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Snoring can be deadly | Dr. Rich
For the last year, I've been asking many of my dental patients a couple of unusual questions: "How do you sleep?" and "Have you been told you snore?"
These are not questions most dentists ask during an exam. Why would I ask my patients about the quality of their sleep? Because a dentist, if properly trained, is in an excellent position to screen for a deadly condition that affects more than 40 million Americans. That condition is called Obstructive Sleep Apnea (OSA). In fact, the number of people afflicted is likely far higher than 40 million. It is estimated that only about 15-20 percent of those who have the condition have actually been diagnosed. In other words, the majority of the people who have this potentially deadly condition are not even aware of it.
OSA is not just about snoring, although a person with the condition almost always does snore. OSA is a condition in which the tongue and tissues in the back of your throat relax so much during sleep that they collapse over your windpipe. When that happens, even though you are trying to breath, no air can get through. For those with OSA, it happens for at least 10 seconds or more, as many as 60-80 times per hour. The resulting lack of oxygen in your blood alerts your brain, which constantly wakes you up to move and reopen your blocked airway.
Since the time spent awake is just a few seconds or minutes, most people with sleep apnea don't even remember the disruptions the next morning. However, the constant wake-sleep, wake-sleep cycle prevents you from achieving deep sleep. This typically results in a constant drowsy feeling during the day, and increases your risk for having a heart attack or stroke by 4-5 times because of a tremendous strain on your heart. To your brain, it is the same as if someone was trying to strangle you multiple times per night.
The following may indicate the presence of sleep apnea. If you or your bed partner notice one or more of the symptoms below, you should request that your physician refer you to a sleep specialist for further evaluation and a possible overnight sleep study:
• Loud snoring
• Snorting or choking sounds during sleep
• Waking up with a sweaty head and neck
• Headaches upon waking in the morning
• Falling asleep or extreme drowsiness during the day
• Drug resistant high blood pressure
• Having to get up multiple times per night to go to the bathroom
Obstructive sleep apnea is more common in men than in women, especially after the age of 40. However, anyone can suffer from sleep apnea, including children and young adults.
Obesity is strongly associated with OSA due to the extra fat and tissue deposits in the neck that further block the airway. Other risk factors include smoking, alcohol use within three hours of bedtime, taking sedatives or tranquilizers and a family history of the condition.
The treatment for sleep apnea traditionally has been limited to instructing the patient on the use a CPAP machine. A CPAP is a small, electrically powered air pump connected to a hose and mask that the patient must wear while they sleep. It works very well if the patient is able to tolerate the mask and air being blown into their nose and mouth all night.
Although most are able to adapt to the device, some find it too claustrophobic or uncomfortable to wear, and abandon its use, despite the serious health consequences of untreated OSA.
Most people are unaware that there is another treatment option. Since 2006, the American Academy of Sleep Medicine has recommended that a custom-made dental appliance be considered for the treatment of all early, and many moderate, cases of OSA. Although not as successful, it is also indicated for use in cases of severe OSA where the patient has tried and failed to use the CPAP machine.
These dental devices have been used successfully on thousands of patients across the country. They are small, effective and don't require any electricity. However, many physicians have had no experience with them or don't know of a properly trained dentist in their area to refer patients to who may benefit from this treatment option. If you suspect you have OSA, or have further questions about how a dental device may successfully treat your OSA, please give our office a call.
The device does require a prescription from an MD, as well as documentation of your OSA from an overnight sleep study. It is covered by most medical (not dental) insurance plans, even if you have already tried CPAP treatment. If you want further information, feel free to give our office a call or email us, and we will mail you a brochure that further describes this treatment option.
If any of the symptoms described earlier in the article apply to you, please don't wait. Snoring is no joke. It could be your body's way of sending you a "wake-up call" that may just save your life.
Reach Stuart Rich, DDS, PS, at 253-939-6900 or sleep@StuartRichDDS.com. For more information, please visit www.stuartrichdds.com.