Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep. The term sleep apnea is derived from the Greek etymology meaning “without breath”. Breathing pauses can last anywhere from several seconds to minutes, and happen as often as 30 times or more per hour. Ongoing disrupted breathing causes an imbalance between the carbon dioxide and oxygen levels in the bloodstream, as not enough carbon dioxide is exiting and not enough oxygen is entering the body.

Sensing this imbalance, the brain sends a message to the body, telling it to wake up to restart breathing the process. People with sleep apnea will partially awake as they struggle to breathe, and this is often accompanied by loud snoring or choking sensations. Because people with sleep apnea don’t always completely awake during the episodes, they are often unaware they have a sleeping disorder and it can remain undiagnosed.

There are two main types of this disorder; central sleep apnea which occurs when the brain fails to send important signals to the breathing muscles, and obstructive sleep apnea which occurs when air cannot flow through the nose or mouth even though the body is still trying to breathe. Obstructive sleep apnea is far more prevalent and easily treatable by the dentist.

Common signs of obstructive sleep apnea in adults can include severe early morning headaches, sleepiness in the daytime, and insomnia.

In children with sleep apnea, s/he may have slept continuously throughout the night when in reality s/he woke up dozens, or even hundreds, of times and these tiny awakenings are not remembered when waking in the morning.  Quite often a child may say that "sleeping makes him tired!" and s/he is not waking up feeling refreshed.   Fatigue in children often surfaces in the form of hyperactivity or trouble paying attention, and unfortunately this can easily be misinterpreted, hence mistaken for attention or learning disorder, such as ADD.   Symptoms commonly described by parents of children with sleep apnea include teeth grinding (bruxism), snoring, laboured breathing, unusual chest movements (paradoxical respiratory effect), observed apnea, restlessness, sweating, unusual sleep positions (eg. sleeping sitting up, hyperextension of the neck), and bedwetting. Growth hormone levels are also suppressed and children may have difficulty gaining weight (as opposed to adults with sleep apnea who are quite often obese). Mouth breathing may also be present.  (Click here to learn more about mouth breathing).  Fortunately, the dentist is equipped with the necessary technology and expertise to treat sleep apnea in several different ways.

Snoring can be an early sign of obstructive sleep apnea in addition to interfering yours and your partner's sleep!!!

Reason for treating sleep apnea

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop numerous times per hour, and this can quickly turn into a deadly situation. Obstructive sleep apnea occurs when the soft tissue lying at the back of the patient’s throat collapses into the airway. The tongue then falls towards the back of the throat which tightens the blockage and prevents oxygen from entering the lungs.

The problem worsens when the chest region, diaphragm, and abdomen fight for air. The efforts they make to obtain vital oxygen only cause a further tightening of the blockage. The patient must arouse from deep sleep to tense the tongue and remove the soft tissue from the airway.

Because sleep apnea causes carbon dioxide levels to skyrocket in the blood and oxygen levels to decrease, the heart has to pump harder and faster to compensate for the lack of oxygen. Sleep apnea patients can technically “die” many times each night. Sleep apnea has been linked to a series of serious heart-related conditions, and should be investigated by the dentist at the earliest opportunity.

What does sleep apnea treatment involve?

Initially, the dentist will want to conduct tests in order to investigate, diagnose, and pinpoint a suitable treatment. The dentist can offer many different treatment options which depend largely on the exact diagnosis and the health of the patient. The dentist may advise the patient to halt some habits that aggravate sleep apnea such as smoking, alcohol consumption, and tranquilizer use.  A team approach is taken by always consulting with the physician to manage any airway problem such as allergies or enlarged tonsils.

Sleeping masks were traditionally used to keep the patient’s airways open while they slept, but nowadays there are some less intrusive options. Dental devices that gently tease the lower jaw forward are very effective in preventing the tongue from blocking the main air passage.  These dental devices are gentle, easy to wear, and often help patients avoid unwanted surgeries.

A more permanent solution is to have surgery that sections the lower jaw and helps pull the bone holding the tongue forward slightly. This surgery has an impressive success rate and is simple for the dentist or oral surgeon to perform. The dentist needs to formally make a diagnosis of each individual case before recommending the best course of action.