Download what is obstructive sleep apnea?

FIRST PERSON
By Dr. John Pawlowicz III, LVI Clinical Instructor
WHAT IS OBSTRUCTIVE
SLEEP APNEA?
This article is a brief attempt to bring to
light the seriousness of undiagnosed and
untreated obstructive sleep apnea (OSA) in
our region. As published in the Institute of
Medicine (April 2006), 50 million to 70
million Americans suffer from sleep disorders.
As a neuromuscular dentist, I play a role in
providing options for participating in
multispecialty diagnosis and treatment
options for OSA.
Symptoms of Obstructive
Sleep Apnea:
• Loud snoring
• Fatigue and excessive daytime sleepiness
• Choking or gasping for breath
while sleeping
• Depression and excessive irritability
• Reduced resistance to infection
Did you know that 90 percent of stroke
victims also suffer from OSA? People with
OSA are four times more likely to have a heart
attack. If you have OSA, then you are twice as
likely to die in your sleep and seven times
more likely to have a motor vehicle accident.
Snoring and OSA are common problems that
can affect your sleep and your health and have
a significant impact on your quality of life.
Your airway can move through several
stages of airway obstruction during the night.
Snoring is often a cardinal symptom of OSA,
caused by changes in your upper airway while
sleeping. What typically happens while you
are sleeping is that the muscles in the upper
body completely relax. Your airway may
narrow, limiting air flow as you breathe. The
soft tissue vibrates (snoring) or it may
completely collapse, causing breathing to stop.
Collapsing of the soft tissue is called
obstructive sleep apnea, and may last for 10
seconds or more. When the upper airway
collapses, the action of the diaphragm to draw
air into the lungs becomes as difficult as
pulling air through a small, wet straw. Most
patients with this problem have no difficulty
with breathing while awake, but develop
prolonged periods of partial airway
obstruction and shorter episodes of complete
obstruction when they fall asleep.
Not achieving a restful and full night's sleep
due to OSA or sleeping next to a partner with
OSA has a dangerous effect. Achieving only
six hours of sleep (two hours of sleep
deprivation) has been shown to be the
equivalent of drinking three-and-a-half beers
(blood alcohol content of 0.045 percent).
Achieving only four hours of sleep is the
equivalent of five-and-a-half beers (blood
alcohol content of 0.095 percent). A blood
alcohol level of 0.08 percent is legally drunk.
A common complaint of a person suffering
from OSA is waking with a dry mouth and/or
a scratchy throat since the person cannot
adequately breathe during stages of sleep.
They repeatedly rouse themselves to lighter
stages of sleep just to breathe and as a result,
don’t feel rested upon waking. Falling asleep
while driving an automobile; while at work or
while relaxing is a common occurrence among
those who suffer from OSA. In fact, daytime
sleepiness is the most consistent sign of OSA.
Morning headaches are also common as a
result of the low oxygen uptake due to poor
breathing. Headache is one of the most
common afflictions. It ranks very high on the
scale of primary complaints resulting in a visit
to a medical doctor. It is a major source of
both lost time and productivity in the work
place and a leading cause of medical
diagnostic procedures.
Daytime sleepiness that results in drowsy
driving is a very important safety
consideration. Approximately 31 percent of all
drivers have fallen asleep at the wheel at least
once. There are 100,000 accidents each year
caused by people asleep at the wheel. These
“People with OSA are four times more likely to have a heart attack.
If you have OSA, then you are twice as likely to die in your sleep and
seven times more likely to have a motor vehicle accident.”
accidents cost the American taxpayer $30
billion each year, and cause 1,500 deaths. The
statistics are even more shocking for longdistance truck drivers: 47 percent having fallen
asleep at the wheel at least once. All told, 100
million people drive drowsy each year.
Another side effect of undiagnosed OSA
can be seen in children suffering from
compromised airways. Behavior changes are
typical in under-oxygenated and sleepdeprived children. This can range from
depression and agitation to behavior
difficulties and hyperactivity. Intellectual
impairment is commonly noted in these
children by parents and teachers. A younger
child may go through a developmental delay
as a result of OSA and the accompanying
under-oxygenation. Common complaints in
children suffering from undiagnosed and
untreated OSA are frequent upper airway
infections, earaches, nighttime mouth
breathing, snoring, restless sleep, night terrors
and headaches.
So what can be done to treat OSA? It is
essential to have a comprehensive evaluation
performed by a properly trained and qualified
dentist or doctor. The diagnosis and
subsequent treatment protocol for OSA is a
medical team approach involving physicians,
dentists and often surgeons.
Treatment options for OSA:
• Lifestyle changes such as weight loss, overthe-counter medications (nasal steroids and
sleep aids) with improved sleep hygiene
first step in opening a good
airway.
• OAT (Oral Appliance
Therapy) or MAS (Mandibular
Advancement Splint): a
custom-made, effective bite
guard that moves a person's
lower jaw forward. The slightly
forward movement tightens the
soft tissue and muscles of the
upper airway, preventing
obstruction and aiding in
airflow while a person sleeps.
Caption
“Common complaints in children suffering from
undiagnosed and untreated OSA are frequent upper
airway infections, earaches, nighttime mouth breathing,
snoring, restless sleep, night terrors and headaches.”
For persons wearing a CPAP, it enhances the
flow of air and often allows for a decrease in
the airflow pressure of the CPAP.
The MAS is a highly effective and
noninvasive solution for the majority of
patients suffering from OSA. This therapy has
exceptional levels of patient acceptance and
compliance as well as treatment efficacy borne
out in a large body of clinical research.
The dangers of OSA are real and the
diagnosis and treatment of OSA is a
multidisciplinary task. As properly trained and
qualified neuromuscular dentists, we are
happy to evaluate your needs and be part of
your treatment solution. • CPAP (Continuous Positive Airway
Pressure): a mask and tube that covers the
nose, worn while sleeping to aid the flow
of oxygen
• Surgery: There are several different
procedures that have varying degrees of
success. The intention of surgery is to create
a more open airway so that obstructions are
less likely to occur. Surgery in adults can be
quite invasive and sometimes worsens the
apnea. In children, the early removal of large,
impinging tonsillar and adenoid tissue is
much less invasive and a routinely successful
Complete Family and Cosmetic Dentistry for Adults and Children Since 1964
Dr. John Pawlowicz III, Clinical and Featured Instructor at LVI Global
516 Hansen Ave., Lyndora, Pa. 16045
To schedule an appointment or for more information,
call 724-287-4000 or visit www.wowsmilenow.com
www.leadingdentist.com.
The information in First Person advertisements is the responsibility of the advertiser.