Sleep Apnea

To start off click on the snoring video link below. This is about a 60 second video of someone going through a sleep apnea episode.  The graphic overlay is great at showing how the airway becomes blocked.  As the CO2 levels increase the brain stimulates the person to "wake up" in order to open the airway and get oxygen back into the system.  This cycle often repeats all night long resulting in the sleep deprivation symptoms and low oxygen levels. 

Snoring Video

Sleep apnea, a potentially life-threatening condition, is a breathing disorder characterized by brief interruptions of breathing during sleep. There are two types: central and obstructive. Central sleep apnea occurs when the brain fails to send the right signals to the muscles to initiate breathing. Obstructive sleep apnea, which is more common, occurs when air can’t flow into or out of a person’s nose or mouth, although efforts to breathe continue.

The number of involuntary breathing pauses or apneic events may be more than 60 per hour. These breathing pauses are often accompanied by snoring, although not everyone who snores has sleep this condition. Sleep apnea can also be characterized by choking sensations. Sleep interruptions can lead to excessive daytime sleepiness and early morning headaches.

Early diagnosis and treatment of sleep apnea are important because it may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke.

What is Sleep Apnea?

There are three types of Obstructive Sleep Apnea: obstructive, central, and mixed. Of the three, obstructive is by far the most common. Despite the causative differences of each type, people with untreated obstructive sleep apnea stop breathing repeatedly during their sleep. This may happen hundreds of times during the night and can often last for a minute or longer. In central sleep apnea, the brain fails to signal the muscles to breathe. Mixed apnea is a combination of central and obstructive sleep apnea.

What is Obstructive Sleep Apnea?

Obstructive Sleep Apnea (OSA) is a serious condition in which the sufferer stops breathing during sleep due to a completely blocked airway, sometimes for up to a minute at a time. OSA is an extremely serious condition that can result in extremely fragmented and of poor quality sleep, and should be treated by a qualified physician.

Who has OSA?

OSA occurs in 24% of men and 9% of women, which is approximately as often as adult diabetes. Although sleep apnea can affect anyone at any age, it is usually between the ages of 45-65. Due to a lack of public awareness, the vast majority of sufferers remain undiagnosed and therefore untreated despite the fact that the disorder can have serious medical consequences.

What Happens in Sleep Apnea

1. The sufferer falls asleep.
2. Muscle tone in the body relaxes.
3. The airway narrows and/or collapses, causing breathing to be difficult or impossible. The collapse of the airway may cause loud snoring, snorts, pauses in airflow, and labored breathing.
4. Oxygen levels begin to fall.
5. They continue to struggle for breath, sometimes for up to a minute.
6. The heart rate falls below normal, and there is decreased oxygenated blood to pump through the body.
7. The brain senses low oxygen/high carbon dioxide levels and releases jolt of adrenaline in an attempt to awaken their brain and body and prevent suffocation.
8. The sufferer awakens briefly and takes five or six large breaths breathing in oxygen and blowing off excess carbon dioxide (CO2). The sufferer typically does not remember arousal but often repositions him or herself on the bed.
9. The heart rate speeds up in response to the rush of adrenaline and is now pumping above normal heart rate.
10. The oxygen/carbon dioxide levels return to near normal and their brain allows sleeping to resume.
11. The sufferer falls asleep and the cycle repeats.

How do I know I have Sleep Apnea?

The best way to find out if you suffer from obstructive sleep apnea is to have a sleep study conducted either in a hospital or in your home. There are several symptoms of OSA which include:

• Decreased sex drive
• Excessive daytime sleepiness
• Poor concentration/memory
• Depression
• Morning headaches
• Gastro-esophageal reflux
• Sore, dry throat on waking
• Being accident prone
• Increased cholesterol
• Hypertension

Consequences of OSA

The consequences of OSA can be very serious and include an increased risk in motor vehicle and work related accidents and poor job performance. It can also lead to family tension, an irritated bed partner and a general decrease in the quality of life.

How severe is my OSA?

The severity of OSA is measured by three variables:
Blood oxygen level, the presence of daytime sleepiness and the number of apneic episodes per hour-also known as an Apnea/Hypopnea Index (AHI).

• An AHI of 5-15/hr is considered mild obstructive sleep apnea.
• An AHI of 16-30/hr is considered moderate obstructive sleep apnea
• An AHI of +30/hr is considered severe obstructive sleep apnea

The Thornton Adjustable Positioner (TAP) Appliance

How the TAP Works

The Thornton Adjustable Positioner (TAP®) is a custom-made two piece adjustable appliance that is worn while sleeping. The trays of the appliance snap over the upper and lower teeth and hook together. The design is based on the same principle as cardiopulmonary resuscitation, CPR. The airway must be opened to allow air to pass through the throat. 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. The more you pull your jaw forward, the more your airway will open.

