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Sleep Apena and Tooth Wear

7.20.16 in General

Healthy Mouth Sounds- The Oral Systemic Connection

Part 4- Sleep Apnea and Tooth Wear

I have 3 questions.
1. Who told you that you snore?
2. Who is responsible for helping you arrive at a diagnosis of sleep apnea?
3. Who is a set up to be widowed?

I have one answer.
My spouse!

Yes, often it is because of a spouse, “annoyed” by snoring or gasping of the partner during “sleep” that prompts an investigation. Sometimes that investigation even results in a diagnosis and treatment. But what if no signs or symptoms are noticed by a spouse as anything but “usual”?

Then the risk of question #3 happening, increases.

Sleep apnea is a disorder of airway patency, or breathing that is known as a “silent killer”. There are 3 main types of sleep apnea. Obstructive sleep apnea (by far the most common), central sleep apnea (when the brain does not remind us to breathe), and Complex sleep apnea syndrome (a combination of the first two types).

Obstructive sleep apnea, or OSA, is so called because something blocks the airways normal passage of air to the lungs. That something is the soft tissues of the throat and tongue. So, clue # 1… obesity and excess tissue girth around the airway are almost always present in OSA.

But what actually happens during sleep apnea episodes, and why is that dangerous? Well, as we sleep and move air normally, all is well. As the musculature of our airways relaxes, the airway can become partially blocked. When air now moves through that narrowed opening, often, though not always, a noise is created from vibration of the soft tissues. We call that noise- snoring. If the airway is totally blocked, no air will move to our lungs, and eventually our brains detect this lack of oxygen, and arouse us, we gasp for air, relax, and start the cycle again. People with sleep apnea may awaken up to 10, 20 or 30 times per hour in a given night. Though the arousal state may only be for seconds, and not remembered, this can equate to waking up every 2 minutes, all night long. There is a price to pay for that!

OSA sufferers often are not refreshed upon awakening, feel sleepy throughout the day, have a hard time concentrating. Do any of these signs sound familiar?

During an episode of apnea, our heart rate and blood pressure increases, and OSA sufferers are more prone to cardiac and stroke related diseases, and death.

So, how can we treat this disorder? Well, simply stated, don’t let the airway get blocked. That can be achieved in numerous ways. Weight loss is probably the first line of defense. Decreasing obesity, especially around the neck area will improve airway flow. Avoiding alcohol, especially right before sleeping can help. Then some sort of a device to help keep the airway open is often indicated.

The “gold standard” is a c-pap device. This stands for continuous positive airway pressure. It works by keeping the soft tissues of the back of the throat open by a constant flow of air through a mask that one would wear to sleep. Another method might be to open the airway by “repositioning” the tongue and lower jaw in a forward manner. This can be accomplished by using a specifically engineered mouth guard, worn during sleep.

The only way to know of a diagnosis of OSA is to have a sleep study performed. The reasons one might be led to have a sleep study in the first place is because of suspicions of OSA by spouses or health care providers. Those who are suspect for OSA are: Men more than women; snorers; obesity; neck sizes greater that 17 inches in men and 15 inches in women, those who fall asleep often during normal waking hours, or do not awaken refreshed.

In my office all of these signs and symptoms raise our suspicions, and no one of them alone provides a diagnosis of sleep apnea. It is in the recognition of the elements of the story that urges us to recommend sleep studies.

One can chalk snoring up to “normal behavior, and even dismiss the fact that you may not be refreshed when you wake up. But the consequences for ignoring signs can abruptly end your life, and increase the number of widowed partners in this world. Contact your physician or dentist if any of these signs exist for you.

It is the whole person, and their overall health that we should be looking at as health care providers, no matter what our specialties are. And that is the next topic we tackle. So stay tuned in, and keep smiling. Dr W.

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Gary Williams, DMD

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