. This could be due to the relaxation and collapsing of the muscles of your throat as you age or sleep in certain positions. It can also be due to the narrowing of your airway due to your genetic makeup or excessive fat storage due weight gain. In the case of central sleep apnea, it is a signaling issue from the brain that is the cause.
Symptoms of Sleep Apnea
Some signs and symptoms of sleep apnea include:
- Excessive daytime fatigue
- Episodes of slowed or stopped breathing during sleep
- Abrupt awakening with gasping or choking
- Restless sleep
- Morning headache
- Difficulty concentrating during the day
- Weight gain
- High blood pressure
- Decreased libido
- Frequent trips to the bathroom at night
Three Types of Sleep Apnea
- Obstructive Apnea
Caused by a blockage of the airway. This blockage is due to your tongue or the muscles in your throat relaxing and closing off your airway. In overweight or obese individuals, the airway can be narrowed leading to an increased risk of obstructive sleep apnea. This is the most common form of sleep apnea and can be treated in a number of ways dependent upon the severity. Severe cases may require surgery while most other cases can be treated with CPAP or an oral re-positioning device.
- Central Apnea
Caused by a signaling problem in the brain that prevents proper breathing. This is a less common form of sleep apnea and may be a caused as a co-morbidity of other conditions such as heart failure, stroke, or complications from opoids. Central apeneas require treatment of the underlying conditions and airway therapy with CPAP or other device. A dental sleep device is not recommended in this situation because it is not caused by an obstruction.
- Complex/Mixed Apnea
Caused by a combination of both obstructive and central sleep apnea. This requires treatment with CPAP or other positive airway pressure device.
How is Sleep Apnea Diagnosed?
Sleep apnea is diagnosed with the help of a sleep study. This study can either be done at a sleep center, or utilizing a home sleep test. Both produce valid results that will record the number of episodes of stopped or slowed breathing, movements, and the oxygen levels in your body during these events. These results will provide an AHI score, which is the number of times per hour that your breathing is stopped or slowed. Your severity of apnea will depend on this score:
Mild: 5-14 events per hour
Moderate: 15-29 events per hour
Severe: 30+ events per hour
Is Treating Sleep Apnea Important?
Treating sleep apnea is incredibly important to your health. When your breathing is altered, so is the amount of oxygen that is coming into your body. The disruption of oxygen leads to restless sleep due to your body subconsciously trying to find a position where it oxygenation is not altered. When left untreated, sleep apnea can often cause excessive daytime fatigue, headaches, and can increase your risk of falling asleep while driving and experiencing workplace accidents. The lack of oxygen from untreated apnea also puts additional stress on your body which can lead to a multitude of systemic health issues such as:
- High blood pressure (hypertension)
- Heart attack
- Chronic acid reflux
There are four main ways to treat sleep apnea that are dependent upon the severity of your disease. Speak with your doctor to determine which style of treatment is best for you. A combination of some of the following may be the best course of action.
Non-medical changes to your lifestyle is one of the first lines of defense against sleep apnea. It may also be beneficial as a combination with another form of sleep apnea therapy. Some of the most common behavioral modifications are:
- Weight loss
- Avoiding drugs and alcohol
- Avoiding drinking caffeine late at night
- Alteration of sleeping posture
Oral Appliance Therapy
This type of treatment is best for those diagnosed with mild or moderate sleep apnea or those who are CPAP intolerant. The oral appliance is custom made for your mouth by Dr. Fiorentini and helps to hold your lower jaw slightly forward, and slightly open. This keeps your tongue forward and limits the collapsing of your airway during sleep. Although a dental sleep apnea device is not as effective as CPAP therapy, it is more likely to be tolerated during an entire night's sleep and therefore can be the best choice for many patients suffering from obstructive sleep apnea.
The most aggressive is with surgery. The gold standard for severe sleep apnea, and the one you have probably heard the most about is CPAP (continuous positive pressure airway) therapy. CPAP therapy involves wearing a face mask connected to a machine that continuously forces air and keeps your airway open. And the third is with an oral appliance that we can fabricate with a visit in our dental office. This oral appliance helps to position your jaw in a certain way to prevent collapse of the airway.
What Can You Do Today?
To get started, give us a call or see your primary care physician. Once you have taken the sleep study and have a diagnosis of apnea, we can begin the process of fabricating an oral appliance for you. With the proper diagnosis, this appliance may be covered by your medical insurance.
Even if you are not diagnosed with apnea, but are a heavy snorer and would like to stop, or more likely your significant other would like you to stop, we can still fabricate the same appliance and you should see immediate results.
Call us today to schedule a consult with Dr. Fiorentini about sleep apnea therapy