Sleep Apnoea

Do you have a snoring problem? Do you feel listless and sleepy during the day? There is a chance you may be suffering from Obstructive Sleep Apnoea (OSA).

A Sound Sleeper Dentist is able to help with your sleeping disorder and provide a solution for your snoring condition. Click here to locate a Sound Sleeper dentist near you today.

What is Sleep Apnoea?

Sleep apnoea is a potentially serious disorder that causes the sufferer’s breathing to be interrupted by repeated pauses during sleep. An apnoea, which literally translates as “without breath”, refers to completely obstructed breathing. In clinical terms, it is the condition that causes the sufferer’s airflow to be reduced for about 10 seconds or more.

sleep apnoea

There are two types of sleep apnoea; namely Obstructive Sleep Apnoea (OSA) and Central Sleep Apnoea (CSA). OSA is caused by complete or partial blockage of the airways during sleep. CSA is usually caused by medical conditions that hinder the brain’s ability to signal the muscles responsible for controlling breathing. Based on overnight sleep study (polysomnography) results, OSA is far and away the more common type – accounting for 90 – 96% of all apnoeas. The oral appliance therapy that we provide is suitable for treating patients with Obstructive Sleep Apnoea but NOT those with Central Sleep Apnoea.

It is important to note that both OSA and CSA can cause serious health issues. Untreated sleep apnoea can lead to serious medical and lifestyle problems including diabetes, high blood pressure, increased risk of stroke, daytime fatigue or a lack of concentration in school or at work.

To locate an accredited Sound Sleeper Dentist who can help with sleep disorder, click here to begin your search.   

Causes and symptoms

Most people would associate sleep apnoea with snoring. In reality, OSA has many well-documented signs and symptoms, many of which are direct or indirect consequences of disrupted sleep.

The sleep deprivation is caused by the breathing interruptions that occur throughout the night. An adult requires about 7-8 hours of sleep per night, a quarter of which time is spent in the deepest phase of sleep. It occurs approximately once every minute, which effectively robs the sufferer of the adequate rest he or she needs in order to function properly the next day. As such, the signs and symptoms may be classified into two categories: Those that occur as a result of the condition, usually during sleep, and others that are knock-on effects of these nocturnal symptoms, or if you prefer, the daytime symptoms.

Nocturnal symptoms and effects

  • Snoring: Usually the first and most telling sign. Can be persistent and loud, hence causing annoyance to others, especially a spouse or partner.
  • Choking/ gasping for air: Follows after pauses in breathing during sleep. A common OSA symptom if witnessed repeatedly at night.
  • Wake up to urinate more than usual.

Daytime symptoms and effects

  • Excessive sleepiness: Due to insufficient rest.
  • Dry mouth/ sore throat: Usually experienced in the morning when you wake up. Caused by sufferers’ tendency to breathe through mouth during sleep.
  • Morning headaches
  • Prone to irritation and mood swings: May be attributed to fatigue.
  • Lack of concentration
  • Memory loss
  • Bed-wetting: Affects mostly children.

Causes of sleep apnoea

As mentioned, anyone can have sleep apnoea. However, a person might have certain physical attributes, medical conditions or natural dispositions that can contribute to either obstructive sleep apnoea or central sleep apnoea.

The risk factors for obstructive sleep apnoea are:

  • Obesity
  • Alcohol
  • Smoking
  • Males over the age of 65
  • Family history of sleep apnoea sufferers
  • Certain facial bone shape/ muscle size: E.g. Receding chin, enlarged nostrils.
  • Caffeine
  • Allergies and medical conditions: especially those that cause nasal blockages.
  • Certain illnesses: Central sleep apnoea is normally associated with serious medical conditions like stroke, heart disease or neurological condition.

Types of Sleep Apnoea

The two types of sleep apnoea are: Obstructive Sleep Apnoea (OSA) and Central Sleep Apnoea (CSA).

Obstructive Sleep Apnoea (OSA)

When we sleep, the muscles in our bodies become more relaxed – including those muscles that help to keep our throats open so that air can flow into our lungs. Obstructive sleep apnoea occurs when tissues and muscles in the upper airway collapse resulting in a narrowed or partially blocked air passage. This contributes to pauses in breathing, which is called an apnoea. Common tell-tale signs of an OSA sufferer is someone who snores loudly or repeatedly chokes and gasps while sleeping.

