
What Is Obstructive Sleep Apnea (OSA)
Sleep Apnea, most commonly refers to Obstructive Sleep Apnea (OSA) which is a dangerous sleep disorder. Obstructive Sleep Apnea involves the complete obstruction of the airway while sleeping. This obstruction prevents air from entering the lungs. This event is what the term Apnea refers to. It is the most common type of sleep-disordered breathing (SDB). Obstructive Sleep Apnea is characterized by recurrent episodes of airway collapse during sleep. Events of Apnea are always accompanied with arousals (a disturbance from deep sleep to light sleep) or an awakening (regaining consciousness) from sleep.
An apnea event occurs when someone is in deep or dreaming (REM) sleep. In REM sleep the muscles of the body relax, including the muscles of the head and neck. When this happens, the lower jaw (mandible) and tongue fall back and the tongue blocks the airway (throat or pharynx). The brain senses the decrease in oxygen as dangerous and arouses or awakens the person out of deep sleep either into light sleep or to an awakened state. The frequent arousals from the many apneas people experience during the night results in a fragmented sleep and therefore excessive daytime sleepiness.
A critical issue with an apnea event is how long the event lasts and how long oxygen is cut off. When the airway is blocked for more than ten seconds oxygen loss begins to occur. Most apnea events last 20 to 30 seconds. It’s not unusual for events to last up to up to 60 or even 90 seconds. These events can ultimately lead to a condition of oxygen denial called hypoxia, which is very dangerous and even life threatening.
Another critical measure of sleep apneas severity is the frequency of apnea events. In cases of significant severity between 100 and 400 or more apnea events can be experienced in a single night.
When you consider how Sleep Apnea disrupts sleep it’s no wonder sleepiness is one of the most common symptoms of the disorder.
“It has been working. I can tell the difference because I have more energy. As for the snoring it has improved. … I’m happy I came to get my sleep apnea under control.”
– Melissa Tomaszewski
How Serious Is Sleep Apnea
Sleep apnea can make other potentially fatal illnesses far worse.
Apnea events are often accompanied by wide swings in heart rate, a precipitous decrease in oxygen saturation, and brief electroencephalograph (EEG) arrhythmias.
If you have severe untreated obstructive sleep apnea you may be shortening your life!
During apnea events the brain perceives that the body is suffocating. This perception is triggered by decreasing oxygen levels. The brain, particularly the Hypothalamus responds to this plummeting oxygen level releasing hormones that triggers the Pituitary Gland and the Adrenal Glands. These hormones include Epinephrine (adrenaline) and Cortisol. Additionally sugars are also released into the blood, which stimulates the pancreas to release large amounts of insulin. It’s not unusual for OSA patients to become insulin resistant leading to Adult Type 2 Diabetes. The result of these events reoccurring hundreds, thousands and tens of thousands of times over extended periods causes enormous stress and damage to the body. It can be and often is devastating to health and wellness. During these apnea events loud snoring is very common.
No Skid Marks! No Mystery
Police, firemen and EMS professionals know it well. It’s the scene of a fatal accident. It was a grisly, high speed impact with no skid marks, no attempt to brake! Unsolvable mystery? Not really. Sleeping drivers don’t brake, they just kill themselves and others.
Some of the health consequences of Obstructive Sleep Apnea:
- Heart failure
- Cardiac arrhythmia (Atrial Fibrillation)
- Myocardial infarction (heart attack)
- Hypertension (high blood pressure)
- Cardiovascular disease
- Coronary artery disease (blood flow restriction to the brain)
- Insulin-resistance diabetes (Adult Type 2 Diabetes)
- Metabolic syndrome (including chronic inflammation, obesity, dyslipidemia)
- Short term memory loss (a common symptom of dementia)
- Mood disorders (anxiety and depression)
- Obesity
- Decreased testosterone in men (loss of sexual desire)
- Decreased estrogen in women (decreased libido)
- Chronic pain
- TMJ (temporal-mandibular joint dysfunction)
- Sleep related accidents (especially while driving)
Sleep Apnea Is an Epidemic
We believe that up to eighty million (80,000,000) Americans have some form of sleep breathing disorders. This alarming number includes children. According to the National Sleep Foundation between 80 and 90% of Americans with OSA remain undiagnosed and untreated.
What are the symptoms of sleep apnea?
Symptoms of sleep apnea include:
- Snoring
- Gasping during sleep
- Morning headaches
- Waking up abruptly
- Waking up out of breath
For some, sleep apnea can become life threatening. Apnea events are accompanied by an increased heart rate and decreased oxygen. Continued events cause stress and damage to the body.
Sleep apnea is associated with a number of serious conditions including:
- Heart failure
- Cardiac arrhythmia
- High blood pressure
- Mood disorders
- Temporomandibular joint dysfunction
- Stroke
Patients with sleep apnea are often sleep-deprived and at increased risk for sleep-related accidents, especially while driving or using machinery.
Who is at risk for sleep apnea?
