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The Sleep Center

Obstructive Sleep Apnea

All of the muscles in your body become more relaxed during sleep. This includes the muscles that help keep the airway open and allow air to flow into the lungs.

Normally, the upper throat still remains open enough during sleep to let air pass by.
However, some people have a narrower throat area. When the muscles in their upper throat relax during sleep, their breathing can stop for a period of time (often more than 10
seconds). This is called apnea.

The snoring in people with obstructive sleep apnea is caused by the air trying to squeeze through the narrowed or blocked airway. However, everyone who snores does not have sleep apnea. Other factors may also increase your risk:

• Certain shapes of the palate or airway that cause the airway to be narrower or collapse more easily
• Large tonsils and adenoids in children that can block the airway
• Large neck or collar size (17 inches or more in men and 16 inches or more in women)
• Large tongue, which may fall back and block the airway
• Being overweight

Sleeping on the back also increases sleep apnea episodes.

 

Symptoms

A person who has obstructive sleep apnea often is not aware of the apnea episodes during the night. Often, family members witness the periods of apnea.  A person with obstructive sleep apnea usually begins snoring heavily soon after falling asleep. Often the snoring gets louder. The snoring is then interrupted by a long silent period during which there is no breathing. This is followed by a loud snort and gasp, as the person attempts to breathe. This pattern repeats.

Many people wake up unrefreshed in the morning and feel sleepy or drowsy throughout the day. This is called excessive daytime sleepiness (EDS).

People with sleep apnea may:

• Act grumpy, impatient, or irritable
• Be forgetful
• Fall asleep while working, reading, or watching TV
• Feel sleepy while driving, or even fall asleep while driving
• Have hard-to-treat headaches

Problems that may occur with this condition:

• Sudden heart attack
• Depression that becomes worse
• Hyperactive behavior, especially in children
• Leg swelling (if severe)

 

Testing for Obstructive Sleep Apnea

At Dr. Collins office, all new patients are evaluated for Obstructive Sleep Apnea.  If OSA is a possible health concern, Dr. Collins will notify you, and she will suggest that you take a sleep test.  You can either take a sleep test through your healthcare provider, or you can go home with our sleep test kit.  Regardless of which you choose, both forms of sleep tests will yield an accurate result of your sleep disorder, and what your needs may be.

 

Dental Sleep Appliance Treatment Advantages

There are many forms of treatment for Obstructive Sleep Apnea.  CPAP, or Continuous Positive Airway Pressure (CPAP), is the gold standard treatment for obstructive sleep apnea in most people. CPAP is delivered by a machine with a tight-fitting face mask.  However, it has been noted that most patients do not have the discomfort tolerance to be fitted with CPAP.  Now Medicare has endorsed the FDA approved dental devices as a first line of treatment for certain cases of sleep apnea.

Surgery may be an option in some cases. This may involve:

• Uvulopalatopharyngoplasty (UPPP) -- to remove excess tissue at the back of the throat (this has not been proven to work well, and in fact has been regarded by many surgeons as permanently damaging to the throat, and has been known to reverse.)
• More invasive surgeries -- to correct abnormal structures of the face in rare cases when patients have severe sleep apnea or treatment has not helped
• Tracheostomy -- to create an opening in the windpipe to bypass the blocked airway if there are physical problems (rarely done)
• Surgery on the nose and sinuses.

Surgery is not usually an option for a patient, especially given the temporary results of the procedures.  That is why we recommend as a first line of defense, the mandibular repositioning device, a non-invasive method to preventing Obstructive Sleep Apnea.  Some of the appliances used in our office are the SomnoDent or TAP3 appliances as seen below. 

 

For the treatment of OSA, the SomnoDent® MAS is worn during sleep to maintain the patency of the upper airway by increasing its dimensions and reducing collapsibility. It is a custom made oral device that is comprised of upper and lower dental plates with a unique patented fin coupling component to maintain mandible protrusion. The fin coupling mechanism is a key differentiator from other oral devices as it enables the patient to maintain normal mouth opening and closing while wearing the SomnoDent® MAS.  We have received fantastic reviews from patients who we have fitted with this appliance, and their overall experience of sleep has improved dramatically.

 

 

The TAP 3® is intended to reduce or alleviate nighttime snoring and obstructive sleep apnea (OSA). The appliance is for adult patients to be used when sleeping at home. The device is contraindicated for patients with loose teeth, loose dental work, dentures, or other oral conditions which would be adversely affected by wearing dental appliances. In addition, the appliance is contraindicated for patients who have central sleep apnea, have severe respiratory disorders, or are under 18 years of age.  The TAP holds the lower jaw in a forward position so that it does not shift nor fall open during the night. This prevents the airway from collapsing.  This device has proved, like the Somnodent, to provide great and oftentimes immediate relief in patients with OSA.

 

 

It is predicted by medical professionals that by 2020, 1 in every 5 Americans will suffer from
Obstructive Sleep Apnea.  It is a serious condition with sometimes fatal results that should be treated sooner rather than later.  If you or a family member believes that you suffer from this condition, please do not hesitate to call our office to make an appointment for an evaluation and schedule a sleep test.