Obstructive sleep apnoea is the most common form of sleep apnoea that affects about 90%-96% of patients with breathing disorders. The Apnoea Hypopnoea Index (AHI) is the most widely acknowledged measurement of OSA. Derived from an overnight sleep study, the AHI measures the extent of OSA; scores of > 5 indicates the presence of OSA and > 30 signalling a severe case.

According to estimates derived from AHI readings, obstructive sleep apnoea occurs in approximately 24% of middle-aged males and 9% of middle-aged females. These estimates are consistent with a 2010 report by the Australian Institute of Health and Welfare that finds the sleeping disorder affecting around 26% of male Australians between ages 40 – 65. It is more likely to affect middle-aged males, with higher incidence rates amongst smokers and frequent alcohol consumers. Loud snoring is a common symptom of OSA sufferers.

Central Sleep Apnoea (CSA)

Central Sleep Apnoea occurs when the patient’s brain fails to signal the muscles to breathe, which often result in longer lasting and more frequent apnoeas (breathing pauses) as compared to OSA. It affects about 10% of people with breathing problems. Unlike OSA, patients with CSA do not suffer from a blocked airway. The body isn’t making any attempts to breathe during the pauses. The breathing stops momentarily until there is another effort to breathe again. There are many possible reasons for CSA: Weakness of muscles that enable lungs to expand and contract; stiffened lungs; neuromuscular disorders, etc. CSA not only results in sleep deprivation but also causes your body to retain carbon dioxide, leading to morning headaches and other symptoms.

Risk Factors of Sleep Apnoea & Diagnosis

How is OSA diagnosed?

OSA diagnosis primarily takes the form of a sleep study – also known as a polysomnography. A sleep physician will administer the polysomnography, during which multiple physiological monitors will be attached to the patient’s body while several electrodes are pasted to his or her head. While the monitors record the nocturnal breathing patterns as well as brain and physical activity, the electrodes measure the brain’s electrical activity via an electroencephalogram (EEG). The study shows the brain activity at different stages of sleep and whether the patient is aroused during these stages thus losing adequate rest. When the number of arousal events recorded by the polysomnography exceeds certain pre-determined markers, it would indicate either the presence or severity of the sleeping disorder.

Risk factors and effects

Like any other respiratory condition, you should seek early treatment if you have been diagnosed with sleep apnoea. Delayed treatment may aggravate the condition with serious health implications. Besides those effects mentioned above that serve as symptoms of the condition, there are other long-term effects associated with sleep apnoea. The following are serious consequences of sleep apnoea, many of which can be attributed to the long-term effects of oxygen depletion as caused by the breathing disorder.

  • High blood pressure: 45% of OSA patients that do not have high blood pressure will develop it within 4 years if their condition is untreated.
  • Depression
  • Anxiety
  • Stroke: Risk increases by 1.5 times.
  • Heart failure: Risk increases by 2.3 times.
  • Pre-diabetes and diabetes
  • Heart rhythm disturbances
  • Cognitive impairment
  • Headaches
  • Impaired mental processes
  • Death: OSA can increase the risk of sudden death, which may impact both the patient and their loved ones, for example, if they are operating a vehicle when the sudden death occurs.

Treatment

Many people with OSA have not been diagnosed or received treatment. While sleep apnoea can be managed using Continuous Positive Airway Pressure (CPAP) therapy, other treatment options for the sleep disorder include surgery or oral appliance therapy.

Dental appliances

The two most popular dental appliances used to treat obstructive sleep apnoea are the tongue-retaining device and the mandibular repositioning device. Most of the dental devices are designed to fit snugly inside your mouth – in much the same way you would wear a teeth whitening tray or athletic mouth guard.

The Mandibular Advancement Splint/ Device (MAS/ MAD) is a frequently recommended oral appliance solution that works by repositioning the mandible – the largest and lowest facial bone that holds the teeth in place – in such a way that prevents your tongue from obstructing your airway during sleep.

The SomnoDent oral sleep device (a type of MAS appliance) treats the breathing condition by bringing your lower jaw forward during sleep. Customised to fit snugly in your mouth, the appliance consists of a set of splints for your upper/ lower jaws. The teeth-hugging device may be titrated (fine-tuned) for optimum comfort and effectiveness throughout the treatment process.

