About
Snoring...
Snoring
is a breathing noise that occurs while someone
is sleeping. The actual snoring sound is produced
from the vibration of the soft palate and
sides of the throat when air brushes against
them. The sound of snoring occurs when the
airway collapses and the muscles fail to maintain
their normal function.
In
recent years, snoring has been acknowledged
as a warning sign that normal breathing is
not taking place during sleep. For the majority
of adults snoring does not involve a serious
medical disorder. However, adults who snore
need to know that it may be the first sign
of obstructive sleep apnea (OSA).
Understanding
Sleep Apnea
Apnea
is a Greek word that means "want breath."
A person is considered to be a sleep apnea
sufferer when they stop breathing for at least
10 seconds up to 30 times or more in one night.
A few of the medical and dental conditions
that lead to snoring are:
- Overweight
- A
small retruded jaw
- Sedatives
- Allergies
- Alcohol
before retiring
- Airway
obstruction
Snoring
may be indicative of sleep apnea, a cessation
of breathing during sleep, which can put a
great strain on the cardiovascular system.
This is why sleep apnea, left untreated, increases
risk of heart attack and stroke. Besides snoring,
other common symptoms of sleep apnea include:
- Morning
headaches
- Dry
mouth and throat
- Excessive
daytime sleepiness
- Sudden
short-of-breath awakenings
- Loss
of interest in sex
There
are three basic classifications of sleep apnea:
-
Central-
when airflow and respiratory movements
temporarily cease although the airway
may remain open.
-
Obstructive-
when airflow ceases due to an upper airway
obstruction in the presence of a respiratory
effort. (This is the most common)
-
Mixed-
a combination of central and obstructive
apnea
Diagnosis
and Treatment
Before
any therapy is performed to treat sleep apnea,
the use of sleeping aids and alcohol is restricted
and a weight loss program is suggested for
those who are overweight. When sleep apnea
is suspected, an experienced, specially trained
dentist usually refers patients to a physician
for a complete medical assessment.
Most
likely, the physician will suggest a test
called polysomnogram. This technologically
advanced sleep study monitors breathing patterns,
sleep stages, and cardiac rhythm along with
airflow and length of non-breathing episodes.
Once diagnosed, sleep apnea can be treated
several different ways:
1)
Oral Appliance Approach- A conservative
treatment is to have a dental appliance made
to wear during sleep which gently moves the
lower jaw forward causing a positive change
in tongue position. The advantage of this
form of therapy that it is inexpensive, non-invasive,
easily accepted by patients, and reversible.
As a special member of the sleep apnea team
of health professionals, a trained dentist
will perform an intraoral exam to determine
where the blockage is and what is causing
the obstruction. When oral evaluation reveals
an airway restriction due to chronically enlarged
tonsils, an enlarged tongue or soft palate
abnormality, a dental appliance can be a successful
treatment of snoring and/or obstructive sleep
apnea. To increase breathing potential, sometimes
orthodontics can be performed to make additional
room for the tongue and widen the arch.
Research
has shown that appliances are very effective
when choosing a treatment modality--especially
as an alternative treatment. An appliance
worn during sleep prevents the airway from
collapsing by creating extra space. Only a
specially trained dentist can properly select
and fit the type of appliance that is needed.
Most dentist who also treat TMJ--temporomandibular
disorders--are an excellent choice because
they pay close attention of jaw positions
when making the device. In fact, TMJ appliances
can often be adapted to work for sleep apnea.
Appliances are light and easy to wear. In
only a few weeks, most patients are comfortable.
2)
Continuous Positive Airway Pressure
(CPAP)- consists of an air
compressor and mask which delivers pressurized
air through the nose when a person is sleeping.
This opens up the airway from the inside--as
if the air were an internal splint. The biggest
hurdle for using this method is compliance.
Many patients feel claustraphobic with it
and others find wearing a mask to be offensive.
The strap of the mask worn around the head
may even cause headaches.
3)
Surgery - This
is the most invasive method of treatment and
is performed only in cases of severe obstructive
sleep apnea when excessive tissue reduces
airway space. This surgery is known as UPPP
surgery (Uvulopalatro-pharynpalasty) and,
according to clinical investigations, is only
50% effective except in cases where abnormalities
are present; enlarged tonsils, nasal polyps,
a deviated septum or jaw malformations. These
defects are helped and corrected by surgery
procedures.
With
so many advances in the dental field, dentists
are able to conservatively and successfully
treat those suffering with snoring and sleep
apnea. If poor sleep interferes with your
daily activities like reading, remaining
alert during meetings, watching television
or driving or operating equipment, discuss
it with your dentist. He or she will determine
what course of treatment is best for you.
