Obstructive Sleep Apnea

Do you suffer from Obstructive Sleep Apnea?

The most severe type of sleep apnea, Obstructive Sleep Apnea (OSA) is a sleep disorder that occurs when the airway is blocked during sleep – often by the tongue or soft tissue in the back of the throat. This can mean sufferers of OSA can stop breathing many times a night causing a lack of oxygen to their brain and a buildup of CO2.

As the CO2 builds up in the brain, the brain kicks the body into action by causing an abrupt gasping of breath in an attempt to re-oxygenate the brain. This gasping of breath disrupts REM (Rapid Eye Movement) sleep that is needed to fully recover and energize each night.

This lack of restful REM sleep will then cause sufferers to wake up feeling drowsy, sluggish and sleepy during the day. Intellectual ability and memory can also be reduced. If left untreated, OSA can lead to a persistent daily fog in thinking and functioning  as well as pulmonary and cardiovascular pathology, trouble at work, depression, and can even cause an early death.

Treatment

Mild cases of OSA can be treated with a few lifestyle changes, including losing weight, avoiding alcohol, and quitting smoking. Mild to moderate OSA can be treated with an oral dental appliance that keeps the airway open during sleep.  More severe cases may need to be treated with surgery or an airflow machine known as Continuous Positive Air Pressure or CPAP.  Losing excess weight may be one of the best ways to reduce advanced sleep apnea, but more aggressive treatments are needed for life threatening OSA.

My Personal Experience

On a personal note, I have mild sleep apnea with the accompanying snoring. I was amazed 9 years ago when I started wearing a sleep apnea dental appliance that keeps the lower jaw positioned a little bit forward. This in turn keeps the soft tissue from closing off my airway, reduces the snoring and allows me to get back into REM sleep every night. I found that after just one to two weeks of  wearing my appliance, I started to dream again which I had not recalled doing for years. I was getting enough REM sleep to be fully rested and felt refreshed in the morning and less drowsy during the day.

Diagnosis

Sleep apnea and especially moderate to severe OSA is most commonly diagnosed by a sleep specialist, who observes the patient in an overnight sleep study. In our area, the University of Pennsylvania has a very good overnight sleep study lab.

Primary care physicians and specializing dentists can evaluate your symptoms and health history and determine if you should see a sleep specialist. If you think you may have sleep apnea, consider keeping a sleep diary to bring to your doctor.

Risk factors for OSA include:

  • Obesity
  • Large neck (greater than 16-17 inches in men and 14.5 inches in women)
  • Retrognathia or micrognathia
  • Crowded airway
  • Enlarged tonsils
  • High-arched hard palate
  • Nasal deformities/sleep deprivation

Consult a physician if you have a history of:

  • Disruptive snoring
  • Witnessed apnea or snorts
  • Gasping/choking while sleeping
  • Excessive daytime sleepiness
  • Difficulty with concentration or short-term memory loss
  • Excessive night urination
  • Difficulty with sleep maintenance
  • Restless/unrefreshing sleep
  • Decreased libido
  • Morning headaches
  • Irritability

If you think you could have sleep apnea or if you have been diagnosed with OSA, Briglia Dental Group would be happy to evaluate if a dental appliance is right for you. Our goal is to get you the treatment you need. If we feel you would not benefit from a dental appliance, we will help you find the appropriate studies or treatment outside of our office.

Tests

Still not sure if you have OSA? Use these quick tests to determined the likeliness that you may be suffering from OSA.

Epworth Sleepiness Scale

You can use the following Epworth Sleepiness Scale– a medical exam used to measure excessive daytime sleepiness, which correlates with the severity of sleep apnea in patients.

Use the following scale to choose the most appropriate number for each situation:
0 = would never doze or sleep.
1 = slight chance of dozing or sleeping
2 = moderate chance of dozing or sleeping
3 = high chance of dozing or sleeping

Epworth

How to interpret your results:

A score of 10 or more is considered Sleepy. A score of 18 or more is Very Sleepy.

 

The STOP-BANG questionnaire

This highly accurate questionnaire is quick and easy to complete, while covering a range of factors that effect patients with OSA.

STOP
S- Snoring
Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?
Yes/No

T- Tired
Do you often feel tired, fatigued, or sleepy during the daytime?
Yes/No

O- Observed
Has anyone observed you stop breathing during your sleep?
Yes/No

P- Pressure
Do you have or are being treated for high blood pressure?
Yes/No

BANG
B- Body Mass Index
BMI > 35?
To calculate your BMI click here.
Yes/No

A- Age
Age > 50 years?
Yes/No

N- Neck circumference
Male > 17in.         Female > 14.5 in.
Yes/No

G- Gender
Gender male?
Yes/No

How to interpret your results:

If you answered 3 or more questions “Yes” you have a high risk of OSA.

If you answered 3 or more questions “No” you have a low risk of OSA.

If you answered 5-8 questions “Yes” there is a high probability that you have moderate to severe OSA.

If you answered all 8 questions “Yes” is very likely that you have severe OSA.

 Video Resources

Oral Appliance for OSA

Personal OSA Story

Shaq attacks sleep apnea

Patient Info

Oral Appliance for Snoring and Sleep Apnea

45 Minute Sleep Apnea Lecture by Dr. Mark Wallace

Testimonials

Overall, a very comforting experience for a patient very anxious over going to see a dentist.
Jim C.

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