What is Sleep apnea?
Sleep apnea is a sleep disorder that many people suffer from. This disorder involves repeated breathing interruptions throughout the night. These can happen numerous times and may be due to structural abnormalities or brain malfunctions. When breathing is normal, air passes through the nose, throat, uvula and tongue. If a person is awake, the muscles hold the airway open. If you are asleep, the muscles with relax and the airway should stay open. When the upper airway and airflow are blocked, sleep apnea will occur. When this happens, oxygen levels drop in both the brain and blood. This results in shallow breathing or pauses in breathing while asleep.
Causes of Sleep Apnea
There are many factors that can put certain people at risk for sleep apnea. These include:
- Enlarged tonsils or adenoids
- Cardiovascular problems
- Family history
- Nasal congestion
- Throat and tongue muscles that are more relaxed than normal
Adults over the age of 60 may be more at risk of developing sleep apnea. The aging process may limit the brain’s ability to keep the throat muscles stiff while asleep. If you drink alcohol heavily or use sedatives, you may also be at a higher risk. These substances can relax the muscles of the throat, causing the breathing disruptions.
Types of Sleep Apnea
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most common form of sleep apnea. It occurs when the soft tissue at the back of the throat closes, blocking or obstructing the airway. Patients who are overweight, have high blood pressure, are older, smoke or have a family history of sleep apnea may have an increased risk of developing obstructive sleep apnea.
Central Sleep Apnea
With central sleep apnea, the airway remains open but the brain does not send signals to the muscles involved in breathing. Patients with heart-related conditions, such as heart disease or a stroke, may suffer from central sleep apnea.
Mixed Sleep Apnea
Mixed sleep apnea includes aspects of both obstructive and central sleep apnea. A warning sign of mixed sleep apnea may be snoring, interspersed with gasps or lack of breathing.
Sleep Apnea Symptoms
Common symptoms of sleep apnea include shortness of breath that awakens you from your sleep. Also, you may wake up with headaches in the morning and feel excessive fatigue during the day. Additional symptoms may include:
- Loud snoring
- Waking up with a dry mouth or sore throat
- Abrupt awakenings during the night
Diagnosis of Sleep Apnea
Your doctor will be able to diagnose sleep apnea after reviewing your symptoms and completing a physical exam. You may be referred to a sleep specialist who can perform various diagnostic tests to confirm a diagnosis. It is common for evaluations to involve overnight monitoring of breathing and body functions while asleep. Other diagnostic tests may include home sleep tests and nocturnal polysomnography. This test monitors your heart and lung function, brain activity, blood oxygen levels, as well as your breathing patterns during sleep.
Sleep Apnea Treatment
Fortunately, sleep apnea may be treated with lifestyle changes. These may include losing weight, decreasing alcohol consumption and quitting smoking. Nasal training devices are also commonly used for treatment. Some individuals may need a CPAP for treatment. A continuous positive airway pressure (CPAP) involves the patient wearing a pressurized mask over their nose while asleep. This mask pumps air through the airway to keep it open.
If your sleep apnea is directly caused by sinus issues, it may be treated with the continuous use of a neti pot. The use of a neti pot may bring relief to your nasal symptoms without medication by flushing out the nasal passages. To learn how to use a neti pot, watch this video of Dr. Gill teaching her daughter.
If conservative treatment is unsuccessful in treating sleep apnea, there are other options available. Surgery may be the best treatment options for individuals who suffer from severe cases of sleep apnea that may lead to serious medical conditions. The goal of most surgical procedures is to remove the excess tissue from the nose or throat and open upper air passages to facilitate breathing. Sleep apnea may cause serious problems if left untreated. Patients with sleep apnea have a higher risk of developing high blood pressure, heart failure and stroke.
Oral Appliances for Sleep Apnea
Custom made oral appliances may also treat sleep apnea. Some of these devices can help open the throat by bringing the jaw forward. Oral appliances can help relieve snoring and mild obstructive sleep apnea. Individuals who are unhappy using a CPAP may prefer using oral appliances to help their sleep apnea.
