Sleep Apnea – No Laughing Matter!
By Dr. Grace Liu and Dr. Lewis Yu
Snoring is often joked about but, Sleep Apnea, the likely cause is
not something to laugh about.
It is the root cause of many medical conditions, some with potentially life affecting results. Obstructive Sleep Apnea (OSA) is defined by recurring interruption of breathing during sleep due to obstruction, usually of the upper airway. Symptoms may include loud snoring, excessive daytime sleepiness, depression, fatigue, impaired concentration, and/or morning headaches. OSA can contribute to high blood pressure, heart failure, stroke, and heart attack.
Diagnosing OSA begins with an initial screening questionnaire of the person and their bed partner, provided by the primary care physician (PCP) and/or dentist. The PCP or dentist then evaluates the questionnaire and reviews the patient’s medical history to identify health issues that may be contributing factors.
If the evidence raises the suspicion of sleep apnea the person should be then referred to a sleep specialist. The most definitive test for sleep disorder is a polysomnogram (PSG). It requires the person to spend a night in a sleep laboratory. The test measures and records multiple aspects of a person’s sleep, such as breathing pattern, eye movements, body turning, oxygen level, and brain waves. The information is analyzed to determine how many times the patient breathes shallowly or stops breathing during the night. It is possible the doctor may first suggest a home sleep test. While similar to the PSG, it records fewer types of data but enables the person to sleep more comfortably in his or her own bed, which makes the data
Besides of weight and life style management, several options are available to improve the condition. The first step is to determine if the airway needs to be cleared of excessive soft tissues such as tonsils and adenoids. Constant positive air pressure, commonly referred to as C-PAP, has been the main choice of treatment. It works by blowing air through a mask into the nasal passages at pressures high enough to overcome obstructions in the airway and stimulate normal breathing. It is a proven effective method; however, there are compliance issues, as the most common complaints are the interfering face mask and inability to breathe normally due to the high air pressure. If a patient doesn’t use the C-PAP effectively, OSA will not improve.
Dentistry and Sleep Apnea
For patients with mild to moderate OSA, the American Academy of Sleep Medicine recommended that dentists be involved in managing OSA by fitting patients with oral appliances. The purpose of an oral appliance is to enlarge the airway by physically moving the lower jaw forward. For patients with severe OSA, it is possible to combine an oral appliance with C-PAP, which reduces the level of C-PAP pressure.
Because of our knowledge and personal relationship with our patients, dentists are often able to identify those who may be suffering from sleep apnea. Our specialized training in TMJ and oral appliance therapy make us a trusted, qualified partner in the treatment. The separation between medical and dental fields is diminishing. It is increasingly clear that dentists must work closely with physicians to raise the standard of care for all patients.
Think you have concerns that you may have Sleep Apnea? Come talk to us at All About Smiles, we offer in home sleep tests. (302) 239-1641, or visit our website, allaboutsmilesde.com.
Dr. Lewis Yu earned his dental degree from the University of Pennsylvania School of Dentistry in 1996. He received two years of advanced post-graduate oral surgery training in both the New York City Hospital System and the Hospital of the University of Pennsylvania. He continues his education through extensive hands-on training at the prestigious Las Vegas Institute for Advanced Studies and the Pankey Institute. The Las Vegas Institute has provided Dr. Yu with advanced training in Neuromuscular Dentistry and Comprehensive Aesthetic Restorations. He had practiced in Philadelphia and Newark, Del. before joining All About Smiles, P.A. He is a member of the Delaware State Dental Society, American Dental Association, and the Academy of General Dentistry.
Dr. Grace Liu has been practicing dentistry since 1996, having earned her degree from the New York University School of Dentistry. She continued her education through post-graduate studies at Columbia University, the Las Vegas Institute for Advanced Studies in Nevada and the Academy of Dentistry. She is also a member of the Delaware State Dental Society, American Dental Association, and the Academy of General Dentistry.