Although sleep apnea can affect anyone, there are certain factors that increase your risks. Risk factors for sleep apnea include:
- Excess body weight
- Naturally narrow airways
- Smoking
- Use of opioids and sedatives
- Heart disorders
- Stroke
- Being male
If you or your dentist suspect you’re suffering from sleep apnea, the specialists at Chase Dental can help you determine the cause of your condition and the best treatment option for effective relief.
How Is Sleep Apnea Diagnosed
The first step in diagnosis is screening. Some screening tests are subjective questionnaires to determine levels of sleepiness or risk factors for sleep apnea. Other screening methods include home sleep tests and overnight pulse-Oxyimetery.
If you screen positive for being at risk for obstructive sleep apnea, the next step is a sleep study. A sleep study allows the physician to make a definitive diagnosis and whether or not you are a candidate for therapy. This sleep study is called a Polysomnography (PSG), is performed in a sleep center lab or by utilizing a home study testing device.
Who Suffers From Sleep Apnea
Although Obstructive Sleep Apnea is most common in middle aged and older people, sleep apnea is prevalent in young adults as well. Excessive weight predisposes a person to OSA but many thin, in-shape people can have sleep apnea. Obstructive sleep apnea is slightly more common in men that woman, but women can have very severe apnea.
How is sleep apnea treated?
Treatment for sleep apnea begins with an accurate diagnosis. Your dentist performs a dental airway assessment to determine if an obstruction is the cause of your sleep apnea. You discuss your symptoms before deciding between a home sleep test or an in-lab polysomnography.
The sleep study is used to develop a definitive diagnosis and determine the best treatment for your condition. Chase Dental SleepCare specializes in a comprehensive approach to patient care, providing a number of conventional and alternative treatment options. Treatment for your sleep apnea may include:
- Oral appliance therapy
- Continuous positive airway pressure (CPAP)
- Epigenetics
- Surgery
Some patients achieve relief from obstructive sleep apnea with lifestyle changes like weight loss and ceasing smoking. To find out which treatment is right for you, book your appointment by phone or online today.
Diagnosis
If you’re experiencing sleep difficulties or poor quality sleep that is not restful, you need to get screened and if indicated by the screening, you should be tested.
The first step is screening. Some screening tests are subjective questionnaires to determine levels of sleepiness or risk of having sleep apnea. Other screening methods include home sleep tests and overnight Pulse-Oximetry.
If you screen positive for being at risk for obstructive sleep apnea, the next step is a sleep study. A sleep study allows the physician to make a definitive diagnosis and whether or not you are a candidate for therapy. A definitive diagnosis of sleep apnea can be made only with a sleep study conducted during a visit to a sleep lab, usually overnight, or a home study performed with special equipment.
“I feel better with using the appliance. As soon as I put it in my mouth I felt my airway open.”
– Carolyn DelVecchio
Two Sleep Study Options
In Lab-Polysomnography (PSG)
Polysomnography (PSG) is the most comprehensive test for sleep apnea. This test takes place in a sleep lab overnight. This test records electrical activity of your brain, eye movement, muscle activity, heart rate, and breathing, airflow through your nose and mouth, and blood oxygen levels. Polysomnography also records electrical brain waves (EEG) which determines sleep staging, i.e. light sleep, deep sleep, and rapid eye movement (REM-dreaming) sleep.
Home Sleep Tests (HST)
Home Sleep Tests (HST) is an alternative to an in-lab Polysomnography where the patient can self-administer the sleep test. The Patient is able to spend the night in their own bed in familiar surroundings. Home sleep studies can be especially advantageous to the home-bound, elderly, and those with chronic illness. It is also beneficial for those with trouble arranging time out of their schedule to spend the night at a lab. The Home Sleep Test typically yields similar results to a Polyspmnograph. The diagnosis of Obstructive Sleep Apnea is covered by most insurance plans.
A definitive diagnosis of sleep apnea requires a sleep study. A sleep study monitors and records what happens to your body during sleep.
The diagnostic devices used for screening for sleep apnea and many other serious sleep disorders are easy to use, highly accurate, and covered by medical insurance. If you believe you’re experiencing a sleep related illness, there is a very good chance that you are. Talk to your physician about your symptoms.
If you need a physician referral or some other type of guidance to determine if you have sleep apnea, call the Chase team. We’re here to help.
Sleep Deprivation vs. Sleep Disorder
A sleep disorder can aggravate sleep deprivation and vice versa but they are not inherently the same. What’s the difference between a sleep disorder and sleep deprivation? Sleep deprivation is when someone is sleepy and has not slept because they chose not to sleep or could not find the opportunity to do so. The point is, they could enjoy healthful sleep if given the chance.
Someone with a sleep disorder cannot experience healthful sleep even when they allow time for sleep. Some sleep disorders like sleep apnea don’t permit healthful, restful sleep even though the person “falls asleep”.
We see patients in the following surrounding cities: Manhattan, NYC, Bronx, Queens, Staten Island, New Jersey, and Connecticut. Call us to book your appointment today.