Posts for tag: sleep apnea

By Paul E Gray DMD
August 13, 2018
Category: Oral Health
Tags: sleep apnea   snoring  
SleepApneaMightbeRobbingyouofMorethanaGoodNightsSleep

Fatigue, a “foggy” mind, and irritability are all signs you’re not getting enough sleep—and neither might your sleeping partner from your continuous snoring. You might have a common form of sleep-related breathing disorder (SRBD) known as obstructive sleep apnea.

Sleep apnea occurs when the airway becomes obstructed (usually by the tongue), resulting in a lack of oxygen. The body rouses from sleep just enough to correct the obstruction. This can occur and interrupt deep sleep several times a night, causing the aforementioned problems as well as personality changes, high blood pressure or increased stomach acid reflux. If the problem persists, sleep apnea could also become a long-term factor in the development of heart disease, diabetes or other serious conditions.

Fortunately, we can do something about it. While some may require more invasive intervention, most cases of sleep apnea can be alleviated through continuous positive airway pressure (CPAP) therapy. In this therapy, an electrical pump supplies pressurized air into a face mask worn while sleeping. The increased air pressure helps to keep the airway open.

For some patients, however, CPAP can cause discomfort like claustrophobia, nasal congestion and dryness. If that’s a concern for you, you might want to consider an oral appliance provided by your dentist.

Customized to your own individual mouth contours, this appliance is usually a two-part hinged device that draws the lower jaw and the tongue forward to open the airway. Easily adjustable, these appliances are usually more comfortable to wear than a CPAP and don’t require electricity or have the attendant noise of a CPAP pump.

They do, however, have a few drawbacks: they can disrupt saliva flow, causing either too much or too little; they may result in some morning soreness; and they can stimulate unnecessary tooth or jaw movements. For most, though, these side effects are minor compared to a better night’s sleep.

If you suspect you may have some form of SRBD, you’ll need to have it confirmed through a physical examination and possibly sleep lab testing. If it is sleep apnea, your physician and dentist can work together to help you find the right therapy to regain the benefits of a good night’s sleep.

If you would like more information on sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

SleepApneaandBehavioralProblemsinChildrenHowYourDentistCanHelp

We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).

The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.

What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.

Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.

There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.

If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”

By Paul E Gray DMD
May 11, 2017
Category: Oral Health
Tags: sleep apnea   snoring  
DontLetSleepApneaRuinYourSleep-orYourHealth

Sleep apnea is more than an annoyance. This chronic condition not only interferes with your alertness during the day, it may also contribute long-term to serious issues like cardiovascular disease.

Sleep apnea occurs when your airway becomes temporarily blocked during sleep. Of the possible causes, one of the most common is the tongue, which as it relaxes may cover and block the back of the throat. This lowers the body's oxygen level, which in turn alerts the brain to wake you to clear the airway. You usually go immediately back to sleep, unaware you've wakened. This can happen several times a night.

Although older people are at higher risk, anyone can have sleep apnea, even children with enlarged tonsils or adenoids. If you or a loved one regularly experiences fatigue, brain fog, irritability or loud snoring, sleep apnea could be the culprit. You'll need a complete medical examination to properly diagnose it.

If you do indeed have sleep apnea, there are a number of ways to treat it depending on its severity. One prominent way is with a Continuous Positive Airway Pressure (CPAP) machine that produces a higher air pressure in the mouth to force the tongue forward and keep the airway open.

While CPAP is effective, the pump, hose and face mask you must wear may become uncomfortable while you sleep. We may, however, be able to supply you with a less cumbersome device: a custom-made oral appliance you wear while you sleep. Similar to a retainer, this appliance mechanically pulls and holds the lower jaw forward, which in turn moves the tongue away from the airway opening.

This oral appliance won't work with all forms of sleep apnea, so you'll need an examination to see if you're a candidate. With more advanced conditions, you may even need surgery to reshape the airway or remove soft tissue obstructions around the opening.

Whichever treatment is best for your situation, it's well worth reducing your sleep apnea. Not enduring these nightly incidences of airway blockage will help ensure you're getting a good night's sleep — and enjoying a higher quality of health and life.

If you would like more information on treating sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “If You Snore, You Must Read More!

