FAQ... frequently asked questions about snoring and sleep apnea
What is Snoring?
What is Obstructive
Sleep Apnea (OSA)?
I know I Snore, but I don't know if I have Sleep Apnea. Is there an easy way to screen for Sleep Apnea?
What is the
relationship between snoring and sleep apnea?
What are some of the
reasons why a person would have a higher tendency to have OSA?
What are the signs
and symptoms of having Obstructive Sleep Apnea (OSA)?
What is the common
denominator of all of these health problems?
How does someone find
out if he has sleep apnea?
What is a Sleep
Study?
What information do
you get from a Sleep Study (PSG)?
What are my treatment options?
What is the Pharyngometer?
What should I do?
Answers:
What is Snoring?
Sounds made during sleep caused by
breathing vibrations in the pharynx (air way in the back of your throat). In the diagnosis of obstructive sleep apnea,
snoring volume and frequency of occurrence often correlate with the severity of
the condition.
What is Obstructive
Sleep Apnea (OSA)?
Repetitive
cessation of breathing during sleep for 10 seconds or more due to complete
closure of the throat. Usually characterized by snoring, excessive daytime sleepiness and
other symptoms of fatigue.
I know I Snore, but I don't know if I have Sleep Apnea. Is there an easy way to screen for Sleep Apnea?
Yes. There is a device called a Sleep Strip which you wear on your upper lip overnight and this can easily determine if you also have Sleep Apnea or not.
What is the
relationship between snoring and sleep apnea?
The more severe the snoring the
more severe the chances are of having sleep apnea.
What are some of the
reasons why a person would have a higher tendency to have Obstructive Sleep Apnea?
Overweight
Jaw Position
Tongue Position
Oversized Tonsils or Adenoids
Collapsed Pharyngeal walls (back
of throat)
What are the signs
and symptoms of having Obstructive Sleep Apnea (OSA)?
Snoring (85%)
Fatigue
Impaired Concentration
Hypertension (High Blood Pressure)
twice as common with OSA
Diabetes twice as common with OSA
Impotence
Depression
GERD (Gastroesophageal Reflux Disease or Heartburn)
Associated with Cardiac
Arrhythmias
Alzheimer's disease
What is the common
denominator of all of these health problems?
Oxygen deprivation -- the body
needs to get more oxygen to its cells!!
How does someone find
out if he has sleep apnea?
The most definitive approach is to do a “Sleep Study”.
What is a Sleep
Study?
A Sleep Study or Polysomnogram (PSG) is a multiple-component test, which
electronically transmits and records specific physical activities while you
sleep. The recordings become data, which will be "read" or analyzed
by a qualified physician to determine whether or not if you have a sleep
disorder. This is done in a sleep
center. Most centers today are made to
be quite comfortable; actually often set up to look like a nice hotel room. Sleep studies can also be done in your own
home. Many insurance companies
do not reimburse for these however.
What information do
you get from a Sleep Study (PSG)?
1.
An Electrocardiogram - This is done to see if there is a correlation
between the apneic event and arrhythmia.
2.
Oxygen saturation- This is a measure of oxygen carried by hemoglobin in
the blood. Normal values range from 90%
to 100%.
3.
Length of apneic episodes- Sometimes these episodes can be as long as 90
seconds.
4.
Several other vital signs are taken but the common summary measure used
to describe respiratory disturbances during sleep is the Apnea-Hypopnea Index or AHI. This the total number of episodes of apnea
and hypopnea during sleep divided by the hours of sleep time. Apneas are episodes when breathing stops for
10 seconds or longer. Hypopnea is a partial blockage of airflow resulting in an
arousal and possible drop in oxygen level.
An AHI greater than 5 is diagnostic of OSA.
What are my treatment options?
1. Preventive
a. Get to optimum weight
b. Decrease alcohol consumption
c. Exercise
2. CPAP
CPAP (Continuous Positive Airway
Pressure) is a medical device used to treat sleep apnea. Air pressure is delivered through a hose to a
mask that fits over the nose, or both the nose and mouth. The mask is secured on the face by a headgear
that is worn over the head. The
appropriate air pressure level is determined during the sleep study.
Pros of this treatment.
Very
high success rate (nearly 100% of the time) when used (see below).
Cons of this treatment
After 1 year
there is only about a 30% compliance rate.
Some of the reasons for the low
compliance rate are:
Straps bother patient
Can't move around
Difficult, if not impossible, to
sleep on side
Noise of the pump
Air leakage
Pressure on nose
Don't want to wear it around bed
partner
Feeling of claustrophobia
Creates problems when traveling
3. Surgery
What is commonly recommended most
is a surgical procedure called a Uvulopalatopharyngoplasty UPPP. Essentially it is the removal of the uvula
(the thing that hangs down in the back of your throat) along with a portion of
the back of your soft palate, and the widening of the back of your throat.
Pros
Usually prescribed for the morbidly obese
Cons
The Journal of the American Academy of Oral and Maxillofactial Surgons state
"Unfortunately, there is simply not sufficient evidence that these procedures are beneficial for patients with Sleep Apnea".
Can be painful, particularly
during recovery
Relatively expensive
Down time from
surgery
Effective for 2-6 months; efficacy declines after 1 year.
4. Dental Appliances
A. Mandibular Repositioning Appliance
Moves the mandible (lower jaw)
forward. Moving the jaw forward can help
open the airway. This appliance
typically has some type of device to allow the dentist to adjust the lower jaw
forward 2 to 3 times.
Pros
Can travel with it
Can sleep on side
Handles about 70% of cases
Averages about 56% reduction of AHI
Good for patients with gag reflex
Recent improvements in designs
Cons
Some designs are bulky
Adjustment is to bring jaw forward
and for some this may be difficult on the TMJ (jaw joint).
With over 40 types on the market, the dentist needs to know which is best for the patient
B. The Full Breath Appliance©.
An appliance invented by Dr. Bryan Keropian ,who treats patients with TMJ (jaw joint) pain. This appliance was developed to treat patients where the option to move the jaw significantly forward is not an option.
Pros
Can travel with it
Can sleep on side
One piece appliance
More ability to adjust
75% reduction of AHI
Less likely to cause TMJ problems
More options in treatment
FDA approved
Uses Pharyngometer with treatment
Cons
With the Full Breath Appliance©, we have many
adjustments we can make to help stop snoring and sleep apnea. So there may be more visits with a Full
Breath Appliance©, but this is also why the success rate is higher.
What is the Pharyngometer?
It is a computer program and
device developed at Harvard that is allows one to measure the Volume of Air by
sending sonic waves into the mouth from the opening of the mouth to the back of
the throat. It also measures the Minimum
Width of space in the mouth. With this
instrument we can actually monitor the improvement of space made with different appliances. Go to http://www.oraldilators.com/pharyngometer.htm for more information.
What should I do?
If you, or someone you love,
snores loudly or has been diagnosed with OSA you want to have it handled right
away. Every night that one has an apneic
episode means more oxygen deprivation, and an increased chance of realizing the
negative effects of the medical problems previously mentioned.
Conversely, every night that one
does not experience these episodes, the better chance they have of living a
longer healthier life.
Our recommendation is that you
contact Dr. West’s office to set up an initial interview and testing.
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