Sleep Apnea Disorder

Sleep apnea can be a real problem for many people. While many people think that it is just a problem with snoring, many do not realize that it actually may be slowly killing them. You may not know it either.


Although the terms sleep apnea really does not sound very serious, the truth is that more than 38,000 people die every year from complications caused by it. This means the sooner you take care of it the better, whether you have it or your bed partner. Not only that, but when treated, it means that both of you are going to sleep better and feel refreshed during the day.


The Cause of Sleep Apnea


As you sleep, the muscles in your throat relax. This lets your throat muscles, and possibly your tongue, sink down into your throat, reducing and possibly even closing your airways. This will usually cause snoring, and sometimes your breathing even stops completely many times during the night.


You may or may not wake up when this happens, which is why you may not even be aware of your sleep problems. Your bed partner, however, is likely to be very aware of it and may have told you that your breathing, or snoring, is erratic. It has probably become a source of concern to him or her.


The Symptoms


One of the main symptoms of sleep apnea is that the individual with it will rarely get a good night's sleep that refreshes. This is because the broken sleep, which the body reacts to, but may not actually wake the person, prevents them from entering into restful REM sleep.


It is this sleep level that is necessary for healing and refreshing of the body and the mind. A lack of sufficient REM sleep will leave you tired all day and less able to concentrate. The tiredness will still be there even if you were able to get eight hours of sleep.


There are a wide range of other symptoms that you may be experiencing.


Do you have:


  • A headache in the morning

  • Waking suddenly with shortness of breath

  • Loud snoring

  • Waking in the morning with a sore throat or dry mouth

  • Difficulty in staying asleep

  • Someone telling you your breathing stops for short periods while sleeping

  • Being forgetful

  • Mood changes


Individuals with sleep apnea are often totally unaware of their breathing problems. They may actually think that they are sleeping well, even though they are being briefly waking to breathe. This occurrence may be so short that they do not remember it at all.


Another symptom to be aware of is having to frequently urinate at night, called nocturia. While the average person may get up to use the bathroom once or twice a night, someone with sleep apnea may do so six or more times. After being treated for it, this problem often disappears.


Snoring is another symptom, but not all snoring indicates that you have sleep apnea. Snoring is not normal, and its presence indicates that there is a breathing problem. It is only associated with sleep apnea when there are also periods of not breathing at the same time. Louder snoring is often connected with sleep apnea.


Problems caused by Lack of Meaningful Sleep


Constant breathing is important to the human body. With sleep apnea, breathing may actually stop for several seconds to over a minute each time, and this can occur as many as hundreds of times in a single night. The slowed breathing causes there to be less oxygen flowing through the body. After a while this will cause various health problems in addition to the constant tiredness. This may include:


  • High blood pressure

  • Diabetes

  • Depression

  • Heart disease

  • Headaches

  • Problems with memory

  • Impotence

  • Irregular heart beats

  • Stroke


Because of the lack of quality sleep, the individual is apt to experience problems in areas where they are expected to perform. This may include the workplace, school, may result in vehicle accidents, and children may underachieve.


There is a particular danger if a person with sleep apnea drives. They could easily fall asleep and endanger others. Some states have laws in place to restrict driving privileges of people with sleep disorders, and other states are in the process of implementing them.


Another problem caused by sleep apnea concerns relationships. The breathing problems caused by it, and the snoring, are going to keep the other bed partner awake – which means he or she does not sleep well, either. This common lack of sleep can result in two people being more irritable, increasing the tension in the home. It is not unusual for partners to sleep in another room, or on the floor to get a better night's sleep.


The Risk Factors


Sleep apnea is not limited to any age group. Although it is most frequently seen in men over 40, children can also be affected by it. Other risk factors include:


  • Being overweight

  • Nasal obstruction as a result of allergies or sinus

  • Having a large tongue or tonsils, or a small jaw bone

  • Having a large neck

  • Family history

  • GERD

  • Tobacco and alcohol

  • Some medications

  • African-American and Hispanic men.


Types of Sleep Apnea


There are three types of sleep apnea. Each one requires treatment, but may occur in different degrees of severity.


  • Obstructive sleep apnea (OSA) This form causes the breathing to stop multiple times a night due to blockage of the throat caused by relaxed throat muscles or the tongue. It is the most common type.


  • Central sleep apnea (CSA) This form is caused as a result of the brain not sending the right signals to the muscles that are responsible for breathing. It may be caused by other health problems such as liver or heart problems. The use of opiates can sometimes cause this problem.


  • Complex sleep apnea syndrome This type is a combination of the other two. It is believed to be about 15 percent of the sleep apnea cases.


Prevalence of Sleep Apnea


It is believed by the Sleep Foundation that as many as 22 million Americans suffer from sleep apnea. Rates among children cannot be accurately determined due to insufficient monitoring and reporting.


Men are twice as likely to develop sleep apnea (OSA) as women. Women are more likely to develop it if they are obese and after they reach menopause. Because Americans continue to gain weight, the number of people with the disorder is increasing. Obese people increase their risk of sleep apnea by four times than what a person of normal weight would experience, due to the accumulation of fat in the throat.


When to Seek Treatment


You should seek treatment for sleep apnea if you or your partner observes some of the following symptoms.


  • Irregular breathing, with pauses, while you sleep.

  • Waking up from sleep and gasping for air, choking, or having shortness of breath.

  • Being excessively drowsy during the day and falling asleep while working, watching TV, or driving.

  • Loud snoring that wakes you and others.




