Sleep Dentistry

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Several types of sleep apnea exist, but the most common type is obstructive sleep apnea, which occurs when your throat muscles intermittently relax and block your airway during sleep. The most noticeable sign of obstructive sleep apnea is snoring, although not everyone who has obstructive sleep apnea snores.

Anyone can develop obstructive sleep apnea, although it most commonly affects older adults. It's also especially common in people who are overweight.

Signs and symptoms of obstructive sleep apnea include:

• Excessive daytime sleepiness (hypersomnia)
• Loud snoring
• Observed episodes of breathing cessation during sleep
• Abrupt awakenings accompanied by shortness of breath
• Awakening with a dry mouth or sore throat
• Morning headache
• Frequent urination at night
• Difficulty staying asleep (insomnia)

Causes

 

Obstructive sleep apnea occurs when the muscles that support the soft tissues in your throat, such as your tongue and soft palate, temporarily relax. When these muscles relax, your airway is narrowed or closed, and breathing is momentarily cut off.

 

Obstructive sleep apnea

Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the soft palate, the uvula — a triangular piece of tissue hanging from the soft palate, the tonsils and the tongue.

When the muscles relax, your airway narrows or closes as you breathe in and breathing may be inadequate for 10 to 20 seconds. This may lower the level of oxygen in your blood. Your brain senses this inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.

You can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths, although this sequence is rare. You may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you'll probably feel sleepy during your waking hours.

People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they sleep well all night.

Risk factors

Anyone can develop obstructive sleep apnea. However, certain factors put you at increased risk:

• Excess weight. More than half of those with obstructive sleep apnea are overweight. Fat deposits around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight and vice versa. Thin people can develop the disorder, too.
• Neck circumference. The size of your neck may indicate whether or not you have an increased risk of obstructive sleep apnea. That's because a thick neck may narrow the airway and may be an indication of excess weight. A neck circumference greater than 17 inches (43 centimeters) for men and 15 inches (38 centimeters) for women is associated with an increased risk of obstructive sleep apnea.
• High blood pressure (hypertension). Obstructive sleep apnea is relatively common in people with hypertension.
• A narrowed airway. You may inherit a naturally narrow throat. Or your tonsils or adenoids may become enlarged, which can block your airway.
• Chronic nasal congestion. Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. This may be due to narrowed airways.
• Diabetes. Obstructive sleep apnea is three times more common in people who have diabetes.
• Being male. In general, men are twice as likely to have sleep apnea.
• Being black, Hispanic or a Pacific Islander. Among people under age 35, obstructive sleep apnea is more common in blacks, Hispanics and Pacific Islanders.
• Being older. Sleep apnea occurs two to three times more often in adults older than 65.
• Menopause. A woman's risk appears to increase after menopause.
• A family history of sleep apnea. If you have family members with sleep apnea, you may be at increased risk.
• Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat.
• Smoking. Smokers are nearly three times more likely to have obstructive sleep apnea.

Complications

Sleep apnea is considered a serious medical condition. Complications may include:

• Cardiovascular problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. About half the people with sleep apnea develop high blood pressure (hypertension), which raises the risk of heart failure and stroke. The more severe the obstructive sleep apnea, the greater the risk of high blood pressure. Patients with sleep apnea are much more likely to develop abnormal heart rhythms such as atrial fibrillation. If there's underlying heart disease, these repeated multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event.
• Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible. People with sleep apnea often experience severe daytime drowsiness, fatigue and irritability. They may have difficulty concentrating and find themselves falling asleep at work, while watching TV or even when driving. Children and young people with sleep apnea may do poorly in school, have reduced mental development or have behavior problems. Treatment of sleep apnea can improve these symptoms, restoring alertness and improving quality of life.
• Complications with medications and surgery. Obstructive sleep apnea also is a concern with certain medications and general anesthesia. People with sleep apnea may be more likely to experience complications after major surgery because they're prone to breathing problems, especially when sedated and lying on their backs. Before you have surgery, tell your doctor that you have sleep apnea. Undiagnosed sleep apnea is especially risky in this situation.
• Sleep-deprived partners. Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. It's not uncommon for a partner to choose to sleep in another room. Many bed partners of people who snore are sleep deprived as well.

People with obstructive sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, and a need to urinate frequently at night (nocturia).

A key part of the evaluation of obstructive sleep anea is a detailed history. Below is a sample of questions you may be asked.

Do you have pre-hypertension?
                                Are you waking frequently to urinate?
                                Increased appetite and weight gain?
                                Tiredness-are you tired when you wake up?
                                Are you tired through out the day?
                                Even after a good nights sleep?
                                Have you gained more than 5 pounds in the last year?
                                Are you irritable when you can't sleep?
                                Do you snore?       Does your partner snore?
                                Do you feel achy and stiff in the morning?
                                Does it take you a long time to fall asleep?
                                If you wake up during the night, do you have a hard time falling back to sleep?
                                Do you often seem to wake up because of dreams?
                                Do you wake up gasping for breath?
                                Have you fallen asleep while driving?
                                Are you accident prone?
                                Do you have poor memory?
                                Do you have facial pain?           
                                Do you have morning headaches?
                                Do you have digestive problems?

If you think you might be suffering from a sleep disorder call our office to find out your options. 541-938-3363