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. 

Women with Obstructive Sleep Apnea

The cause of death of a famous movie star, Carrie Fisher, was sleep apnea and “other undetermined factors” in December 2016.  She was 60 years old.  Typical obstructive sleep apnea patients are usually men who are overweight and snore loudly with choking or gasping sounds at night.  While obstructive sleep apnea patients are common in men, many women suffer from OSA and go undiagnosed and misdiagnosed.  Obstructive sleep apnea patients come in all shapes, size, genders, races and some have atypical symptoms.

These are some of the reasons women with OSA who are undiagnosed and misdiagnosed:

·       Women present atypical symptoms

·       Men are less likely to complain about their wives snoring

·       Doctors are less likely to ask women about sleep related symptoms

According to a study at The University of Chicago, “Sleep apnea presents itself differently for women, which may lead them to go undiagnosed.”                                                                              Some of the atypical (not classic) symptoms in women with OSA:

·       Insomnia

·       Restlessness in legs

·       Tired or fatigue

·       Depression

·       Daytime sleepiness

·       Morning headaches

·       Fibromyalgia

·       Concentration or memory difficulties

·       Frequent urination at night

·       Heartburn at night

·       Night sweats

·       Lack of energy during day

·       Dry mouth on awakening

·       A feeling of being overwhelmed

·       Uncontrollable high blood pressure

·       Obesity

The classic symptoms in men with OSA are snoring, gasping for air during sleep, drowsiness and sleepiness during the day, at work, or while driving.

*Note:  Not everyone who snores has sleep apnea.                                                                                     *Note:  Not everyone who has sleep apnea snores.

Women & Sleep Apnea Toolkit: raises awareness of sleep-disordered breathing (OSA) in women

·       November 29, 2017, the Society for Women’s Health Research released the toolkit

·       Purpose of toolkit: provide women and their health care providers with gender specific information about obstructive sleep apnea and sleep disordered breathing

·       Patient page asks women about their daytime and night time symptoms

Daytime symptoms of OSA: feeling depressed, anxious, irritable, impatient, tired or drained.  Women with OSA may notice that they struggle to stay awake and may fall asleep at the wrong time or place.  Cognitive difficulties, such as forgetfulness, foggy or fuzzy thinking

Nighttime symptoms OSA:  snoring is not the only symptom with OSA.  Women have difficulty falling asleep, frequent awakenings and restless sleep

·       Toolkit guides the women and their health care providers to improve diagnosis, treatment and management of sleep disorders

Some treatment options for women with OSA:

·       CPAP (Continuous Positive Airway Pressure): In 2006, the American Academy of Sleep Medicine (AASM) reviewed all available evidence for CPAP and concluded that treatment was effective for patient s with moderate to severe OSA

·       Oral Appliance Therapy (OAT) is a treatment option for patients with mild to moderate OSA

·       Life style changes:  lose weight

Obstructive sleep apnea is a serious medical problem for men and women.  If you are experiencing any of the classic or atypical (not classic) symptoms of sleep apnea, contact Glendora dentist,                   

 Dr. Anna Lee.  She is a trained dentist in sleep apnea who can assist you with treatment.  For more information, please visit our sleep website at www.glendorasleep.com  or call our office at 626-335-5114 for a FREE sleep apnea Consultation.

Sleep Apnea

Sleep apnea is a serious sleep disorder where breathing repeatedly stops and starts while the patient is asleep.  Patient may not be aware of these short breathing pauses that occur hundreds of times a night. The sleep deprivation (can’t fall asleep or can’t stay asleep) caused by sleep apnea can result in daytime sleepiness, slow reflexes, poor concentration, and increased risk of driving accidents.  Sleep apnea is also linked to some serious medical problems, including heart disease, stroke, liver problems, and diabetes.

Major warning signs of Sleep Apnea

·       Loud and chronic snoring almost every night

·       Choking, snorting, or gasping during sleep

·       Pauses in breathing

·       Waking up at night feeling short of breath

·       Daytime sleepiness and fatigue

                                         Other warning signs of Sleep Apnea

·       Insomnia or nighttime awakenings; restless sleep

·       Waking up with a dry mouth or sore throat

·       Going to the bathroom frequently during the night

·       Forgetfulness and difficulty concentrating

·       Moody, irritable, depress

·       Morning headaches

*If you experience any of these symptoms, contact Glendora dentist, Dr. Anna Lee, for a free consultation for Sleep Apnea. Call for an appointment at 626-335-5114 or email: drannalee1@gmail.com.

                                           Sleep Apnea Treatment Options

Mild to Moderate Sleep Apnea

·       Lose weight

·       Quit smoking

·       Avoid alcohol, sleeping pills, sedatives

·       Avoid caffeine and heavy meals with 2 hours of going to bed

·       Exercise regularly, maintain regular sleep hours

·       Oral Appliance Therapy (OAT)-dental device that fits inside the mouth, like an athletic mouth guard. OAT is a first line treatment for patients diagnosed with mild to moderate sleep apnea. OAT is comfortable, easy to wear, quiet, portable and convenient for travel.

Moderate to Severe Sleep Apnea

·       Continuous Positive Airflow Pressure (CPAP)-machine is used with a variety of breathing masks that cover the nose and mouth, providing a constant stream of air that keep the breathing passages open while sleeping.  CPAP machines are being updated and improved; they are lighter, quieter and more comfortable.

·       Sleep Apnea Implants-one of the newest treatments; involves the insertion of a pacemaker system that stimulates muscle to keep airways open for breathing during sleep.

·       Surgery-increase the size of the airway; risks of complications and infections.

Glendora dentist, Dr. Anna Lee, is a trained dentist in Sleep Apnea who can assist you with treatment.    Dr. Anna Lee performs an airway assessment and Sleep Apnea evaluation.  Dr. Anna Lee also conducts a full evaluation of your teeth, mouth and temporomandibular joint (TMJ) to ensure that your teeth and jaw structure are healthy enough to wear an oral appliance.  If you have any questions, please call for a free consultation at 626-335-5114 or visit our sleep website at www.glendorasleep.com

Sleep Apnea

Sleep apnea is a serious sleep disorder where breathing repeatedly stops and starts while the patient is asleep.  Patient may not be aware of these short breathing pauses that occur hundreds of times a night. The sleep deprivation (can’t fall asleep or can’t stay asleep) caused by sleep apnea can result in daytime sleepiness, slow reflexes, poor concentration, and increased risk of driving accidents.  Sleep apnea is also linked to some serious medical problems, including heart disease, stroke, liver problems, and diabetes.

Major warning signs of Sleep Apnea

·       Loud and chronic snoring almost every night

·       Choking, snorting, or gasping during sleep

·       Pauses in breathing

·       Waking up at night feeling short of breath

·       Daytime sleepiness and fatigue

                                      

   Other warning signs of Sleep Apnea

·       Insomnia or nighttime awakenings; restless sleep

·       Waking up with a dry mouth or sore throat

·       Going to the bathroom frequently during the night

·       Forgetfulness and difficulty concentrating

·       Moody, irritable, depress

·       Morning headaches

*If you experience any of these symptoms, contact Glendora dentist, Dr. Anna Lee, for a free consultation for Sleep Apnea. Call for an appointment at 626-335-5114 or email: drannalee1@gmail.com.