What Is Sleep Apnea?
These terms describe parts of the continuum of airway collapsibility expressed as sleep-disordered breathing. This spectrum ranges from slight vibration of tissues at its mildest to death from asphyxiation at its severe extreme. Between lies pathologic snoring and periods of complete airway closure and breathing cessation called “apnea”.
One with this condition basically stops breathing for a few seconds – or longer – while he or she is at rest. This causes the body to suddenly awaken, even if the sleeping person does not realize he or she is “jumping” from sleep. Because this interrupts the sleep cycle necessary for a restful slumber, the individual with sleep apnea wakes up feeling out of sorts and groggy.
Sleep apnea affects people of all ages, although it is found more often in those who are male, overweight or obese, over 40, have a larger than average neck size, have enlarged tonsils, have been diagnosed with GERD, or have a nasal obstruction.
Some of the most serious chronic diseases of man have been associated with snoring and sleep apnea, including: stroke, hypertension (high blood pressure), myocardial infarction (heart attack), arteriosclerosis (hardening of the arteries), cardiac arrhythmias (irregular pulse), diabetes, gastro-esophageal reflux disorder (GERD), polycythemia vera (thickening of the blood) and others.
Sleep disordered breathing also disrupts the normal patterns of brain activity and relaxation, precluding restorative sleep. Overwhelming daytime sleepiness contributes to the risk of accident and injury from decreased attention span, judgment and reflex. The risk of automobile accident in the untreated sleep apnea patient is about 8 times that of the normal sleeper. Work productivity and safety suffer.
During the increasing muscular relaxation of deepening sleep, the airway can become increasingly flaccid. The relaxing tongue falls back, sealing against the back of the throat during the sucking, negative pressure of the attempt to take a breath. Snoring is the vibration of the uvula, soft palate and throat walls against the tongue during the inspiratory phase of breathing, with reduced airflow due to increased resistance. As collapsibility increases, complete closure can occur.
In either narrowing (hypopnea) or closing (apnea) events, oxygen levels of the blood can drop precipitously triggering a response of the brain to prevent asphyxia. This “sympathetic discharge” of adrenaline, corticosteroids and other agents raise blood pressure, pulse rate, muscle activity and brain activity to protect the unconscious sleeper from death.
The sleep apnea patient may have these events occur up to 600 times or more per night resulting in fragmented, non-refreshing sleep as well as chronic activation of the sympathetic nervous system. This activation is thought to be the reason for such devastating long-term negative effects on cardio-pulmonary health. Untreated for nine years, sleep apnea patients may lose 20-50% of lifespan.
The main types of sleep apnea are:
- Obstructive sleep apnea, the more common form that occurs when throat muscles relax.
- Central sleep apnea, which occurs when your brain doesn’t send proper signals to the muscles that control breathing.
- Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, occurs when someone has both obstructive sleep apnea and central sleep apnea.
If you think you might have any form of sleep apnea, contact Los Gatos Dentist Dr. Mamal Rahimi today. Treatment can ease your symptoms and may help prevent heart problems and other complications.
Constantly Tired? It’s Time to Get a Good Night’s Sleep!
According to the National Sleep Foundation, around 18 million people in America suffer from sleep apnea. If you wake up feeling tired every morning, or your partner constantly complains that you snore excessively, you could be one of them.
What Are The Risk Factors?
Sleep apnea may occur if you’re young or old, male or female.
Even children can have sleep apnea. But certain factors put you at increased risk:
Fat deposits around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight. Thin people develop the disorder, too. Snoring (Snoring can cause the soft palate to lengthen, which in turn can obstruct the airway)
The size of your neck may indicate whether or not you have an increased risk of sleep apnea. That’s because a thick neck may narrow the airway and may be an indication of excess weight. A neck circumference greater than 17.5 inches (44 centimeters) is associated with an increased risk of obstructive sleep apnea.
A Narrowed Airway:
You may inherit a naturally narrow throat. Or, your tonsils or adenoids may become enlarged, which can block your airway.
Men are twice as likely to have sleep apnea as women are. However, women increase their risk if they’re overweight, and the risk also appears to rise after menopause.