It is very important to get your oral appliance supplied and fitted by a dentist who specialises in sleep apnoea. It is also recommended that you visit the dentist regularly during the treatment process. Not only will the dental practitioner be able to deal with any unforeseen dental problems that may occur during the treatment phases, the clinician is also in the best position to periodically adjust your device to fit better.

Continuous Positive Airway Pressure (CPAP)

The CPAP machine is a portable unit with an attached face/nasal mask connected via tubing. The machine delivers gentle streams of pressurised air through the mask to hold the palate, nose and throat tissues open. The mask is worn with a bit of suction to the face to avoid air leakage. CPAP is not easy to use for some people, as not everyone can tolerate sleeping with the face mask and constant blowing of pressurised air through one’s nostrils and throat throughout the night.

Medication

It has been difficult finding appropriate medication to treat obstructive sleep apnoea simply because the narrowing of the airway is due to anatomic reasons, rather than medical ones. That said, many medications have been tested and used for specific cases with varying results. These include nasal steroid sprays, topical nasal decongestants, thyroid replacement therapy (for those whose OSA is caused by hypothyroidism) and diet medications.

Surgery

Many types of surgery, usually performed on an outpatient basis – are available to help people with sleep apnoea. They are typically recommended for patients who have difficulty coping with conservative treatments like CPAP therapy. Somnoplasty is a minimally invasive procedure that administers low-power radio frequency (RF) energy to tighten the soft palate at the back of the throat in order to enlarge the airway. The upper airway stimulator involves a procedure that places a tiny pulse generator – with a device called Inspire – in the upper chest to stimulate the nerves that control airway muscles. Other types of surgery include the mandibular/maxillary advancement surgery and nasal surgery, both of which are intricate procedures reserved for patients with severe sleep apnoea problems.

Home Treatment

Weight loss regimes have become an integral facet of many sleep apnoea treatment programs. Since obesity is one of the main causes of sleep apnoea, sleep physicians often recommend nutritional diet and exercise as part of a holistic treatment. Other lifestyle changes include: Limiting the intake of tobacco (quit smoking), alcohol and sleeping pills; change of sleeping position, and getting plenty of sleep.

Costs of treatment/ Private Insurance

The costs of an oral appliance therapy vary according to the extent of treatment. Following a referral from a medical practitioner or qualified sleep physician, partial rebates may be claimable depending on the terms of benefits and coverage with your private health insurance provider. Arrange your consultation with one of our Sound Sleeper dentists to find out how much the oral appliance therapy will cost you.

Advantages of a Sound Sleeper Dentist

If you have been diagnosed with a sleep disorder by a trained sleep physician or undertaken a sleep study, your next step would be to visit an accredited Sound Sleeper dentist. The accreditation indicates that the dentist is appropriately trained and educated in the field of sleep medicine. It is important that your dentist is well informed and versed in the various dental options in sleep apnoea treatment, as he or she would be working closely with your sleep physician or medical practitioner throughout your treatment process.

If a mandibular splint is determined as an effective treatment option for you, a Sound Sleeper dentist is able to supply the custom-made oral appliance such that it fits snugly inside your mouth. The device is designed not just to temporarily alleviate your symptoms but offer a long-term solution to your sleep apnoea condition. Over time, the dental device can even recondition your breathing habit to restore your health in a safe and measured way.

What makes a Sound Sleeper dentist the choice health professional to treat your sleep apnoea condition? At Sound Sleeper, we employ clinically tested methods and use only high quality materials for all our treatments. We provide the highly effective SomnoDent therapy, also known as a form of Continuous Open Airway Therapy (COAT). The SomnoDent appliance offers a discreet and travel-friendly treatment option that allows you to talk and open/close your mouth. Made from high quality acrylic materials, the clinically effective dental device is not only comfortable to wear, it has a proven track record of improving the sleep quality for the majority (91%) of OSA patients.

Do you have a snoring problem? Do you feel listless and sleepy during the day? There is a chance you may be suffering from Obstructive Sleep Apnoea.

A Sound Sleeper Dentist is able to help with your sleeping disorder and provide a solution for your snoring condition. Click here to locate a Sound Sleeper dentist near you today.

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