Watch as Dr. Gill demonstrates how custom made Oral Appliances treat Snoring and Sleep Apnea
What types of oral appliances are offered?
Our objective in treating sleep apnea with oral appliance therapy is to achieve results as quickly and as comfortably as possible. We do this with the use of the MicrO2™ jaw advancement device. The MicrO2™ is easy to use and easy to care for, making it an excellent alternative to CPAP treatment for many patients.
Who would benefit from an oral appliance?
Oral appliance therapy may be indicated for individuals who suffer from mild to moderate obstructive sleep apnea. A thorough consultation and pre-screening process are conducted before treatment recommendation. We pre-screen patients in our office with a take-home kit called the Medibyte Jr. Studies suggest that a wide range of patients have benefitted from the use of oral appliances that advance the jaw to a more appropriate position during sleep. Oral appliance therapy may even be considered as an alternative to CPAP for patients who do not tolerate any aspect of such medical treatment.
Some of the reasons that we use the MicrO2™ device include benefits such as:
- Easy adjustment
- Lingual-free design
How can an oral appliance help sleep apnea?
The MicrO2 oral appliance that we use exclusively supports healthy sleep through mandibular advancement. It is the bony structure of the jaw that supports the windpipe. During sleep, the muscles around the throat relax. For some, this relaxation leads to obstruction of the airway. A mandibular advancement device positions the jaw in such a way that structural support sustains the airway against lax muscles.
When are oral appliances used?
Oral appliances may be used when a patient with mild to moderate obstructive sleep apnea is not able to tolerate standard CPAP medical therapy or would prefer an alternative to forced airway pressure. We can help you determine the MicrO2 is right for your situation. Contact our Golden, CO office to learn more.
How are these oral appliances made?
We have selected the MicrO2 mandibular advancement device for sleep apnea patients for benefits such as:
- Predictability. These devices are made with CAD/CAM technology, which enhances precision and predictability due to an excellent fit.
- Comfort. This jaw advancing device has been purposefully designed with a small profile for maximum comfort.
- Durability. Made with control-cured polymethylmethacrylate (PMMA), the MicrO2 can withstand force and will also resist picking up odor.
- Ease of use. There are no elastics or screws involved in adjusting this device.
- Freedom. Some mandibular advancement devices lock in place. Not the MicrO2. This oral appliance holds the lower jaw forward in a way that does not prevent movement. It also does not inhibit the tongue in any way.
Surgical Sleep Apnea Procedures
This surgery treats obstructive sleep apnea by tightening the tissue in the throat and palate. Uvulopalatopharyngoplasty is performed to expand the passageways. Removal of the tonsils and adenoids may also be part of the procedure.
During a maxillomandibular advancement procedure, the upper and lower part of the jaw are moved forward. Moving the jaw forward will create more space behind the tongue and soft palate. This reduces the risk of obstruction during sleep and breathing is restored as the path for airflow is cleared.
A tracheostomy is often performed if other procedures fail. This involves inserting a metal or plastic tube into the throat to help the patient breathe during sleep. The opening remains covered during the day but helps air pass directly in and out of the lungs during sleep. This procedure is reserved for severe, life-threatening cases of sleep apnea.
Thermal Ablation Palatoplasty
Thermal ablation palatoplasty (TAP), is a group of procedures that treat snoring and sleep apnea. During these procedures, electric current cuts away obstructive tissue in the airway and roof of mouth. Another reason may be to shrink and stiffen obstructive areas in rear of the mouth and the uvula. Radio frequency ablation emits energy to shrink excess tissue.
Genioglossus and Hyoid Advancement
Genioglossus and hyoid advancement are common procedures to treat sleep apnea. The surgical procedure prevents the collapse of the lower throat by pulling the tongue muscles forward. This opens the obstructed airway.
Septoplasty and Turbinate Surgery
Nasal septoplasty reduces resistance to air flow through the nose. The surgery repairs and straightens the bone and tissue separating the two nasal passages. It also repairs the layers of spongy horizontal bones, or turbinate, which are inside the nasal cavity.