By Paul E Gray DMD
October 27, 2016
Category: Oral Health
Tags: sleep apnea   snoring  
CustomOralAppliancesCouldHelpStopSleepApnea

For millions of Americans, sleep apnea is a serious health condition. Not only can it impair your day-to-day living, you might be more susceptible to high blood pressure, heart disease or stroke.

Sleep apnea occurs when you stop breathing for short periods while asleep. When blood oxygen drops too low, your body automatically wakes you to take a breath. This can disrupt your sleep several times a night. Chronic symptoms like drowsiness, irritability or headaches during the day, or indications you're a loud snorer, are all possible signs of sleep apnea.

Fortunately, we can treat sleep apnea. One way is continuous airway pressure therapy (CPAP), a pump device that supplies pressurized air through a mask to keep the airway open during sleep. Although CPAP is effective, some people find it uncomfortable to use.

There's a more comfortable option for sleep apnea caused by mouth structures like the tongue or tonsils obstructing the airway. It involves a custom-fitted oral appliance worn while you sleep that moves these structures out of the way.

Such appliances come in two basic types. One type fits over the upper and lower teeth and uses tiny metal hinges to move the lower jaw and tongue forward away from the airway. The other fits around and presses the tongue down like a tongue depressor to move it forward.

Before starting treatment, we need to first find out if you actually have sleep apnea and what's causing it (some cases may be more acute and require advanced treatments like jaw surgery). We'll need to perform medical and oral exams and take a history, and we'll likely refer you to a sleep medicine specialist for further testing.

If you have obstructive sleep apnea, a custom-fitted appliance could be a good solution. We'll create and adjust it according to your particular mouth and jaw contours for maximum comfort. Besides the appliance, you might also lose excess weight, adjust your sleep position, seek treatment for allergies, and quit smoking. All these could help reduce sleep apnea.

In any event, your first step is to find out if you have sleep apnea. From there we'll help you find the right treatment to improve your overall health and well being.

If you would like more information on treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

By Paul E Gray DMD
May 05, 2014
Category: Oral Health
Tags: sleep apnea   snoring  
FrequentlyAskedQuestionsAboutObstructiveSleepApnea

Q: What is sleep apnea, and how common is it?
A: Obstructive sleep apnea is a type of sleep-related breathing disorder (SRBD) in which the airflow to the lungs is restricted — or even cut off completely — during sleep. This condition is usually caused by the collapse of soft tissues in the back of the throat, and is potentially deadly. Sleep disorders, including SRBD, are thought to affect tens of millions of people in the United States. They have been blamed for several catastrophic accidents, including the 2014 Metro-North train crash in New York, and the 1989 Exxon Valdez oil spill in Alaska.

Q: How can I tell if I might have sleep apnea?
A: Everyone has trouble sleeping sometimes. But if you constantly snore, wake up feeling irritable, and experience sleepiness and diminished performance during the day, it may mean you suffer from this condition. After a while, SRBDs can trigger depression, confusion, memory loss, and other personality changes. Medical professionals note that a person with SRBD tends to be obese; to show enlargement of the tongue, tonsils, or uvula; to have nasal polyps or congestion; and possibly, to exhibit other signs.

Q: How is sleep apnea treated?
A: There are various treatments for sleep apnea, depending on the severity of the problem and its likely cause. These include oral appliance therapy (wearing a retainer-like device in the mouth at night); orthodontic treatment and/or oral surgery; and using a CPAP (constant positive airway pressure) machine to help facilitate breathing at night. Each has advantages and disadvantages that should be discussed with a healthcare provider who has experience in the area of sleep disorders.

Q: What does all this have to do with dentistry?
A: Dentists are, of course, extremely familiar with the anatomy of the mouth. We sometimes notice signs of potential sleep problems before they become life-threatening. What’s more, we may be able to successfully treat the problem with oral appliance therapy. We can properly fabricate, fit and adjust an oral device that helps keep your airway open at night. Because it is inexpensive, removable, and relatively comfortable, an oral appliance may be a good remedy to try before moving on to more complex treatments, such as a CPAP machine or surgery. So if you think you might have SRBD, maybe it’s time to make an appointment and talk to us about it.



Dentist - Ashland
929 29th Street
Ashland, KY 41101

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