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St. Charles Family Dentistry, Ltd.

 516 E. Main Street
 St. Charles, IL 60174
 (630) 377-3131   
 
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Sleep Disorders/Sleep Apnea

The term "sleep disordered breathing" (SDB) refers to a full range of breathing problems that result from an insufficient amount of air that reaches the lungs (i.e., hypopnea and apnea). It is estimated that one-third of the U.S. population suffers from some type of sleep disorder. Approximately 40 million individuals are chronic sufferers, yet less than 10% have been diagnosed or sought treatment. Without proper diagnosis and treatment, the results can be life-threatening - from an increased risk of heart attack, congestive heart failure, cardiovascular disease, stroke, high blood pressure, diabetes and work and driving related accidents. Sleep apnea patients may also suffer with memory impairment, difficulty concentrating and low energy. Obstructive sleep apnea syndrome (OSAS) in children is being increasingly recognized as a cause of attention and behavior problems.

Several types of sleep disorders affect both children and adults but the most prevalent is sleep apnea. Also known as obstructive sleep apnea (OSA), this manifests itself at night when a child or adult is sleeping. As the muscles relax, the tongue and soft palate collapse onto the back of the throat and block the upper airway, causing airflow to stop. When the oxygen level drops low enough, the brain moves out of deep sleep and the sleeper partially awakens. The airway then contracts and opens, causing the obstruction in the throat to clear. The flow of air starts again, usually with a loud gasp. Although this arousal from sleep may only last seconds, the cycle repeats throughout the night, disrupting the sleep pattern and preventing the individual from getting a continuous flow of oxygen and reaching the stage of restful, deep sleep the body needs in order to rest and replenish its strength. It is this combination of low oxygen levels and interrupted, fragmented sleep that contributes to most of the ill effects suffered by the sleep apnea patient.

Typically, the frequency of waking episodes is somewhere between 10 and 60. A person with severe OSA may have more than 100 waking episodes in a single night. Men usually have a greater incidence of OSA until women reach the age of menopause. This is because men accumulate fat in their throats and bellies (stomach) and women accumulate fat on their hips and thighs (pre-menopausal). However after menopause, women also accumulate fat in their throats and bellies due to increasing testosterone and reducing estrogen levels.

What is Sleep Apnea

Obstructed Airway

When you have Obstructive Sleep Apnea (OSA), your throat collapses during sleep, blocking the airway and preventing air from getting to your lungs.

Generally, your throat muscles keep the throat and airway open. The site of obstruction in most patients extends from the soft palate to the base of the tongue. There are no rigid structures, such as cartilage or bone, in this area to hold the airway open.

During the day, while you are awake, the muscles in the region keep the passage wide open.
At night, when a person with OSA falls asleep, these muscles relax to the point where the airway becomes obstructed.







Causes and risk factors of obstructive sleep apnea:

  • Being overweight or obese
  • Large tonsils or adenoids
  • Distinctive physical attributes- deviated septum, shape of head and neck, receding chin or enlarged tongue
  • Nasal congestion or blockage
  • Throat muscles and tongue relax more than normal during sleep

In adults, the most typical individual with obstructive sleep apnea syndrome suffers from a decrease in muscle tone causing airway collapse and sleep apnea. Excessive weight is also a cause for OSA in adults and children which results in symptoms of restlessness, exhaustion and forgetfulness.

Unlike adults, obstructive sleep apnea in children can be caused by obstructive tonsils and adenoids. This may be cured with surgery (tonsillectomy or adenoidectomy) though a full evaluation is necessary to confirm the root cause of the sleep disorder. A non-invasive treatment plan could prove more productive and provide better long-term results.

Symptoms of Sleep Apnea

People with sleep apnea present with a variety of signs and symptoms.

Signs are things that a doctor may observe during a comprehensive exam:

  • Scalloped borders of the tongue
  • Hyper-keratinized buccal mucosa (cheek tissue)
  • Small airway observed with tongue protruded
  • Enlarged tonsils
  • Tooth damage due to grinding or bruxing
  • Tori (boney deposits) on roof or floor of mouth
  • Swollen gums due to mouth breathing

Symptoms that a person may experience:

  • Excessive daytime sleepiness
  • Pain including head, neck and back pain
  • GERD
  • Tooth sensitivity, and wear due to grinding/bruxing
  • Depression, anxiety
  • Cardiovascular disease
  • Weight gain
  • Sexual dysfunction

Causes of Sleep Disorders

When you have obstructive sleep apnea, your throat collapses during sleep, blocking the airway and preventing air from getting to the lungs. Generally, your throat muscles keep the throat and airway open. The site of obstruction in most patients is the soft palate, extending to the region at the base of the tongue. There are no rigid structures, such as cartilage or bone, in this area to hold the airway open. During the day, muscles in the region keep the passage wide open. But as a person with OSA falls asleep, these muscles relax to a point where the airway collapses and becomes obstructed.

Causes and risk factors of obstructive sleep apnea:

  • Being overweight or obese
  • Large tonsils or adenoids
  • Distinctive physical attributes- deviated septum, shape of head and neck, receding chin, enlarged tongue
  • Nasal congestion or blockage

Throat muscles and tongue relax more than normal during sleep
In adults, the most typical individual with obstructive sleep apnea syndrome suffers from a decrease in muscle tone causing airway collapse and sleep apnea.
Excessive weight is also a cause for OSA in adults and children which results in symptoms of restlessness, exhaustion and forgetfulness.

Diagnosis and Treatment of Sleep Apnea

If there is a suspicion of OSA, a home screening study may be performed and a referral made to a physician. The physician may order a PSG (sleep study) to verify the presence of OSA. This diagnosis must be made by a physician, and you may be referred to a doctor (MD) who specializes in sleep medicine.

The sleep physician may recommend a CPAP (Continuous Positive Air Pressure) to treat moderate to severe apnea. The CPAP device provides positive pressure airflow to keep your airway from collapsing, and has been proven to be very effective if the patient is compliant. Some people cannot tolerate the CPAP device and will choose OAT after a CPAP trial period. In this case, the physician will refer you to a dentist who is experienced in Oral Appliance Therapy (OAT).

If you have mild or moderate OSA, the treatment of choice is Oral Appliance Therapy (OAT). There are many options of types of appliance, but they all work on the same general principle of repositioning the lower jaw to maximize your airway while you are asleep.

Drs. Lynn and Ed Lipskis have received over 1500 hours of post doctoral education in the treatment of sleep apnea / TMJ disorders and use their expertise to determine which appliance may provide the best outcome for your individual situation. They will complete a comprehensive evaluation prior to making an appliance they provide, Our office protocol requires an annual home screening study to make sure that the appliance continues to be effective to help keep you in the optimum state of health. These results are forwarded to your physician so they are kept up to date on your progress.