What is Snoring and Sleep Apnea ?

This is a new field in dentistry that evaluates the dental contributory factor on snorers and to apneic patients in their predisposition to the condition. Evaluation aims to find out the upper airway obstructions in the nose and throat (pharyngeal area). These obstruction lead to mouth breathing, thus snoring results in a noisy breathing while asleep. Annoying noisy sound is not only the concern but primarily the apneic episodes that put the life of individual in danger. Apnea is a condition that unconsciously put a person to stop breathing for at least 10 seconds or more wherein the brain is deprived of oxygen supply which in a worst scenario may result to brain death if not medically attended. Prolong and chronic apneic episodes could also be bad to another medical conditions such as high blood pressure (circulatory problem), frequent headaches, sleep disorders, heart problem, sexual problem (erectile dysfunction), lung problem, excessive day time sleepiness, irritability (mood swings), and aggravation of diabetic and kidney conditions.

Dentists trained in managing snoring and sleep apnea attribute this condition to the structural lower jaw retrusion (backward position of the lower jaw in relation to the upper). Such retruded position diminishes the airway especially during sleep in a supine position. Insertion of Mandibular Oral Repositioning Appliance (MORA) could be of great help for opening the airway in the throat. Other obstructions cause by inflamed nasal turbinates, polyps, adenoids, and tonsils could be addressed by ENT doctors who specialize in sleep disorders.
 
Dentists at Queen Mary Holistic Center in association with sleep doctors offer optimum health management for snorers and apneic patients.

Understanding Sleep Apnea

Apnea is a Greek word that means “want of breath”. A person is considered to be a sleep apnea sufferer when they stop breathing for at least 10 seconds up to thirty times or more a night. A few of the medical and dental conditions that can lead to snoring are:

Overweight, a small retruded jaw, sedatives, allergies, alcohol before retiring, airway obstruction

Snoring may be indicative of sleep apnea, a cessation of breathing during sleep, which can put a great strain on the cardiovascular system, Respiratory system & Kidney. This is why sleep apnea, left untreated, increases risk of heart attack and stroke. Besides snoring, other common symptoms of sleep apnea include:

Morning headaches, dry mouth and throat, excessive daytime sleepiness, lost interest in sex
sudden short-of-breath awakenings, choking or gasping

A lack of sleep effects our waking lives and those around us. Even the fable of “Sleeping Beauty” could have ended differently if the Prince had detected snoring and not awakened her with his magic kiss.

There are 3 basic classifications of sleep apnea:

1. Central - when airflow and respiratory movements temporarily cease although the airway may     remain open.

2. Obstructive - when airflow ceases due to an upper airway obstruction in the presence of a     respiratory effort. (This is the most common kind.)

3. Mixed - a combination of central and obstructive apnea which usually begins with a central     episode followed by an obstructive one.

Diagnosis and Treatment Modalities
( Diagnosis and Treatment of Snoring and Sleep Apnea)

Sleep Laboratory Test Polysomnogram:

This technologically advanced sleep study monitors breathing patterns, sleep stages and cardiac rhythm along with airflow and length of non-breathing episodes.
 
Different ways in treating Snoring and Sleep Apnea:

1. Oral Appliance Approach

     A conservative treatment is to have a dental appliance made to wear during sleep      which gently moves the lower jaw forward causing a positive change in tongue      position. Advantages of an appliance - also known as an orthotic device or mouth      guard - over other therapies include:
        
        a Inexpensive cost
        b. Non-invasive
        c. Easily accepted by patients
        d. Reversible

2. Continuous Positive Airway Pressure (CPAP)

     Consists of an air compressor and mask, which delivers pressurized air through the      nose when a person is sleeping. This opens up the airway from the inside - as if the      air were an internal splint. The biggest hurdle for using this method is compliance.      Many patients feel claustrophobic with it and others find wearing the mask to be      offensive. The strap of the mask worn around the head may even cause headaches.
 
3. Surgery

     This is the most invasive method of treatment and is performed only in cases of      severe obstruction apnea when excessive tissue reduces the airway space. This      surgery is known as UPPP surgery (Uvulopalatopharyngoplasty) and, according to      most clinical investigations, is only 50% effective except in cases where      abnormalities      are present; enlarged tonsils, nasal polyps, a deviated septum or      jaw malformations.      These defects are helped and corrected by surgery      procedures.