SLEEP APNEA

Sleep Apnea FAQ
What is Sleep Apnea?
How do you know if you have it?
How can Sleep Apnea be Diagnosed?
What are my treatment options?
I've heard about Oral Appliances, what are they?
What is a "CPAP"?
What about Surgical Procedures?
Do you have Facts or Statistics?
How do I know if I'm a sufferer?


Snoring occurs when the soft-tissue structures of the upper airway collapse onto themselves and vibrate against each other as we attempt to move air through them. This produces the sound we know as snoring. Large tonsils, a long soft palate, a large tongue, the uvula, and excess fat deposits in the throat all contribute to airway narrowing and to snoring.

Usually, the more narrow the airway space, the louder or more habitual the snoring. Snoring also decreases Nitric Oxide levels, which are important for proper heart muscle and blood vessel function. Please note that if your child snores, they need to see a dentist trained in assessing airways immediately to prevent future long-term health problems.

Obstructive Sleep Apnea
Obstructive Sleep Apnea (OSA) occurs when the tongue and soft palate collapse onto the back of the throat. This blocks the upper airway, causing air flow to stop. When the oxygen level drops low enough, the brain moves out of deep sleep and the individual partially awakens. The airway then contracts and opens, causing the obstruction in the throat to clear. The flow of air starts again, usually with a loud gasp. When the air flow starts again, you then move back into a deep sleep. The airway muscles collapse, as you awaken with a gasp. The airway clears once again as the process repeats itself. This scenario may occur many times during the night.
The low oxygen levels and fragmented sleep are the major contributors to most of the ill effects that sleep apnea patients suffer. In addition to excessive daytime sleepiness, studies show that sleep apnea patients are much more likely to suffer from heart problems (heart attack, congestive heart failure, and hypertension) strokes, as well as having a higher incidence of work-related and driving-related accidents. People with sleep apnea also have poor concentration and often perform poorly in school. People with sleep apnea tend to die 10 years premature due to the stress on the heart and tend to have a poor quality of life. NFL Hall of Famer Reggie White passed away from sleep apnea-related problems at the age of 43, two years after retirement. Don't be a statistic. If you have trouble sleeping, have excessive day time sleepiness or wake up in the middle of the night, or if your spouse tells you that you stop breathing when you sleep, get diagnosed. It may save your life.

How do you know if you have OSA?
Take a simple test below, but be sure to visit your physician if you think you have a problem.

Diagnosis of Obstructive Sleep Apnea
Since OSA is a serious medical condition, it must be diagnosed by a physician. Diagnosis is based on the results of an overnight sleep study called a Polysomnogram (PSG). Other factors of determining OSA are patient evaluation and history.

Treatment Options
Good sleep hygiene, weight loss and exercise are some helpful OSA treatments a patient can practice on their own. However, medical and dental treatments include Continuous Positive Airway Pressure, Oral Appliance Therapy, and surgery.

Oral Appliance Therapy
"Since I started using the snoring appliance made for me, I am experiencing better, more refreshing sleep. Also when I wake, my mouth is no longer dry from sleeping with my mouth open. The appliance, which was originally suggested to reduce teeth grinding, is comfortable to wear and easy to care for. I am very pleased with the results." - Glenn P.

Oral appliances are worn in the mouth to treat snoring and OSA. These devices are similar to orthodontic retainers or sports mouth guards. Oral Appliance Therapy involves the selection, design, fitting and use of a custom-designed oral appliance that is worn during sleep.

This appliance then attempts to maintain an opened, unobstructed airway in the throat. There are many different oral appliances available. Approximately 40 appliances have been approved through the FDA for treatment of snoring and/or Sleep Apnea. Oral appliances may be used alone or in combination with other means of treating OSA. These means include general health and weight management, surgery, or CPAP. Oral appliances work in several ways:

Repositioning the lower jaw, tongue, soft palate and uvula

Stabilizing the lower jaw and tongue

Increasing the muscle tone of the tongue

Dentists with training in Oral Appliance Therapy are familiar with the various designs of appliances. They can determine which one is best suited for your specific needs. The dentist will work with your physician as part of your diagnosis, treatment, and ongoing care. Determination of proper therapy can only be made by joint consultation of your dentist and physician. Initiation of oral appliance therapy can take from several weeks to several months to complete.

