Snoring and Sleep Apneas

According to recent studies, approximately 20% of North Americans suffer from a sleep problem. Problems with sleep affect both men and women of every race, age, and socioeconomic class. Although lack of sleep appears to be a benign problem, its effects are far reaching. One of the major causes of sleep deprivation is obstructive sleep apnea (OSA). OSA is a complete cessation of breathing during sleep for at least 10 seconds. It affects men more than women and particularly individuals between the ages of 40 to 60. If OSA is left untreated, it can lead to an increased risk of heart disease, stroke, high blood pressure, diabetes, arrhythmias, as well as sleep-deprived motor vehicle accidents.

The symptoms of obstructive sleep apnea include:

  • Intermittent snoring
  • Poor memory
  • Excessive daytime sleepiness
  • Irritability
  • Headaches
  • GERD

Risk factors for obstructive sleep apnea include:

  • Increasing age
  • Obesity
  • Family history
  • Male gender
  • Alcohol use
  • Smoking
  • High blood pressure
  • Asthma

You might be asking yourself, “So how does my dentist come into play with obstructive sleepapnea?” Well, aside from the above mentioned symptoms of OSA, there are several oral manifestations of obstructive sleep apnea that can be seen by your dentist that may help in the detection of OSA. These symptoms include:

  • Enlarged scalloped tongue
  • Pain on palpation of the jaw joints
  • Jaw joint sounds when opening or closing the mouth
  • Crowding of teeth
  • Wear patterns on teeth

Because of the widespread prevalence of OSA and the fact that it remains largely undiagnosed in the general population, it is increasingly important that you are screened by your dentist or family doctor so that the treatment process can begin in a timely manner. Next time, we will discuss how OSA is treated and how your dentist can play a huge role in helping you get better sleep.

Through a thorough clinical examination, your dentist can detect these signs that may encourage him/her to refer you to your medical doctor for further investigation of potential sleep apnea through a sleep test. If the sleep test confirms that you indeed have obstructive sleep apnea, there are a number of treatment options available to help optimize the amount of air travelling to your lungs so that you can breathe properly during your sleep. The three treatment options include:

  1. CPAP machine
  2. Surgery
  3. Oral appliance therapy

CPAP (Continuous positive airway pressure) therapy involves the use of a machine that opens up the airway by using positive air pressure. It involves the use of a nasal mask that must be connected to the patient at all times during sleep. However, studies show that compliance with CPAP machines is poor. This may be due to a number of problems associated with its use. These include trauma to the bridge of the nose by the mask, bloating of the stomach, and nasal congestion. Also, the device is not mobile and therefore restricts movement during sleep.

The other treatment option for obstructive sleep apnea is surgery. Surgery can be effective in removing anatomical obstructions such as enlarged tonsils, however studies show it is only 30-50% effective.

The third treatment option is the use of an oral appliance, supplied to you by your dentist. The goal of oral appliance therapy is to reposition the lower jaw and tongue in order to create a favourable environment for air to flow to the lungs. Success rates have been as high as 76% in treating mild to moderate cases of obstructive sleep apnea. The advantages include:

  • Non-invasive treatment
  • Less noticeable than CPAP machine
  • Reversible therapy
  • High patient compliance

If you have trouble sleeping at night, wake up tired in the morning, or your partner complains of your snoring throughout the night, talk to your dentist or family doctor about the possibility of obstructive sleep apnea. The first step in getting better sleep is identifying the problem and this can only be done by consulting either your dentist or family doctor. Just think, a visit to your dentist could mean a good night’s sleep in the future.