Obstructive Sleep Apnea

                

                                    

  I have attended several sleep apnea seminars in the past, but the Dr. Radar seminar that I attended in August 2018 was the most informative and practical seminar compared to others.  There was plenty of information that kept me awake throughout the entire seminar.   I want to share the information that I have learned about sleep apnea with my patients.

What is obstructive sleep apnea (OSA)?

Sleep apnea is a serious medical condition in which breathing repeatedly stops and starts while the patient is asleep. Obstructive sleep apnea (OSA) is the most common sleep disorder.  It is estimated that 22 million Americans suffer from OSA, with 80 percent of the cases of moderate and severe OSA undiagnosed.  OSA can affect people of any age, including men, women and children.  OSA is a treatable medical condition.  There are treatment options for OSA which includes Positive Airway Pressure Devices (CPAP), oral appliance therapy (OAT) and surgery.

What are the signs and symptoms of OSA?

One of the most common signs of OSA is loud and chronic, ongoing snoring.  Pauses may occur in the snoring; choking or gasping may follow the pauses.  Other signs and symptoms:

·       Excessive day time sleepiness, at work or while driving

·       Impaired cognition, memory or learning problems, not able to concentrate

·       Depression

·       Irritability/mood Disorders

How does sleep apnea affect your health?

Harvard Medial, May 2011:  Study by the American Academy of Sleep Medicine (AASM) found that patients untreated for moderate to severe sleep apnea had a decrease life expectancy of 8-11 years as opposed to patients that were treated for the same condition.

·       Higher risk of stroke: 65% of stroke patients have sleep apnea

·       Higher risk of heart diseases: 40-83% patients with hypertension have sleep apnea. Studies show sleep apnea increase the heart rate and blood pressure

·       Higher risk of diabetes: 48% of type 2 diabetes patients have sleep apnea

*Patients with OSA have 23x higher risk of Heart Attack compared to a healthy patient.                                      

How do people get diagnosed with sleep apnea?

·       ONLY a physician can diagnose OSA

·       Physicians typically do not look in patients’ mouths.  Physicians do not recognize the common oral facial signs and symptoms of OSA

·       DENTTISTS have a right to SCREEN for OSA and treat with Oral Appliance Therapy (OAT) per Dental Practice Act

Dental Practice Act (Business and Professions Code Section 1625-1636.6):                                                            

Dentistry is the diagnosis or treatment, by surgery or other method, of diseases and lesions and the correction of malpositions of the human teeth, alveolar process, gums, jaws, or associated structures; and such diagnosis or treatment may include all necessary related as the procedures as well use of drugs, anesthetic agents, and physical evaluation.

Sleep Tests

Sleep test is needed for the physician to diagnose the sleep disorder. Sleep test can be performed at home or hospital sleep lab.

·       Home Sleep Test (HST)-patient is provided with simplified tests to be used at home to diagnose sleep apnea.  These tests involved measuring the heart rate, blood oxygen level, airflow and breathing patterns while the patient is sleep.  It is usually 2 nights of testing.  The test result is read and diagnosed by Board Certified Sleep Physician.

·       Hospital Sleep Lab-test is performed in the hospital sleep lab and is hooked up to equipment that monitors the heart, lung and brain activity and breathing patterns while the patient is sleep.

What are the options of treatment?

·       Positive Airway Pressure Devices (CPAP)-the most widely used treatment for Moderate and Severe Sleep Apnea. They are endorsed by the AASM.  It is the most common and reliable method of treating sleep apnea, but some people find it cumbersome and uncomfortable.  The problem with CPAP is patient compliance; estimates about 24-40% compliance. 

·       Oral Appliance Therapy (OAT)-best for Mild to Moderate Sleep Apnea.  AASM recommends OAT for patients with severe OAT who are not unable to tolerate wearing CPAP devices.

*Combination Therapy-wearing CPAP and OAT together to help reduce the pressure on the CPAP machine, making it more comfortable to use.

·       Surgery-an option for patients after other treatments have failed.  The goal of the surgery is to enlarge the airway through the nose or throat that may be causing the blocking of the upper airway passages.

Dr. Anna Lee is a dentist trained in sleep apnea. She conducts a full evaluation of your teeth, mouth and temporomandibular joint (TMJ) and screen for sleep apnea.  Sleep test is necessary for the physician to diagnose the sleep disorder.  Dr. Anna Lee can then help you with different option treatments of the sleep disorder.  Please visit our sleep website at www.glendorasleep.com or call our office for a free sleep consultation at 626-335-5114.