INTRO TO SLEEP APNEA – PART 1

Today and next week is a re-introduction to what this severely underdiagnosed medical condition is, and the different ways to treat it. The more you become aware of the different symptoms associated with this problem, the more likely you are to identify whether you or a loved one may be affected. Treatment can extend life.

Sleep apnea is a serious, potentially life-threatening sleep disorder that affects approximately 18 million Americans. It comes from the Greek meaning of apnea which means “want of breath”. People with sleep apnea have episodes in which they stop breathing for 10 seconds or more during sleep. (Note: They are always unaware this happens.)

Diagnosis of sleep apnea usually requires an overnight sleep study in a sleep lab, although there are methods for diagnosis at home. In fact, more and more sleep physicians are using home testing devices because they have improved in reliability.

There are two major types of sleep apnea, both of which can severely disrupt the regular sleep cycle.

Obstructive sleep apnea is when the muscles in the walls of the throat relax to the point where the airway collapses and prevents air from flowing into your nose and mouth. However, as you continue to sleep you also continue to try to breathe. This is the most common type of sleep apnea.

Central sleep apnea is the other type. This is when breathing interruptions during sleep are caused by problems with the brain mechanisms that control breathing.

What are the symptoms associated with sleep apnea? People with sleep apnea usually do not remember waking up during the night. Some of the potential problems may include morning headaches, excessive daytime sleepiness, irritability and impaired mental or emotional functioning, excessive snoring, choking/gasping during sleep, insomnia, or awakening with a dry mouth or throat.

So, what is the difference between snoring and sleep apnea? Unlike mild/moderate snoring, individuals with sleep apnea stop breathing completely for 10 seconds or more, typically between 10 and 60 times in a single night. If the person sleeping in the same room hears loud snoring punctuated by silences and then a snort or choking sound as breathing then resumes, this could be sleep apnea. (Note: In fact, these witnessed events are a strong indicator of sleep apnea.)

Studies have shown that people with diagnosed sleep apnea can be so fatigued during the day that, when driving, their performance is similar to that of a drunk driver. If left untreated, sleep apnea can lead to impaired daytime functioning, high blood pressure, heart attack, or stroke.

Sleep apnea is a medical problem and must be diagnosed by, and treatment dictated, by a physician. Since many people see their dentist on a regular basis, if there is any concern of sleep apnea, the dentist can work closely with a physician to refer for evaluation. If a positive diagnosis is made, the dentist and MD can work together to implement and manage a prescribed therapy.

More and more dentists are getting training in this area of medicine because they can be a help in the treatment of some of the problems associated with sleep-related issues. In my experience, there also seems to be a large part of the population who are un-diagnosed, or are diagnosed but have issues with treatment modalities they are using.

Next week we will discuss the diagnosis of and treatment options of this potentially life-threatening disorder.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.