If you have family members with sleep apnea, you may be at increased risk.
Use Of Alcohol, Sedatives or Tranquilizers:
These substances relax the muscles in your throat.
Smokers are three times as likely to have obstructive sleep apnea as are people who’ve never smoked. Smoking may increase the amount of inflammation and fluid retention in the upper airway. This risk likely drops after you quit smoking.
Oral Appliance Therapy
Oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea (OSA). A custom-fit oral sleep appliance can improve your sleep, restore your alertness and revitalize your health.
How common is this disorder?
Recent research estimates that about 1/3 of the population has some form of sleep disordered breathing which is a spectrum of severity from mild snoring to complete closures of the airway (obstructive sleep apnea) to death from asphyxiation.
17% of the population has obstructive sleep apnea, and in the age groups over 60 years, the occurrence rate doubles. Sleep apnea is made worse with increasing body weight. As the obesity rates are rising in the United States, so is the incidence and severity of Obstructive Sleep Apnea (OSA)
How would I know if I have OSA?
Several peer-reviewed research articles have examined the relationship between patient medical history and sleep testing for the presence of OSA.
If you answer “yes” to two questions:
A. “Do you snore regularly?” and
B. “Do you sometimes gasp for air?”
there is an 88% chance of accurately diagnosing OSA at a severity level of 10 collapses per hour. This is significant and requires treatment.
Adjusted Neck Circumference Survey for OSA
New England Journal of Medicine 347:498-504, 2002
The adjusted neck circumference survey uses 4 predictors of OSA to screen patients for the likelihood and possible severity of the disorder.
|1. Neck circumference in cm (2.5 X inches)
2. History of high blood pressure (treated or not) ADD 4
3. Snoring ADD 3
4. Gasping or choking in sleep (observed or awakened) ADD 3
Probability of Obstructive Sleep Apnea
Less than 44 = LOW
44 – 48 = MODERATE
Greater than 49 = HIGH
If you are unsure if you have Obstructive Sleep Apnea or have already been diagnosed, make an appointment with Dr. Rahimi to learn more about treating this condition. Our staff is knowledgeable with medical insurance and will do everything to maximize your reimbursement. Schedule an appointment with Los Gatos Sleep Specialist Dr. Rahimi and get your life back today!
How do I get treatment for OSA?
Any practitioner treating OSA should do so by practice parameters established by the American Academy of Sleep Medicine (AASM). To be in compliance, patients must be diagnosed by polysomnography (PSG) which is an overnight sleep test at a sleep laboratory. 16 channels of physiology are studied including brain function and cardio-pulmonary status.
A. Get an evaluation appointment with Dr. Rahimi. Referrals for diagnostic sleep testing can be obtained at that visit if you have not been tested. If you have been tested and are looking for treatment, Dr. Rahimi will be able to make sure that you are fully informed of all treatment options available.
B. If you select oral appliance therapy, Dr. Rahimi will provide standardized care with proper informed consent, proper follow up therapy and objective measurement of results in accordance with AASM standards of care.
Will my insurance cover this therapy?
It is very likely that your medical insurance carrier will cover oral appliance therapy for you. Dr. Rahimi can offer a complete insurance assessment at the initial visit. This assessment, prior to accepting any therapy virtually eliminates patient uncertainty over any financial obligations. Please contact Dr. Rahimi for complete details.
About Oral Appliance Therapy
Worn only during sleep, an oral appliance fits like a sports mouth guard or an orthodontic retainer. It supports the jaw in a forward position to help maintain an open upper airway. Research shows that oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea.
Breathe Easy Again
Custom oral devices for the treatment of Snoring, Obstructive Sleep Apnea and TMJ
Obstructive sleep apnea (OSA) is a serious and potentially life threatening disease. At Respire, we have developed a range of oral sleep devices designed to assist patients in the treatment of this condition.
When selecting an oral sleep device we believe that one design is not suitable for all patients needs. At Respire we have developed a range of products designed to meet these requirements. Each recognizable device has a different function, and each with a different color.