Sleep Apnea
Sleep Apnea
Dr. Rachel E Pickworth has advanced training in dental sleep medicine. Dr. Pickworth offers solutions for Sleep Apnea patients and provides the best sleep apnea treatment for them. She helps patients get their sleep apnea diagnosed, and provides effective treatments, with a focus on oral appliance therapy.
Sleep apnea is a potentially serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, most are not aware it is happening.
If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.
What is Sleep Apnea?
Sleep apnea is a night-time condition that causes a person to stop breathing at various times throughout the night. The pauses in normal breathing can occur hundreds of times each night and studies have shown that each episode can last up to 30 seconds, if not longer.
There are three main types: obstructive, complex, and central. In each type of sleep apnea, your breathing stops too long and too often. But the reason why breathing stops depends on the type.
Obstructive Sleep Apnea (OSA) is caused by a blockage that occurs within the airway that impedes the natural flow of breathing. (OSA) occurs when the tongue and soft palate collapse onto the back of the throat, blocking airflow into the lungs. Lacking oxygen, the brain awakens the sleeping person to breathe (up to 300 times /night), depriving the person of essential REM Sleep and causing a list of problems associated with chronic lack of sleep.
Central sleep apnea, the problems with breathing throughout the night occur because of miscommunication within the brain.
Complex sleep apnea is a combination of these two. This makes diagnosis even more vital as it’s important to not only know if you have it or not, but it’s crucial to know what type you have so that the treatment prescribed to you works flawlessly.
OSA STATS & FACTS
- Nearly 50% of Middle–aged adults snore
- Obstructive Sleep Apnea (OSA) increases the risk of heart attacks, hypertension, congestive heart failure, stroke, diabetes, reflux disease, impotence, and motor vehicle accidents
- 1 in 5 adults have it
- 30 million Americans snore
- Fewer than 10% have been diagnosed
What Causes Sleep Apnea?
There are a number of factors that increase risk, including having a small upper airway (or large tongue, tonsils or uvula), being overweight, having a recessed chin, small jaw or a large overbite, a large neck size (17 inches or greater in a man, or 16 inches or greater in a woman), smoking and alcohol use, being age 40 or older, and ethnicity (African-Americans, Pacific-Islanders and Hispanics). Also, OSA seems to run in some families, suggesting a possible genetic basis.
Sleep Apnea Symptoms
Chronic snoring is a strong indicator of sleep apnea and should be evaluated by Dr. Rachael Pickworth, an experienced professional in the field of Sleep Medicine. Since people with sleep apnea tend to be sleep-deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or driving. Left untreated, symptoms of sleep apnea can include disturbed sleep, excessive sleepiness during the day, high blood pressure, heart attack, congestive heart failure, cardiac arrhythmia, stroke or depression. For people with sleep apnea, the combination of disturbed sleep and oxygen starvation may lead to hypertension, heart disease and mood and memory problems. Sleep apnea also increases the risk of drowsy driving.
10 Signs you may have OSA
- Daytime Sleepiness
- Snoring
- Depressed
- Forgetful
- Morning Headaches
- Unrefreshing Sleep
- Experienced Gasping
- Energy Loss
- Memory Loss
- Grinding Teeth at Night
Snoring vs Sleep Apnea
Snoring occurs when your throat and tongue muscles relax to the point where the airway is narrowed and partially obstructed. As the air passes through, the structures in the throat vibrate and produce snoring. Although snoring is a strong indication of sleep apnea, the two don’t always go together.
During an “apneic event,” your body experiences an increased amount of carbon dioxide and a decrease in oxygen. This alerts the brain to open the airways, usually accompanied by a snort or gasp, and a short rise out of sleep that you may not even be aware of. These arousals can prevent you from getting a good night’s sleep.
Treatment for Sleep Apnea
Snoring and obstructive sleep apnea are medical problems. Dr. Pickworth will conduct a medical assessment and diagnosis before exploring oral appliance therapy.
Sleep Apnea Testing
A sleep study (also called a polysomnogram) is the only definitive way to tell whether or not you suffer from sleep apnea, and how severe that apnea might be. Sleep studies can be conducted in a sleep laboratory or at home using an ambulatory sleep study device such as the WatchPat (featured at right). In either case, the tests are completely painless and just take one night
One of the most common methods used to diagnose sleep apnea is a sleep study.
The sleep study monitors a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels. This test is used both to diagnose sleep apnea and to determine its severity.
ORAL APPLIANCES
There are over 15 years of evidence supporting the effectiveness of oral appliances. This specialty designed “mouthpiece” fits over your teeth and is custom made for you by Dr. Rachel Pickworth, who has advanced training in dental sleep medicine. This custom designed orthotic device gently realigns the tongue and jaw to assure an open airway and allow normal air flow to the lungs as you sleep.
Oral appliances offer a No Mask solution to CPAP treatment. No Mask, No Straps, No Hoses and No Head Gear! Now you can sleep comfortably and wake rested!
Oral Appliance Therapy involves the selection, design, fitting and use of a specially designed oral appliance that, when worn during sleep, maintains an opened, unobstructed airway in the throat. Oral appliances that treat snoring and obstructive sleep apnea are devices worn in the mouth, similar to orthodontic retainers or sports mouth-guards. They have several advantages over other forms of therapy. Oral appliances are comfortable and easy to wear and care for. They are small and convenient, making them easy to carry with you when you travel. Treatment with oral appliances is reversible and non-invasive.
Oral Appliance Benefits
- Covered by most medical insurances
- East to use and comfortable to wear
- East to travel with
- Better sleep
- Improved daytime functioning
- Higher compliance rates that CPAP therapy
- Less snoring
- May help improve the sleep of your partner
CPAP Machine
CPAP is a mask that fits over the nose and/or mouth and gently blows air into the airway to help keep it open during sleep. This method of treatment is highly effective and has been a popular treatment of choice by many dentists and doctors. However the CPAP is very cumbersome and people tire of it easily.
Surgical Options
Treating sleep apnea with dental appliances will help reposition the lower jaw and tongue. There is also upper airway surgery to remove tissue in the airway; nasal expiratory positive airway pressure where a disposable valve covers the nostrils; and treatment using hypoglossal nerve stimulation where a stimulator is implanted in the patient’s chest with leads connected to the hypoglossal nerve that controls tongue movement as well as to a breathing sensor. The sensor monitors breathing patterns during sleep and stimulates the hypoglossal nerve to move the tongue to maintain an open airway.
Coping with Sleep Apnea
Lifestyle changes are effective ways of mitigating symptoms of sleep apnea. Here are some tips that may help reduce apnea severity:
- Lose weight. If you are overweight, this is the most important action you can take to cure your sleep apnea
- Avoid alcohol; it causes frequent nighttime awakenings and makes the upper airway breathing muscles relax.
- Quit smoking. Cigarette smoking worsens swelling in the upper airway, making apnea (and snoring) worse.
- Some patients with mild sleep apnea or heavy snoring have fewer breathing problems when they are lying on their sides instead of their backs.
Getting adequate sleep is essential to maintaining health in OSA patients. If you have symptoms of insomnia such as difficulty falling asleep, staying asleep, or waking up unrefreshed, talk to your doctor. Keep in mind that certain store-purchased and prescription sleep aids may impair breathing in OSA patients.