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Posts for tag: sleep apnea

SleepApneaandBehavioralProblemsinChildrenHowYourDentistCanHelp

We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).

The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.

What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.

Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.

There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.

If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”

By Mark Lukin
August 01, 2017
Category: Oral Health
Tags: sleep apnea   snoring  
YourDentistmayhavetheSolutionforYourSleepApnea

Your nightly snoring has become a major sleep disturbance for you and other family members. But it may be more than an irritation — it could also be a sign of sleep apnea, a condition that increases your risk for life-threatening illnesses like high blood pressure or heart disease.

Sleep apnea most often occurs when the tongue or other soft tissues block the airway during sleep. The resulting lack of oxygen triggers the brain to wake the body to readjust the airway. This waking may only last a few seconds, but it can occur several times a night. Besides its long-term health effects, this constant waking through the night can result in irritability, drowsiness and brain fog during the day.

One of the best ways to treat sleep apnea is continuous positive airway pressure (CPAP) therapy. This requires an electric pump that supplies constant pressurized air to a face mask worn during sleep to keep the airway open. But although effective, many patients find a CPAP machine clumsy and uncomfortable to wear. That's why you may want to consider an option from your family dentist called oral appliance therapy (OAT).

An OAT device is a custom-made appliance that fits in the mouth like a sports mouthguard or orthodontic retainer. The majority of OAT appliances use tiny metal hinges to move the lower jaw and tongue forward to make the airway larger, thus improving air flow. Another version works by holding the tongue away from the back of the throat, either by holding the tongue forward like a tongue depressor or with a small compartment fitted around the tongue that holds it back with suction.

Before considering an OAT appliance, your dentist may refer you to a sleep specialist to confirm you have sleep apnea through laboratory or home testing. If you do and you meet other criteria, you could benefit from an OAT appliance. There may be other factors to consider, though, so be sure to discuss your options with your dentist or physician to find the right solution for a better night's sleep.

If you would like more information on sleep apnea treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”

FindOutWhyYouorYourPartnerSnores-itmaybeSleepApnea

If your sleeping partner snores, it could be more than an annoyance: it could be a sign of sleep apnea. This occurs when air flow into the lungs becomes obstructed in the throat for a few seconds during sleep. The obstruction can take many forms, but a common one arises from the tongue relaxing against the back of the throat, producing snoring sounds as air attempts to pass through this restricted area.

Sleep apnea can cause severe problems: lower daily energy levels and mood from poor sleep; lower oxygen saturation that could affect brain function; and increased risk for cardiovascular disease. So, if you’re awakened by your partner’s snoring (or they’re complaining about yours!), it’s important to have it checked and treated.

This begins with a visit to us for a complete oral examination. Like many dentists, we’re well trained in the anatomy and structures of the mouth, as well as the causes and treatment of sleep apnea. We’ll examine your mouth, take into account any possible symptoms you’re experiencing and, if your suspicions are correct, refer you to a sleep physician to diagnose if you have sleep apnea.

Treatment will depend on its cause and severity. An oral appliance worn during sleep is the recommended first treatment for mild to moderate sleep apnea that involves the tongue as an obstruction. We develop a custom appliance that helps move your tongue away from the back of the throat, reducing both apnea and snoring sounds. For more advanced sleep apnea you could benefit from a Continuous Positive Airway Pressure (CPAP) machine. This device generates continuous air pressure through a mask worn while sleeping that helps keep the airway open.

Of course, there are other causes for obstruction, some of which may require surgical intervention to relieve the problem. Abnormally large tonsils, adenoids or excessive soft tissue can all restrict air flow. Surgically removing or altering these structures could help reduce airway restriction.

Whatever type or degree of sleep apnea you or your partner may have, there are solutions. The right treatment will not only improve overall health, it will help both of you get a better night’s sleep.

If you would like more information on sleep apnea and how to treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “If You Snore, You Must Read More!

By Mark Lukin
October 03, 2013
Category: Oral Health
Tags: sleep apnea   snoring  
FiveThingsYouShouldKnowAboutSleepApnea

Sleep apnea, a form of sleep-related breathing disorders that is estimated to affect some 22 million Americans, is sometimes thought of as the “quiet culprit” lurking behind many other maladies. But ask anyone who sleeps alongside a sufferer, and you'll get a different response: It isn't quiet at all! Instead, it's often marked by loud snoring and scary episodes where breathing seems to stop. If you've ever worried that you or someone you care about may have this condition, here are five facts you should know.

