Sleep apnea is a widespread sleep disorder that can be detrimental to your overall health. If you’re among the 1 in 5 people who live with obstructive sleep apnea (OSA), your lungs aren’t getting enough oxygen when you sleep because your airways (throat, sinuses, and nostrils) are inflamed. Even in less severe cases, sleep apnea can cause constant drowsiness and weight gain, but in moderate to severe cases, OSA can increase the risk of serious illnesses, including cancer, Alzheimer’s disease, mental health disorders, and heart disease.
It’s highly likely that you or someone you love has obstructive sleep apnea. In fact, 90 percent of the 22 million Americans estimated to suffer from sleep apnea remain undiagnosed. Getting an accurate diagnosis and treatment for OSA can eliminate chronic diseases and remove the need for medication.
The good news is Dr. Wilmer is highly trained in treating obstructive sleep apnea. Dr. Wilmer works with your physician and a sleep doctor to obtain a sleep test, study the results, and collectively come up with the best treatment plan for you based on the type of apnea you have.
Oral Appliance Therapy:
Dr. Wilmer and her team offer custom-fabricated dental sleep apnea devices that are worn at night, similar to nightguards, that open your airway and therefore allow the body to get the oxygen it needs.
NightLase:
Nightlase is a non-surgical laser therapy that causes your body to produce more collagen, thereby opening your airway, allowing you to sleep better at night and function better when you’re awake!
What Are The Benefits of Treating Sleep Apnea?
The results? A good night’s sleep. More energy during the day. Lower blood pressure. Decreased cancer risk. Fewer medications. Less pain. The happier and healthier you that you’re supposed to be.
What Are the Common Symptoms of Sleep Apnea
Symptoms of obstructive sleep apnea include:
- Loud snoring
- Excessive daytime sleepiness
- Observed episodes of stopped breathing during sleep
- Waking during the night and gasping or choking
- Awakening in the morning with a dry mouth or sore throat
- Headaches
- Dark circles under the eyes
- Floppy eyelids
- Large neck circumference
- Trouble focusing during the day
- Depression and Anxiety
- High blood pressure
- Decreased libido
What Are Some Dental Signs of Sleep Apnea?
Your dentist should be evaluating your airway at every recall appointment to determine if you have signs of a sleep-breathing disorder. These signs include, but are not limited to:
- Worn teeth
- Abfractions
- Deep bite
- Enlarged tongue
- Vaulted palate
- Elongated soft palate
- Scalloped tongue
How Is Sleep Apnea Diagnosed?
An evaluation for sleep apnea involves overnight monitoring of your breathing and other body functions during sleep either in a sleep lab or at home. Tests to detect sleep apnea include:
Polysomnography
This test occurs in a sleep center, where you are hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
Home Sleep Tests
An at home test provides you with the same information as the polysomnogram, minus the arm and leg movements and brain activity. It is a much more comfortable test, although the polysomnogram may be recommended for certain comorbidities or if central sleep apneas are suspected.
What Are the Different Types of Sleep Apnea?
There are three types of sleep apnea: obstructive, central, and mixed.
Central Sleep Apnea
Central sleep apneas occur when your brain tells your body to stop breathing.
Obstructive Sleep Apnea
The most common type of sleep apnea is obstructive sleep apnea, or OSA. OSA is a common and serious sleep disorder that causes you to stop breathing repeatedly during sleep. The airway continually becomes blocked and limits the amount of air that reaches your lungs. When this happens, you may snore loudly or make choking or gasping noises as you try to breathe. Eventually the brain “wakes” you to a lighter level of sleep and you reposition your jaw and tongue to open your air way.
This process can occur hundreds of times a night for seconds to minutes at a time. More often than not, sleep apnea is misdiagnosed or missed completely. Symptoms can easily be confused with a separate health problem which is actually a component of the underlying sleep disorder. Although the levels of severity of sleep apnea varies between individuals, it usually greatly affects the quality of life of the sufferer as well as their bed partner. If left untreated, sleep apnea may lead to heart disease, stroke, and premature death.
What Are the Risk Factors for Developing Sleep Apnea?
