Sleep apnea is a severe sleep disorder that occurs when you stop breathing during your sleep. There are different forms of sleep apnea that result from blockage of your airways. Sleep apnea is characterized by snoring, daytime fatigue, dry mouth, and restlessness. Sleep apnea could result in serious health conditions like elevated blood pressure and heart troubles when left untreated. Additionally, this condition could affect your oral health by causing conditions like bruxism and temporomandibular joint disorder.
Treatment for sleep apnea varies from lifestyle changes to dental devices and surgery in serious cases. If you experience any sleep apnea symptoms, you must consult with a skilled dentist. At The Whittier Dentist, we will assess your condition to determine the right treatment for your sleep apnea. If you are a good candidate for oral appliances to treat the condition, your dentist will take your mouth impression to make the device for you. We serve clients seeking treatment for sleep apnea in Whittier, CA.
What is Sleep Apnea?
Sleep Apnea is a condition where your breathing stops suddenly during your sleep. When this happens, your body must wake up to resume breathing. Sleep apnea may be caused by a physical obstruction of the airways or a neurological condition that prevents your brain from sending breathing signals. The sleep interruption caused by sleep apnea prevents you from experiencing enough rest, resulting in daytime fatigue, mood swings, and difficulty staying awake during the day.
Different Types of Sleep Apnea
There are three main types of sleep apnea. Knowing the different types helps understand the cause of your specific condition and how to manage it:
Obstructive Sleep Apnea (OSA)
The most prevalent type of sleep apnea is the OSA. OSA occurs when there is an obstruction in the airways. Inability to breathe caused by airway blockage causes snoring and rattling of the soft palate. The lungs function properly with this type of sleep apnea, but the body does not receive enough oxygen. For this reason, you may need to wake up several times during the night.
OSA prevalence increases with age and is characterized by frequent headaches, snoring, dry mouth, and frequent episodes of breathlessness. In most cases, OAS will need CPAP therapy or surgery to treat.
Central Sleep Apnea (CSA)
Central sleep apnea is another type of sleep apnea that interrupts your breathing as you sleep. Central sleep apnea does not result from airway blockage. But instead, its cause is neurological. With the CSA, your body does not attempt to take in oxygen, and you will not experience snoring. Since your brain does not send the right signals, you may stop breathing abruptly. Some of the common causes of this condition are the use of opiates and congestive heart disease. Sometimes, doctors cannot find the exact cause of central sleep apnea. The best treatment for CSA would be to identify and treat the underlying condition. However, doctors may still utilize CPAP and APAP.
Complex Sleep Apnea (CSA)
One person can be diagnosed with both central and obstructive sleep apnea. Complex sleep apnea is a combination of obstructive and central sleep apnea. Often, this condition is detected when CPAP alone does not correct all the serious symptoms. Complex sleep apnea is characterized by:
- Dr mouth and serious headaches
- Daytime fatigue
- Frequent waking from your sleep
Treatment for complex sleep apnea involves a combination of treatments, including CPAP and treating the underlying conditions.
Risk Factors of Sleep Apnea
The presence of the following factors increases your risk of developing sleep apnea:
- Narrow airway. Having a narrow airway is an inherited condition. Narrow airways are easily blocked by inflamed tonsils and adenoids, resulting in sleep apnea.
- Excessive weight. Overweight and obese individuals are at a higher risk of developing sleep apnea since the excess fat could be deposited around the airway, causing difficulty when breathing.
- Being male. Men have a higher likelihood of developing sleep apnea when compared to women. However, the risk for females increases when they are overweight or as they approach menopause.
- Smoking or alcohol use. Smokers and individuals who use alcohol are more likely to develop OSA. This is because smoking causes inflammation and liquid retention in the airways.
- Medical conditions. Having medical conditions like hypertension and diabetes increases your risk of developing sleep apnea.
Dental Complications Associated with Sleep Apnea
Quality sleep helps you keep your overall health in check, and it prevents mouth ulcers, bad breath, and the progression of gum disease. Some of the common oral health complications associated with sleep apnea include:
When your airways are blocked, your body responds by sending out stress signals. The stress hormones travel to your bloodstream and can cause muscle tightening. Muscle tightening will result in friction between the jaws leading to bruxism. Many people are unaware that they grind their teeth since the condition manifests mostly at night.
Your dentist could notice erosion and cracking of your enamel during your regular dental visits. When left untreated, teeth grinding can cause loosening of the teeth, jaw pain, and damage to the periodontal tissues. The treatment for teeth grinding varies depending on the cause of the condition.
If the condition results from teeth grinding, you may need to undergo CPAP therapy. By applying air pressure to our mouth, your breathing improves significantly. When your breathing is normal, the stress on your muscles is reduced, and teeth grinding will resolve.
Sleep apnea often results from blockage of your airways. When breathing through the nose is challenging, you will tend to breathe with your mouth. Mouth breathing is associated with a dry mouth which encourages bacteria to multiply and causes tooth decay and gum diseases. Additionally, this habit could cause swelling of the gums and bad breath.
