By Dr. F. Jay Ohmes DDS, FAGD, LVIF, FIAPA
More than 40 million Americans suffer from chronic sleep disorders. These can range from snoring to the complete stoppage of breathing called obstructive sleep apnea (OSA).
SERIOUSNESS OF OSA
Having obstructive sleep apnea means that you actually stop breathing multiple times during the night. The lack of oxygen to your brain jolts your body awake briefly so you can take the necessary breaths and then try to fall back into deeper sleep. These apneic episodes have very serious health ramifications and result in drastic drops in oxygen saturation, from 97% to as low as 60%. Your brain, heart and other organs are being starved of oxygen repeatedly throughout the night frequently at a rate of between 5-30 times per hour! The constant disruption of your sleep patterns means you are limiting the rapid eye movement (REM) sleep, the essential sleep stage that helps your body recover and recharge. The next day, your body compensates for its lack of rest, resulting in fatigue and poor productivity. During the day, your concentration is more easily broken and you suffer from daytime sleepiness and irritability.
MOST COMMON HEALTH CONCERNS ASSOCIATED WITH UNTREATED OSA
Car Accidents- a deadly side effect of excessive daytime sleepiness. People with untreated OSA are five times more likely to fall asleep behind the wheel.
Heart Disease/Stroke- the low oxygen levels caused by obstructive sleep apnea stress the body, making sufferers of OSA more likely to have a heart attack or die in the middle of the night. The oxygen disruption makes it hard for your brain to regulate the flow of blood to arteries and to the brain itself.
High Blood Pressure- frequent awakenings during the night cause hormonal systems to become hyperactive, which can result in a dangerous elevation in blood pressure. Sufferers already on blood pressure medications find it hard to regulate their medication.
Weight Gain- obstructive sleep apnea presents a double-edge sword with obesity because fatty deposits in the neck block adequate breathing during sleep increasing the risk and severity of OSA. The lack of oxygen and proper sleep also cause the endocrine system to increase production of several hormones. Specifically, the hormone Cortisol which increases your appetite and the hormone Ghrelin which increases cravings for carbohydrates and sweets. In addition, with the deprivation of Stage 4 REM sleep, the body becomes deficient in the production of HGH, a hormone that helps maintain lean body mass.
Type 2 Diabetes- since Type 2 diabetes is often brought on by obesity; up to 80% of diabetics also suffer from some form of obstructive sleep apnea. Research shows that sleep deprivation can be a contributing factor to insulin resistance, which is the body’s early warning system indicating susceptibility to Type 2 diabetes.
Other Serious Health Concerns: depression, gastric reflux, insomnia, muscle pain, loss of short term memory, fibromyalgia, cardiac arrhythmias, intellectual deterioration, inefficient metabolism, severe anxiety, memory and concentration impairment, mood swings and impotence.
Although OSA can create severe health impairments, treatment can prevent most of these risks. It is even possible to cut down on blood pressure medication because getting adequate rest can lower blood pressure. Treatment is crucial. Often times this means CPAP therapy, a machine that sits beside your bed or on your nightstand and applies positive airway pressure to the respiratory system to prevent apnea episodes. CPAP therapy has proven to be very effective in the treatment of OSA when used as prescribed. However, due to the invasive and obtrusive nature of CPAP therapy patient compliance is extremely poor, as low as 50%. As a result, industry leaders now accept dental appliance therapy as standard practice.
In 2006, the American Academy of Sleep Medicine recommended that oral appliances be used as a first line of treatment for mild to moderate OSA. FDA approved appliances used to treat OSA work by advancing the mandible thus holding the jaw in a forward position. This creates more volume for the tongue and increases the free space in the back of the throat preventing upper airway tissues from obstructing and causing an apnea event.
SCREENING FOR OSA AT THE DENTIST OFFICE
An attentive and knowledgeable dentist is in a perfect position to screen for OSA because he can routinely visualize his patient’s oral cavity and upper airway which may show an anatomical predisposition for obstruction. Dentists that have been educated in the assessment of OSA are aware of the subjective signs and symptoms of OSA and can screen as part of dental and medical history updates. Additional screenings utilized in our office include home sleep testing (HST) and 3-dimensional radiography to assess both the nasal and oral airways. If you or your bed partner suffers from symptoms of OSA, please call us to learn more about how oral appliances can prevent potentially serious health conditions that occur as a result of sleep apnea.
Dr. Jay Ohmes is experienced in all of the different sleep apnea oral appliances available. After a thorough sleep examination, Dr. Ohmes will explain which type of oral appliance will best suit you and why. All of Better Sleep StL’s oral appliances are completely custom fabricated from accurate digital models of your mouth and are thereby effective and easy to wear. Most patients find that it typically takes only a few nights to get used to wearing an oral appliance. Soon, you won’t ever want to sleep without it.
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