Are you drowsy during the day with no explanation? Do you snore loudly or wake up breathless in the middle of the night? Do you miss sleeping with your spouse or significant other? Are you tired of not getting a restful night’s sleep? Do you have unresolved medical conditions due to lack of healthy sleep? Is someone’s snoring ruining your good sleep? night after night? Are you or a family member frustrated with struggling to wear a CPAP for sleep apnea? Has someone told you that you clench or grind your teeth?
If you answered “Yes” to any of these questions, you or a family member may be one of the more than 40 million Americans who are affected by sleep apnea, snoring or other sleep disorder problem.
WHAT IS SLEEP APNEA?
Sleep apnea is a condition in which your breathing stops periodically during sleep, as many as 20-30 times per hour. Each time you stop breathing in your sleep, the resulting lack of oxygen alerts your brain, which temporarily wakes you up to restart proper breathing. Since the time spent awake is so brief, most people with sleep apnea don’t remember it and many believe they are getting a good night’s sleep when, in fact, they are not. The constant wake-sleep, wake-sleep cycle prevents those with sleep apnea from achieving deep sleep, resulting in a constant drowsy feeling during the day.
WHAT ARE THE SIGNS OF SLEEP APNEA?
The following symptoms can indicate the presence of sleep apnea. If you notice one or more of these, contact our practice.
- Insomnia or difficulty sleeping
- Loud snoring at night
- Waking up at night short of breath or gasping for air
- Snorting or choking sounds during the night (indicating a restart of breathing)
- Headaches upon waking in the morning
- Falling asleep unintentionally during the day
- Extreme drowsiness throughout the day
ARE THERE DIFFERENT TYPES OF SLEEP APNEA?
There are three categories of sleep apnea. The most common is called obstructive sleep apnea (OSA) and occurs due to a physical blockage, usually the collapsing of the soft tissue in the back of the throat. Less common is central sleep apnea (CSA), in which breathing stops because the muscles involved don’t receive the proper signal from the brain. And some people suffer from “mixed” or “complex” sleep apnea, which is a combination of obstructive and central apnea.
WHAT ARE RISK FACTORS FOR SLEEP APNEA?
Obstructive sleep apnea is more common in males than females and more common in older adults (40+) than younger adults and children. However, anyone — regardless of gender or age — can suffer from sleep apnea. Other risk factors include obesity, smoking, drinking, use of sedatives or tranquilizers and family history. Central sleep apnea strikes most often in people with heart disorders, neuromuscular disorders, strokes or brain tumors.
IS SLEEP APNEA DANGEROUS?
Sleep apnea is considered a serious medical problem and if left untreated it can lead to high blood pressure, increasing the risk of heart failure and stroke. The ongoing state of fatigue caused by sleep apnea can lead to problems at work or school, as well as danger when driving or operating heavy machinery. Sleep apnea can also cause complications with medication or surgery; sedation by anesthesia can be risky, as can be lying flat in bed after an operation. In addition to snoring and excessive daytime sleepiness sleep apnea can cause memory loss, morning headaches, decreased sex drive and impaired concentration. If you know or suspect you suffer from sleep apnea, let your family doctor know before taking prescribed medication or having surgery.
HOW IS SLEEP APNEA TREATED?
Treatments for sleep apnea depend on the severity of each individual case and the type of apnea. A sleep physician makes the diagnosis of OSA by measuring data collected from an overnight sleep study, also known as a polysomnogram. The sleep physician will determine the most effective treatment option for the patient.
- Continuous Positive Airway Pressure (CPAP) is the most common, efficient and non-invasive treatment for moderate to severe sleep apnea. CPAP is a device worn at night while sleeping. Air pressure is applied through a tube and mask that covers the nose and the mouth. While majority of patients are prescribed a CPAP machine when they are intially diagnosed with obstructive sleep apnea (OSA), various studies report CPAP compliance rates at or below 50 % at 2 years.
- Surgery’s goal is to create a more open airway so obstructions are less likely to occur. Surgery can be quite invasive and sometimes can worsen the apnea.
- Lifestyle changes such as good sleep hygiene, exercise and weight loss may help reduce the severity of OSA.
- The good news is that there is a new dental alternative to CPAP or surgery. It’s called Oral Appliance Therapy.
An oral appliance is a small plastic device that fits in the mouth like a sports mouth guard or orthodontic retainer. Oral appliances help prevent the collapse of the tongue and soft tissues in the back of the throat, keeping the airway open during sleep and promoting adequate air intake. Oral appliances may be used alone or in combination with other treatments for sleep-related breathing disorders, such as weight-management, surgery or CPAP.
Oral appliance therapy involves the selection, fitting and use of a specially designed oral appliance that maintains an open, unobstructed airway in the throat when worn during sleep. Custom-made oral appliances are proven to be more effective than over-the-counter devices, which are not recommended as a screening tool nor as a therapeutic option.
Dr. Luminita Markham is a proud member of the American Academy of Dental Sleep Medicine. She has had extensive training in oral appliance therapy and is familiar with the various designs of appliances and she and the team at Maidu Dental can help you determine which is best suited for your specific needs.
The initial evaluation phase of oral appliance therapy can take several weeks or months to complete. This includes examination, evaluation to determine the most appropriate oral appliance, fitting, maximizing adaptation of the appliance and the function.
Ongoing care, including short- and long-term follow-up is an essential step in the treatment of snoring and Obstructive Sleep Apnea with Oral Appliance Therapy. Follow-up care serves to assess the treatment of your sleep disorder, the condition of your appliance, your physical response to your appliance and to ensure that it is comfortable and effective.
WHAT ABOUT INSURANCE COVERAGE FOR SLEEP APNEA?
OSA is a medical condition and as such, is covered under medical, not dental policy. We will bill your medical insurance for any services related to sleep apnea. The fees will be thoroughly reviewed with you before the treatment is started.
WHAT SHOULD I DO IF I SUSPECT THAT SOMEONE IN MY FAMILY SUFFERS FROM SLEEP APNEA?
Please contact our office to schedule an appointment at (530) 823-8771 and we will do an initial consultation. We may refer you to a sleep apnea physician. The specialist may recommend a sleep study to diagnose the precise extent of the problem and can prescribe appropriate treatment. Depending on your situation, treatment may involve an oral device that we can custom-create for you.