Temporomandibular Joint Disorders
Medical researchers have found that most people who suffer from TMJ have underlying sleep apnea. Many people who suffer from obstructive sleep apnea experience a collapse of the airways. In an attempt to open up the airways, your body pushes your jaw forward. The constant movement of the jaws can result in TMJ, which is characterized by:
- Neck and shoulder pain
- Jaw pain
- Difficulty chewing
- Discomfort and clicking sounds from your jaw joints
Treating sleep apnea through CPAP, APAP, and surgery can help prevent the occurrence or worsening of TMJ.
Treatment Options for Sleep Apnea
If you receive a diagnosis for any of the above types of sleep apnea, your doctor could recommend any of the following forms of treatment depending on the type and severity of your condition:
Continuous Positive Air Pressure
A CPAP machine is the most common and effective treatment for obstructive sleep apnea. The CPAP machine works by sending a steady flow of pressurized air to your mouth and nose when you sleep. The pressurized air helps to keep your airways open, allowing you to breathe normally. A continuous positive airway machine has a compressor that generates a stream of pressurized air, which travels into an air filter and a flexible tube. The tube then delivers pure air into the mask around your mouth or nose.
As the airflow enters your mouth and nose, it lifts any blockages on your airways and ensures that the lungs receive as much oxygen as possible. There are different types of CPAP machines, but they all have similar basic components, including:
- A motor placed in the base unit
- A mask
- A tube that connects the mask and the motor
- A headgear frame
- Straps that allow customization of the device
The masks used to deliver the air to your mouth or nose vary based on your breathing habits and the type of sleep apnea. Different masks used for this treatment include:
- Full mask. This type of mask is triangular and made to cover both the mouth and nose. If you have a blockage in your nose and use the mouth for breathing, your doctor could prescribe this mask.
- Nasal pillow mask. The nasal-pillow mask has a cushion that caps the nostril area and has prongs to fit into the nostrils. This type of mast is suitable if you want to wear your glasses or have facial hair that prevents other masks from fitting properly.
- Nasal mask. A nasal mask for CPAP is designed to cover your nose area, and it may be a good option if you move around a lot during your sleep.
Besides the CPAP, there are other machines that you can use to regulate your breathing during the night and relieve the effects of sleep apnea:
- APAP machine. The automatic positive airflow pressure device works by checking your breathing pattern throughout the night. This machine adjusts air pressure to compensate for any change in sleeping position or other factors that could have interfered with your breathing.
- BiPAP machine. The BiPAP machine has a pressure setting for inhaling and another for exhaling. This device is used for patients who cannot tolerate CPAP or APAP. Additionally, individuals with high levels of carbon in their blood would greatly benefit from this type of treatment.
Like other treatment options for sleep apnea, the use of CPAP has its benefits and drawbacks. CPAP is a commonly prescribed treatment option and has these benefits:
- Reduces the risk of complications caused by sleep apnea
- While providing purified air helps reduce the instances of elevated blood pressure
- Reduces cholesterol and blood glucose
- Improves the quality of sleep
Although the use of the CPAP is a very effective treatment for this condition, it may have the following cons:
- Nasal congestion
- Nose bleeding
- Discomfort in the first days of using the machine
- Air bloating
The use of oral appliances to treat sleep apnea is increasing in popularity. Over one hundred dental appliances have been certified by the Food and Drug Association as effective ways to treat obstructive and central sleep apnea. Before sleep, oral appliances for sleep apnea are placed in the mouth like a sports mouthguard. These oral appliances hold your lower jaw forward to keep the airways open while preventing the upper jaw muscles and tongue from collapsing.
The American Academy of Sleep Medicine approves dental appliances as a first treatment option for mild or moderate sleep apnea individuals. Patients with severe sleep apnea may need to use oral appliances if they cannot tolerate CPAP. Sometimes, you may need to use a combination of the CPAP with oral appliances to avoid discomfort from the CPAP machine.
Many patients prefer the use of oral appliances because it is:
- Convenient for use away from home
- Easy to use
While some oral appliances are available over the counter and in most drug stores, these devices are not always certified by the FDA to treat this condition. When an oral appliance does not fit in your mouth properly, it can cause many complications, including teeth movement, jaw pain, or even worsening sleep apnea.
If you have been diagnosed with mild or moderate sleep apnea and wish to try out the dental appliances, you must make an appointment with your dentist. A general dentist can evaluate your mouth, teeth, and jaws to determine if you are a good candidate for oral appliances. If your jaws are healthy enough to fit the appliance, the dentist will start your mouth and schedule another appointment to fit custom-made oral devices.
Since the oral appliances can be adjusted, your dentist helps you maintain the jaw position by constantly monitoring the device. You can ensure that the device continues to serve its purpose by following up with your dental appointments. When your oral appliance is fitted, you could experience some discomfort. However, within a few days, you will have adjusted to wearing the device all night. During your scheduled checkups, the dentist will check out for the improvement in your symptoms.
Although the dentist fits your oral appliances, it is important to note that your health insurance covers the cost of these devices. Therefore, before you undergo the procedure, it would be best to contact your healthcare insurance company to determine the amount the insurance will pay.
