What is sleep apnea?

Sleep apnea is a major health concern that not only increases risks for heart attacks and strokes, but robs patients of the quality of life they deserve. Snoring and symptoms of apnea often adversely affect relationships and/or health of the significant other and have been shown to increase marital problems and increase divorce rates. The most common warning signs of sleep apnea are snoring, gasping for breath during sleep, excessive daytime sleepiness or just being tired all the time. Patients with sleep apnea frequently report that they feel tired on awakening and often have dry mouth or morning headaches.

Common sleep apnea signs and symptoms:

• Lack of energy
• Morning headaches
• Frequent nocturnal urination
• Depression
• Large neck size
• Excessive daytime sleepiness
• Nighttime gasping, choking or coughing
• Gastroesophageal reflux (GE reflux)
• Irregular breathing during sleep (eg, snoring)

The best way to diagnose Obstructive sleep apnea is polysomnography or an overnight sleep test that not only evaluates Obstructive Sleep Apnea but also can evaluate Central Sleep Apnea, Obstructive Sleep Apnea leads to an almost automatic referral for CPAP treatment. CPAP is the still considered the Gold Standard of treatment for obstructive sleep apnea and is extremely successful if patient compliance is not considered. There is a small percentage of patients who like their CPAP machines from the day they receive them and never have problems. The majority of patients are not so lucky. There are many variations of the standard CPAP machine all designed to increase patient compliance (i.e. use of CPAP) but studies have shown that most of these advancements do not increase compliance.

CPAP Intolerance is a major problem that is best addressed for many patients by utilization of oral appliances or dental devices, that have been very successful in treating sleep apnea and snoring. They are so successful that the American Academy of Sleep Medicine (AASM) has declared that oral appliances are a first-line treatment (the same as CPAP) for mild to moderate Sleep Apnea and an alternative therapy for severe apnea when patients do not tolerate CPAP. Studies have shown that only 23-45% of patients prescribed CPAP actually use it regularly, and that most CPAP users average only 4-5 hours a night not the recommended 7 1/2 to 8 hours per night.

The American Sleep Foundation has declared oral appliances “a therapy whose time has come”, and the American Academy of Dental Sleep Medicine has endorsed the position of the American Academy of Sleep Medicine.

Sleep apnea is probably the single most worrying condition we have observed in our patients, one that affects millions of people, who don’t even realize they are at risk. If you suspect you have sleep apnea, we urge you to come in for a thorough examination.