The TAP® is the only mandibular advancement device that can be adjusted easily by the patient or practitioner while in the mouth. This feature allows the patient to always be in control of their treatment. The unique design also allows the patient to fine-tune their treatment position at home to achieve maximum results.

Most patients experience relief the very first night they wear their TAP®. Although it may take up to a week to get used to wearing a TAP® appliance, this is a small hurdle for patients. Nine in ten patients wear the device all night, every night – making the TAP® a highly effective solution for both snoring and sleep apnea.

The TAP® can help prevent conditions linked to sleep apnea:

• Chronic daytime sleepiness
• High blood pressure
• Heart attack
• Stroke
• Heartburn, reflux
• Morning headaches
• Depression

Thornton Adjustable Positioner (TAP) Appliance
FDA Approval: Approved for both snoring and OSA (Obstructive Sleep Apnea)
Date of FDA Approval: August 21, 1997
FDA Registration Number: K972061

Click on this link for more info about appliance therapy
Sleep Apnea Dental Appliances

Some Common Sleep Apnea Questions

• What is Sleep Apnea?
• How do I know how severe my OSA is?
• What does RDI stand for?
• What is OSA?
• What is Obstructive Sleep Apnea?
• Who has OSA?
• Are snoring and OSA related?
• How can I find out if I have Sleep Apnea?

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What is Sleep Apnea?

There are three types of sleep apnea: obstructive, central, and mixed. Of the three, obstructive is by far the most common. Despite the causative differences of each type, people with untreated obstructive sleep apnea stop breathing repeatedly during their sleep. This may happen hundreds of times during the night and can often last for a minute or longer. In central sleep apnea, the brain fails to signal the muscles to breathe. Mixed apnea is a combination of central and obstructive sleep apnea.

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How do I know how severe my OSA is?

The most accurate way to diagnose obstructive sleep apnea is with an overnight sleep study. Depending on the physician's preference, this study can be performed in the hospital or at home. It will objectively measure many parameters throughout the night that will aid the physician in determining the severity of the problem. Some of the important measurements include: how often breathing is interrupted, the quality of sleep, the oxygen level in the blood, the heart rate and excessive bodily movements.

The severity of the sleep apnea is determined by the assessment of these parameters and should be thoroughly discussed with you by your physician. SomnoMed dentists work closely with sleep physicians and understand the details of the sleep study and how they affect the therapy.

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What does RDI stand for?

The term RDI stands for Respiratory Disturbance Index and is a very important measure of the severity of the sleep disorder. The RDI is a number that represents how many times per hour breathing stops or becomes very shallow. This index is significant as it is often associated with disruption of sleep and dangerous drops in blood oxygen levels. Most physicians agree that an RDI below 5 is normal while an RDI over 30 may indicate severe disease. Many times RDI is used interchangeably with AHI (Apnea Hypopnea Index).

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What is OSA? ?

Obstructive Sleep Apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep.

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What is Obstructive Sleep Apnea?

Obstructive Sleep Apnea (OSA) is a serious condition in which the sufferer stops breathing during sleep due to a completely blocked airway, sometimes for up to a minute at a time. OSA is an extremely serious condition that can result in extremely fragmented and of poor quality sleep, and should be treated by a qualified physician.

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Who has OSA?

OSA occurs in 24% of men and 9% of women, which is approximately as often as adult diabetes. Although sleep apnea can affect anyone at any age, it is usually between the ages of 45-65. Due to a lack of public awareness, the vast majority of sufferers remain undiagnosed and therefore untreated despite the fact that the disorder can have serious medical consequences.

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Are snoring and OSA related?

While snoring is caused by a partial obstruction of the airway, Obstructive Sleep Apnea (OSA) is a complete closure of the airway during sleep. OSA results in repeated episodes of stopping breathing (apnea) during which time you continue to make efforts to breathe. Loud snoring is a common symptom of OSA. The sound occurs as you briefly waken at the end of the apneic period and begin to breathe. Some OSA sufferers are described as making snoring or gasping sounds when they resume breathing.

Snoring without apnea is not usually harmful to your health and many snorers who have none of the above symptoms do not have significant OSA. However, some people with OSA are unaware they have it. Thus, careful medical attention is required to ensure the OSA is properly diagnosed and treated.

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How can I find out if I have Sleep Apnea?

Your family Physician can refer you to a Sleep Specialist who will take a thorough medical and sleep habits history. The Specialist may then schedule an overnight sleep study called a Polysomnogram, which measures several bodily functions such as heart rate, oxygen saturation, EEG and any Apnea episodes during the different stages of sleep.

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