1) Sleep apnea is a potentially deadly disease

For one thing, it leads to chronic fatigue that can make accidents far more likely — a special concern in potentially dangerous situations, like operating machinery or driving a vehicle. It also appears to be related to heart conditions such as high blood pressure, irregular heartbeat, coronary artery disease, and even stroke. Plus, it can lead to weight gain, depression and mood disorders.

2) People with sleep apnea may wake hundreds of times every night

These “micro-arousals” may occur 50 or more times per hour, and may keep a person from getting any relaxing sleep — even though they retain no memory of the episodes. That's why people who suffer from sleep apnea often go through their days on the verge of exhaustion. And they aren't the only ones who suffer: Their bed partners may also be kept up throughout the night, becoming anxious and irritable.

3) Persistent snoring can be a symptom of sleep apnea

Snoring is caused when breath being drawn into the lungs is obstructed by soft tissue structures in the upper airway. Most everyone snores sometimes… but chronic loud snoring is a common symptom of obstructive sleep apnea (OSA) — and the louder and more frequent the snoring, the greater the likelihood of OSA. To confirm a diagnosis of sleep apnea, a sleep study using special monitors may be conducted in a clinical setting, or an at-home test may be used.

4) Your dentist may be able to help diagnose and treat sleep apnea

What does dentistry have to do with sleep apnea? For one thing, sleep apnea is a disease that involves structures in the oral cavity — an area dentists are quite familiar with. Sometimes, fatigued folks who suffer from OSA begin snoring when they recline in the dental chair, showing their symptoms firsthand. But even if their patients don't fall asleep, dentists with proper training are recognized by the American Academy of Sleep Medicine (AASM) as being able to provide first line therapy for mild to moderate sleep disorders.

5) An oral appliance is a good step to try before more invasive treatments

If it's appropriate in your situation, your dentist can custom-fabricate an oral appliance that may alleviate sleep-related breathing disorders. This device, worn while you're sleeping, helps to maintain an open airway in the throat and to reduce breathing problems. With a success rate of around 80%, in many cases it's comparable to the more complex CPAP (continuous positive air pressure) machines, but people often find it easier to wear. Plus, it's a non-invasive treatment that can be explored before deciding on a more involved treatment, such as surgery.

If you would like more information about dentistry and sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”

By Stephen P. Lukin, D.D.S.
August 23, 2012
Category: Oral Health
Tags: sleep apnea   snoring  
HowYourDentistCanHelpYouGetaBetterNightsSleep

Scientists don't know much about sleep even though it has been extensively studied. We do know that several hours of deep, restful sleep per night are essential for a healthy life.

Many people remain tired and unrefreshed, even after a full night's sleep. About a third of them are affected by sleep related breathing disorders (SRBD). Dentists can play a significant role in helping patients overcome these disorders, which range from frequent snoring to severe Obstructive Sleep Apnea (OSA). If you think you may have such a disorder, read on.

Under normal conditions, your upper airway is open, allowing air to flow from your nose, through your throat, and into your lungs. If you suffer from SRBD, you experience frequent reductions in the flow of air to your lungs during sleep. You may not be aware of it, but sometimes your breathing may even stop for brief periods. These reductions happen when your tongue and other soft tissues in the back of your throat collapse backwards and block your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stages of sleep your body needs.

The resulting reduced oxygen flow to your heart and to your brain can cause serious damage. You will also be tired during the day and experience a lack of energy, even if you sleep for seven or eight hours per night. This constant drowsiness puts you at greater risk for accidents.

Because dentists generally see their patients at six-month or other regular intervals, we are in a good position to screen and refer patients with suspected SRBD to physicians for diagnosis and treatment. Dentists can also treat SRBD in a number of ways.

  • One of these is Oral Appliance Therapy (OAT), in which a device that looks something like an orthodontic retainer holds your lower jaw in a forward position relative to your upper jaw, preventing your tongue and soft tissue from collapsing into your airway.
  • Another consists of breathing equipment called Continuous Positive Airway Pressure (CPAP). The CPAP is a mask connected to a machine that pushes air into your lungs.
  • Other treatments include oral surgery or orthodontia. The goal of these techniques is to increase the volume of air passing through your upper airway by pushing your tongue forward.

Medical insurance usually covers the cost of much of these treatments.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine article “Sleep Disorders and Dentistry.”