What is SLEEP APNEA?
Sleep apnea is a type of breathing disorder which is a serious, potentially life-threatening condition characterized by brief interruptions of breathing during sleep.
Oral appliances are only indicated for use in patients suffering from obstructive sleep apnea (OSA). The signs and symptoms of OSA include snoring, excessive daytime sleepiness, gasping or choking during the night, non-refreshed sleep, fragmented sleep, clouded memory, irritability, personality changes, decreased sex drive, impotence, and morning headaches.
Factors that affect obstructive sleep apnea are as follows:
- Sedative Hypnotics (sleeping pills)
Children can also snore and suffer from obstructive sleep apnea. Often they are highly allergic and their airway is blocked due to enlarged adenoids, tonsils or swollen nasal mucosa. Clinical signs would indicate a turned up nose, allergic shiners under the eyes, mucous draining out of the nose, mouth breathing, and a nasal sound to the voice. Other signs are bed wetting, irritability, difficulty in concentrating at school and hyperactivity.
At the present time, obstructive sleep apnea is defined as a medical problem and the diagnosis must be made by a medical doctor or sleep physician (pulmonologist) who is specially trained in the area of sleep medicine.
The dental profession has an important role to play in the treatment of patients with snoring and sleep apnea. If 60% of men and 40% of women between forty and sixty years of age snore, this is a huge problem. Snoring is a serious social problem for the spouse, but obstructive sleep apnea can be a life threatening situation for the patient in that it can lead to irregular heartbeat, high blood pressure and strokes.
At the present time, obstructive sleep apnea is a medical condition that is being controlled and treated mainly by the medical profession. Despite the fact that in September 1995, the American Sleep Disorder Association finally endorsed oral appliance therapy as the third currently acceptable treatment method for snoring and sleep apnea, the vast majority of the medical doctors are not aware of the value of oral appliances.
As time goes on, the public is going to become more aware of the health risks associated with snoring and sleep apnea. It is the dental professionals responsibility to educate their members, the public and the medical profession about the important role that dentists and oral appliances play in the treatment of snoring and obstructive sleep apnea.
Treatment of Snoring & Sleep Apnea
- Oral Appliance
- CPAP (Continuous Positive Airway Pressure)
- Surgical removal of nasal or oral obstruction
Three Types of Sleep Apnea
- Mild Sleep Apnea. Patient stops breathing 5-15 times per hour.
- Moderate Sleep Apnea. Patients stop breating 16-30 times per hour.
- Severe Sleep Apnea. Patient stops breating mroe than 30 times per hour.
In 2006 in the January issue of the Medical Journal Sleep, the sleep specialists in the American Academy of Sleep medicine confirmed that:
- Oral appliances are the first treatment option for mild to moderate sleep apnea
- CPAP was the first treatment option for severe sleep apnea
- Oral appliances may be used for patients who cannot tolerate the CPAP device.
The largest number of patients with sleep apnea (obstructive sleep apnea) are in the mild to moderate categories and should be treated with oral appliances.
The CPAP device (Continuous Positive Airway Pressure) is primarily used to treat patients with severe sleep apnea. While the CPAP device is extremely successful in eliminating sleep apnea in patients with severe sleep apnea when the device is worn, unfortunately, the failure rate is high when the patient cannot tolerate the CPAP device. These patients are then candidates for the oral appliances.