Certain factors can put you at risk of having sleep apnea. They include:
- Excess weight
- Hypothyroidism
- Polycystic ovary syndrome
- Older age. The risk of obstructive sleep apnea increases as you age but levels off after your 60s and 70s
- Narrowed airway
- Enlarged tonsils or adenoids
- High blood pressure, also known as hypertension.
- Chronic nasal congestion
- OSA occurs twice as often in those who have consistent nasal congestion at night
- Smoking
- Diabetes
- Male sex. Men are 2 to 3 times more likely as premenopausal women to have obstructive sleep apnea. However, the risk of obstructive sleep apnea increases in women after menopause to the same rate as men.
- Menopause
- A family history of sleep apnea
- Asthma
Can Children Have Sleep Apnea?
Yes, although it’s more common in adults, children can have sleep apnea. Obstructive sleep apnea is different in children than it is in adults. Starting with symptoms, adults usually experience fatigue, while children are more likely to demonstrate behavioral problems. The cause of OSA is different between children and adults, also. Obesity is usually the leading cause of OSA in adults whereas larger adenoids and tonsils are usually the leading cause of OSA in children. To prevent complications that may affect a child’s growth, cognitive development, and behavior, early diagnosis and treatment are extremely important. Untreated obstructive sleep apnea in children may elevate the likelihood of developing conditions such as high blood pressure, high cholesterol, prediabetes, and other heart and vascular issues in later life. The primary treatment approach for pediatric obstructive sleep apnea involves the removal of tonsils and adenoids.
Nightime Symptoms of Pediatric Sleep Apnea Include:
- Snoring
- Pauses in breathing
- Snorting, coughing or choking
- Restless sleep
- Mouth breathing
- Nighttime sweating
- Bed-wetting
- Sleep terrors
Daytime Symptoms of Pediatric Sleep Apnea Include:
- Poor performance in school
- Trouble paying attention in school
- Learning problems
- Behavioral problems
- Poor weight gain
- Hyperactivity
What Are Some Complications of Sleep Apnea?
- Stroke. 90% of people with sleep apnea will have a stroke.
- High blood pressure. OSA is the leading cause of secondary hypertension.
- Coronary Artery Disease.
- Cardiac Arrhythmias. Patients with OSA are 4x as likely to have atrial fibrillation.
- Congestive Heart Failure. Patients with moderate OSA have increased mortality rates.
- Heart Disease
- Sudden Death. OSA sufferers have a 30% higher risk of heart attack or premature death.
- Depression and Anxiety.
- Daytime sleepiness. Patients have a 6-fold increased risk of car accidents.
- Loud snoring.
- Morning headaches.
- Diabetes. 58% of diabetics have OSA and lack of insulin control with poorly controlled blood sugars.
- Obesity. As sleep shortens in quality, appetite for high-calorie food increases.
- Reflux (GERD).
- Loss of libido.
- Nocturia (frequent urination at night).
- Medical Costs. Untreated sleep apnea costs Americans an extra 4.3 billion per year. Treated sleep apnea can halve a patient’s healthcare costs.
What Are the Treatment Options for Sleep Apnea?
There are two conventional methods to treat sleep apnea: oral appliance therapy and CPAP.
Oral Airway Appliances
Custom dental appliances are an effective alternative to CPAP. They are custom fabricated to support the lower jaw in a forward position to help maintain an open upper airway. Almost every prominent medical insurance providers, along with Medicare, include oral appliance therapy within their coverage. They typically apply the same criteria used to assess the medical necessity of CPAP. This coverage extends to individuals who have experienced unsuccessful outcomes with CPAP and is also considered a primary treatment option for those diagnosed with mild to moderate obstructive sleep apnea. Oral appliances can be used to help quiet your snoring.
CPAP
Continuous Positive Airway Pressure, or CPAP, is comprised of a mask that delivers positive air flow to the nose and sometimes the mouth during sleep. This device is highly effective and the recommended first line of treatment for severe sleep apnea. However, some patients have a difficult time tolerating this therapy. CPAP intolerance can stem from many different factors such as discomfort, mask leakage, and feelings of claustrophobia. Typically, medical insurance covers CPAP machines, which are widely recognized as the primary and effective standard for addressing obstructive sleep apnea.
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