Sleep Apnea Treatment
Sleep Apnea (also known as "Sleep Apnoea") is one of many sleep disorders.
There are numerous types of sleep disorders. Some are related to disordered breathing; some are neurological. These include:
- Sleep Apnea
- Sleep Hyperventilation
- Restless Leg Syndrome
- Sleep Talking, Sleep Walking
- Nightmares, Night Terrors
- Rapid Eye Movement Behaviour Disorder
Sleep Apnea, is characterized by breath pauses during sleep, which may last for 10 to 30 seconds or even longer. Sleep Apnea episodes usually happen five to 30 times in an hour and may cause sleep disturbances. Snorting, choking, and snoring are typical for people with Sleep Apnea. It is common in men and older people, although women and children can also suffer Sleep Apnea.
People suffering with sleep apnea are normally not aware of their sleeping irregularities. In fact, it is said that 80 to 90% of people with Sleep Apnea are undiagnosed. Usually, it is their bed partners who notice their condition.
Once Sleep Apnea is properly diagnosed, there are treatments which can improve the sufferer’s health. In most cases the dentist trained in sleep medicine can help.
Types of Sleep Apnea
There are two types of Sleep Apnea. The more common is called obstructive Sleep Apnea (OSA) and involves a partial blockage of the upper airway. This blockage can result from over-relaxed throat muscles and tongue, obesity, and facial and bone structure deformities. Once the airway is blocked, breathing stops and the person begins to gasp for breath.
The oxygen (O2) level in the blood decreases, and the carbon dioxide (CO2) level slowly increases. This increased CO2 then stimulates the brain to normalize the breathing process and prompts the person to wake up enough to open the airway by adjusting the tongue and throat muscles. Normal breathing then ensues followed usually by clenching or grinding the teeth. The person, however, usually won’t remember either awakening for a short time nor their desperate gasps for air.
The other, much less common type of Sleep Apnea, is called central Sleep Apnea (CSA), which is caused by the brain's delayed signals to the breathing muscles. Breathing stops and oxygen levels begin to drop. It is a central nervous system disorder and can result from an injury or disease that involves the brainstem. This can be the result of stroke or brain tumour, among other things.
Despite different causes, their effects are the same: low level of oxygen in the brain, poor sleep, excessive daytime sleepiness, fatigue, and even depression. Sleep Apnea results in poor quality sleep, making the person tired and restless all day. Research has shown Sleep Apnea to raise the risk for heart attacks, stroke, hypertension, diabetes, and obesity. It can also increase the risk of congestive heart failure.
Causes of Sleep Apnea
Sleep Apnea is one of the most common types of sleep disorder.
The muscles of the airway are responsible for keeping the airway open when you are awake. During sleep, the same muscles become more relaxed. Relaxed airway muscles usually keep the airway open enough, because of the basic muscle tone, so that air still flows freely into the lungs during sleep. However, at times, the airways can become blocked or narrowed, especially during sleep. This is called Sleep Apnea.
There are several reasons why the airway becomes obstructed or blocked during sleep.
Most commonly, in adults, the airway muscles and the tongue become even more relaxed than normal. This is exacerbated by use of alcohol, excessive smoking and various degenerative diseases and neurological disorders.
Second, the tonsils may be larger than normal and cause an obstruction to the opening of your windpipe. This enlargement can be due to infection or irritation.
Third, if you are overweight, there could be extra soft tissue fatty deposits that thicken your windpipe's wall. This makes the interior of the airway opening narrow and flaccid, making it also harder to keep open.
Fourth, tumours in the airway or adjacent tissues can take up airway space, causing obstruction.
Finally, certain developmental anomalies result in the lower jaw and tongue being retruded (too far back), thus restricting the airway.
In all, these causes come down to either diminished muscle tone or some form of physical obstruction.
Regardless of the cause, Sleep Apnea is worsened by drinking alcohol; excessive smoking; certain prescribed medication; recreational drugs; and some neurological conditions. Age is also a factor, as the muscle tone naturally reduces with age.
Because each Apnea Event causes a level of arousal from sleep in order to restart the normal breathing process, there are many disturbances to normal healthy sleep. This results in poor quality sleep. The most obvious symptom of poor sleep is daytime sleepiness in adults and hyperactivity in children.
Daytime sleepiness causes a lack of concentration and poor work performance.
Poor work performance includes reduced intellectual performance. In children and students, this is expressed as delayed or reduced academic performance.
Many people suffering from OSA (but not all) also are aware of awakening during the night a number of times, often to go to the toilet.
Most sufferers wake up in the morning not feeling refereshed or happy to jump out of bed. They will also commonly feel like they need a "nanna-nap" in the early-mid afternoon.
The reduced oxygen levels during sleep, caused by lack of breathing for extended periods, also affects many other areas of blood chemistry. This affects the production and release of various hormones and other blood chemicals required for growth and development and healing and health.
There is also an increase in the release of stress hormones, making it difficult for the sufferer to deal as well with stress in their lives as they might without sleep apnea.
The imbalance in hormones also contributes to increased heart rate, increased blood pressure, irregular heart rate and possible heart attack, regardless of cholesterol levels.
Pancreatic function is also commonly affected by the changes in blood chemistry, and, along with obesity, this commonly contributes to diabetes.
During the body's efforts to restart breathing during an Apnea event, there is a dramatic spasm and vibration of the diaphragm. This causes a disturbance to valve between the oesophagus and the stomach, weakening that resistance to reverse flow. The end result is oesophageal reflux, where some of the stomach acid can leak up into the oesophagus, causing a burning sensation commonly called heartburn.
Treatment For Sleep Apnea
Copyright written by Dr Trevor Baret, edited by Katoomba Dental Centre Pty Ltd.
"I first noticed a relationship between the treatment I was providing and an improvement in breathing disorders as early as 1985.
In those days, there was very little known about “Sleep Disordered Breathing” – disturbances in breathing related to sleep. My observations told him there was a link between jaw position and Snoring and Sleep Apnea, so I studied further. I became an Australian leader in the area of Airway Centric Orthodontics.
In the 1990s, I became a pioneer in the use of an Australian designed oral appliance for the treatment of Snoring and Sleep Apnea, and have since worked with international researchers to stay at the forefront of this area of health. I continue to use the locally designed appliance along with various others – depending on the patient’s individual need." - Dr Trevor Baret. B sD.