Excessive weight, use of alcohol, and smoking are some of the risk factors for obstructive sleep apnea. Therefore, losing excess weight and avoiding the use of alcohol right before you sleep may help relieve the condition. Several studies have shown that losing weight results in less snoring. In cases of severe obesity, you may need to take weight loss medications.
Some individuals with OSA cannot use the Continuous Positive Airway Pressure, the most common treatment for the condition. If you have moderate to severe obstructive sleep apnea, these types of therapy could work inside your body:
- Hypoglossal Neuro-stimulation Therapy. This type of therapy is useful for people with obstructive sleep apnea who are unable or unwilling to use CPAP therapy. Hypoglossal Neuro-stimulation therapy is an implant designed to key the tongue muscles and control the airflow.
- Neuro-stimulation Therapy. This type of therapy involves implantable systems that stimulate a chest nerve to send signals to larger muscles that control your breathing. These signals work similarly to the brain in stimulating breathing. Neuro-stimulation therapy is used to treat central sleep apnea, and its system is placed in a minimally invasive surgical procedure that can be done in the outpatient section. The system is powered by a battery, with one part being used for delivering the signal and the other part to stimulate breathing.
Sometimes, you may only experience sleep apnea or snore when lying on your back. You can treat this condition by learning to sleep on the side. The most common technique used to induce a change in sleeping position is a tennis ball hanging from the back of your pajamas which could hurt when you sleep on the back. However, this type of sleep apnea treatment is effective for mild obstructive sleep apnea individuals. For individuals with severe obstruction, the airway could collapse regardless of the sleeping position.
Continuous Excessive Daytime Sleepiness
After undergoing other treatment options for sleep apnea, some people will still experience excessive sleepiness during the day and may need help to stay awake or be alert. Most sleep apnea people fail to have enough rest during the day, worsening existing conditions and impacting their cognitive abilities.
You could be given medication to improve your daytime functionality in such a case. Treatment for excessive daytime sleepiness is aimed at eliminating the underlying conditions. The medications for EDS stimulate your brain, causing you to stay awake. However, the prescription of previously used medication for the same condition may not be recommended.
Surgery for Sleep Apnea
If you have obstructive sleep apnea, some parts of your airway may be closed, making it difficult to breathe as you sleep. This makes it difficult to rest properly and could affect your performance and overall health. If all other treatment options for the connection are not effective, your last option could be surgery. There are several surgeries used to treat sleep apnea, and the surgery that is best for you will depend on the specific cause of your condition:
1. Palate Surgery
Palate surgery involves reshaping the soft tissues at the roof of your mouth and the throat. This type of surgery is done in different ways, widening your airways.
- Tonsils or adenoid removal. Adenoids are lymph nodes found on the side of your throat and behind the nose. Swelling of these lymph nodes causes a blockage of the airways. Removal of tonsils and adenoids is common for children with obstructive sleep apnea.
- Uvulopalatopharyngoplasty. This is the most common palate surgery in adults with severe OSA. Your surgeon removes part of the palate, uvula, and tonsils for this surgery. The UPPP surgery is an invasive procedure that takes up to eight weeks to heal.
- Palate implants. For patients with mild OSA, the doctor could place rods in the throat to stiffen the palate and prevent it from collapsing over the airways.
2. Nasal surgery
Nasal surgery involves removing or shrinking the part that blocks your airways. This may include curved bones on the walls of your nose and polyp growths. Sometimes, your doctor could work to correct any case of the deviated septum, which is the bone separating your nostrils.
3. Permanent Tracheostomy
Permanent tracheostomy is a surgical procedure that involves making small incisions on the trachea to prevent you from using your upper airways. You can close the holes during the day to help you breathe and talk normally and only open them at night.
4. Tongue surgery
Another way to open your airways and reduce the symptoms of obstructive sleep apnea is by tongue surgery. This type of procedure involves the removal of excessive tissue from the base of your tongue. Sometimes, your surgeon could pull your tongue muscles forward by attaching them to the chin bone.
5. Skeletal Surgery
During a skeletal surgery, your doctor moves your lower and upper jaw forward to help open your throat. However, this procedure can be done to correct structural flaws on your face. It is a common way to treat obstructive sleep apnea. Evidence has shown that skeletal surgery produces more effective results when treating sleep apnea. However, the procedure is a high risk, and you may need to spend up to five days in the hospital and spend weeks in recovery.
Find a Skilled General Dentist Near Me
Sleep apnea is a medical condition characterized by repeated episodes of inability to breathe as you sleep. There are several types of sleep apnea, including obstructive sleep apnea, central sleep apnea, and complex sleep apnea. Most people who suffer from sleep apnea must wake up frequently through the night to catch a breath which results in fatigue and mood swings.
In addition to fatigue, sleep apnea is linked to various health and dental conditions. Fortunately, you do not have to deal with the effects of this condition. Depending on the type of sleep apnea you have and its severity, you can explore various treatment options. If you have mild sleep apnea, a lifestyle change could help relieve some symptoms. However, you may need CPAP, oral appliances, or even surgery in severe cases. At the Whittier Dentist, we help you through the diagnosis and treatment of sleep apnea using oral appliances in Whittier, CA. Call us today at 562-632-1223.