A Good Night's Sleep
Getting a good night’s sleep may have always been the advice of a parent, but in recent years this good advice has also been coming from your health care provider. In this week’s article we will touch on the subjects of snoring and sleep apnea.
Snoring affects around 1 in 8 Americans and is caused by tissues of the upper airway collapsing against each other and partially blocking the airway. Snoring alone isn’t considered a health problem unless it is related to sleep apnea.
Obstructive sleep apnea occurs when the tissues of the upper airway are fully blocked for a period of time causing a disruption of breathing and airflow. Approximately 4-6% of the population has some form of obstructive sleep apnea which can lead to irregular heartbeat, high blood pressure, heart attacks and stroke. Individuals with the condition will often have excessive daytime sleepiness and have an increased incidence of traffic accidents.
So what do you do if you or someone you know snores or has excessive daytime sleepiness? Only a medical doctor can diagnose sleep apnea and will often times start with screening questionnaires to determine if a sleep study is needed. The most common questionnaire used by sleep doctors is the Epworth Sleepiness Scale which can be found easily with a Google search if you prefer to quiz yourself.
A sleep study will measure how many episodes of apnea (stopping breathing) that you have and how long they last. Home sleep study devices are becoming more available but are yet to be considered as accurate or effective as a sleep study in a clinic. If a sleep study leads to a diagnosis of obstructive sleep apnea, there are three forms of treatment: CPAP, surgery, or oral appliance therapy.
CPAP (continuous positive airway pressure) consists of a device that connects a tube pushing air into a mask that covers the nose and/or mouth to ensure the pressure keeps the airways open. CPAP is considered the ideal treatment but for many it is not tolerated well due to being uncomfortable, cumbersome, noisy and inconvenient with travel. For those who are able to adjust, CPAP is life changing.
Surgery is often a last option only after more conservative treatments have failed. It is performed by an ENT.
Oral Appliance Therapy has become much more common in recent years and are mostly fabricated by dentists on a physician’s referral. There are now approximately 50 FDA approved appliances. Oral appliances are indicated for patients who have primary snoring or mild to moderate obstructive sleep apnea. They work by moving the lower jaw forward thus creating more space for airflow and making it more difficult for the upper airway tissues to collapse. Appliances are custom made to fit securely onto the upper and lower teeth and usually similar to wearing orthodontic retainers or sports mouth guards. After an initial adjustment period of 2-3 weeks most people are able to tolerate appliances well and have a decrease in snoring and improved airflow allowing for a better night of sleep.
The number of negative health effects from a poor night of sleep can range from simply being drowsy and not performing tasks well the next day to sever health consequences such as heart disease and obesity when related to sleep apnea. According to the National Commission on Sleep Disorders Research, approximately 38,000 deaths occur on an annual basis related to cardiovascular problems connected to sleep apnea. If you or someone you know snores or has excessive daytime sleepiness discuss this with your physician or dentist.