Your dentist will continue to monitor your treatment and evaluate the response of your teeth and jaws. The new guidelines have stated that for mild and moderate sleep apnea, oral appliance therapy should be the first treatment option. At our office, we have the technology to measure your airway through your nose and mouth to assess if you are a good candidate for an oral appliance. Call us for an appointment at 1-877-283-0497.

Continuous Positive Airway Pressure (CPAP)
Continuous Positive Airway Pressure (CPAP) is pressurized air generated from a bedside machine. The air is delivered through a tube, connected to a mask, covering the nose. The force of the pressurized air splints the airway open. The CPAP opens the airway like air into a balloon; when air is blown into the balloon, it opens and gets wider. This is exactly how CPAP clears the airway. This will work almost 100% of the time if the patient wears it. It is more cumbersome than an oral appliance, loud, and a nuisance when travelling. That being said, for some sleep apnea patients, this is the only thing that will save their life.

Surgical Procedures
In addition to Oral Appliance Therapy, dentists who are oral and maxillofacial surgeons may consider a variety of methods to evaluate, diagnose and treat upper airway obstruction. These dental specialists treat upper airway obstructive disorders by utilizing both minimally invasive procedures and more complex surgery, including jaw advancement.
Additionally, an ENT specialist may evaluate you for other types of surgery, mainly the removal of the excess tissues in the throat. It may be necessary to remove tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate and the throat. When necessary, nasal surgery may also be required to improve nasal breathing. As a side note, Orthodontics can be used as an adjunct to reduce or even eliminate the need for surgery by developing the upper jaw, which will help with nasal breathing.

Scary Facts

An estimated 30 million or 1 in 8 people snore in the U.S. alone.

Approximately 18 million people suffer from sleep apnea.

28 percent of men over the age of 65 suffer from sleep apnea.

Up to 50 percent of sleep apnea patients have high blood pressure.

Risk for heart attack and stroke may also increase in those with sleep apnea.

Nearly 60 percent of Americans suffer from daytime sleepiness, a side effect of sleep apnea.

Snoring is improved and often eliminated in almost 100 percent of patients who use oral appliances.

Each year, sleep disorders add an estimated $15.9 billion to the national health care bill.
If you suspect you have sleep apnea or if you snore, call our office at 1-877-283-0497 and start your journey to improved health and a longer life.

Self Test
The only way to be sure if you have obstructive sleep apnea is to have a sleep test either at home from a qualified sleep physician or in a hospital sleep center. A score of 9 or above on this test is an indication that you should see your doctor.
Please feel free to print this test, fill it out, and take it with you to your physician.

The Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations?
Choose the most appropriate number for each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Activity	Score
Sitting and Reading
Watching TV
Sitting, inactive in a public place (theater, meeting, etc.)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after lunch without alcohol
In a car, while stopped for a few minutes in traffic
Total

A score of 9 or above indicates you may be having a problem with daytime sleepiness, but below 9 does not necessarily mean that you don't have a problem. See your healthcare professional for advice if you snore, have been told that you awake gasping for breath, or if you are sleepy during the day.

If you have difficulty sleeping at night or find yourself waking frequently, you may have signs of Sleep Apnea, which is curable - come see us for a free consultation: 1-877-283-0497

We are currently accepting new patients living in the following areas: Bradford, Alliston, Aurora, Barrie Street, Barrie, Bond Head, Bradford West Gwillimbury, Churchill, Cookstown, East Gwillimbury, Essa, Gilford, Highway 88, Holland Landing, Holland Marsh, Innisfil, Keswick, Kettleby, King City, Mount Albert, New Tecumseth, Newmarket, Pottageville, Schomberg, Simcoe Road, Stroud, Tottenham, Yonge Street, in mid-Ontario, Canada.