Before any treatment can be initiated, it is necessary to be tested for it. This will enable the doctor to understand which type you have, and then treatment will be based on the type.


Testing for sleep apnea involves a sleep test. This means being hooked up for ??l?s?mn?gr??h? (??G), and to a monitor and then going to sleep for a full night. There will be several electrodes hooked up in order to measure your heart rate, breathing, pulse rate, blood oxygen levels, sleep patterns, and positions. You can get tested at a sleep lab, where you are apt to receive more thorough results.


It may be possible to be given a device to record your breathing at home. Different devices will test for different things, so the device will need to be recommended by the doctor. If you are believed to have more severe apnea or other sleep disorders, or if you have certain health conditions, such as congestive heart failure, neuromuscular diseases, etc., you should go to a lab. In some cases, more than one test may need to be given.


Health insurance will often pay for a sleep test when it is prescribed by a doctor. The test will also need to be given by a qualified and experienced sleep specialist.


In addition to being diagnosed for sleep apnea, a diagnosis will also determine the severity of it. You will be placed in a category of mild, moderate, or severe depending on the number of interrupted breathing episodes that occur in an hour.


  • Mild OSA: This person experiences 5 to 14 episodes of interrupted breathing within an hour.


  • Moderate OSA: This person experiences 15 to 30 episodes of interrupted breathing within an hour.


  • Severe OSA: This person experiences 30 or more episodes of interrupted breathing within an hour.




After receiving a diagnosis of sleep apnea, and a category, there are several options that are available to help treat this problem. They may include:


  • Continuous Positive Airway Pressure (CPAP) machine

The CPAP machine is one of the most common methods of treatment for sleep apnea. It supplies pressurized air through a hose to a mask that is worn while the patient sleeps. The mask may fit over the nose or mouth, or both. It is attached to the head with straps so that it will not fall off during sleep.


The pressurized air helps to keep the airways open by keeping the relaxed muscles open. This enables the patient to constantly receive a supply of air, as well as providing uninterrupted sleep due to breathing problems. It also lets patients get a better night's sleep and feel more refreshed during the day.


Other types of CPAP machines are also being developed. This includes machines that change the air pressure automatically, such as the VPAP (variable positive airway pressure) machine, and the APAP (automatic positive airway pressure) machine.


  • Special Pillows

Along with a CPAP machine, special pillows are also recommended. These are designed to enable you to sleep more comfortably on your side, and to help keep the mask on while you sleep. Sleeping on your back is more likely to cause snoring – and breathing problems. A higher pressure is also likely to be necessary.


  • Medications

A number of medications are often used to help treat sleep apnea. They help with being awake and alert during the day, but do little to treat the actual cause. They are often used along with other treatments.


  • Surgical Options

If the CPAP device does not work for some patients, surgery may be recommended. This would be used to remove, make more rigid, or to reposition some of the soft tissue that is closing the airways. It may involve the soft palate, the tonsils, uvula, adenoids, upper and lower jaw, and the tongue. If obesity is involved, surgery may be used to help with weight loss.


Lifestyle Changes That May Help


Breathing problems may also be caused, or increased, due to some of your lifestyle choices. Changing one or more of these may help to provide relief from sleeping and breathing problems. Following these will also help you to live longer. Some of the lifestyle changes that may help include:


  • Weight Loss

If you are obese, or weigh more than is healthy, you will want to lose some weight. This may surprise some people, but once you get down to a healthy weight, you will notice a difference in the sleep apnea. You may even be able to eliminate the problem completely.


  • Exercise

Getting into a regular exercise routine has helped many people reduce the symptoms of insomnia and sleep apnea even when no weight is lost. Aim for 30 or more minutes a day of moderate exercise on at least five days a week.


  • Eliminate Alcohol and Some Medications

Substances such as alcohol, sleeping pills, and various tranquilizers, tend to cause the muscles in your throat to relax. If you suspect the problem may be caused by a medication, talk to your doctor about changing it.


  • Open Nasal Passages

If you have a problem with allergies, you need to help your nasal passages stay open. You can do this by getting a prescription for an antihistamine or nasal decongestant to help.


  • Quit Smoking

This habit makes sleep apnea worse. It is also not good for the rest of your body, too, as well as your teeth.


  • Do Not Sleep on Your Back

When sleeping on your back, it makes it easier for the soft tissue in your throat to collapse your airway. This increases the likelihood of snoring and having breathing problems. It is better to sleep on your side or stomach.


Dental Devices


Many people who have tried CPAP machines to get relief from sleep apnea are not happy with the results. They find that the masks are often uncomfortable or fall off during sleep, rendering them ineffective. Others have difficulty getting accustomed to the pressurized air. These devices have helped many people.


Types of Dental Devices


Another option that many people find very satisfying is dental devices, largely because they are much more comfortable than CPAP masks. They are also called a dental appliance, dental sleep device, or an oral appliance. They are molded plastic forms that fit in your mouth and keep your airways open. They also prevent grinding and clenching your teeth. There are three types of devices:


Mandibular Advancement Devices (MAD) This type of dental device is the most common. It keeps the airway open by moving the lower jaw forward while you sleep. Because your tongue is attached to it, this ensures that it stays out of the way, too.


Tongue Retaining Devices (TRD) This dental mouthpiece works just on the tongue. It keeps the tongue pulled forward so that it will not block your airway. It does not move your jaw at all, but your tongue is attached to your lower jaw.


Combination CPAP/Dental Sleep Device Therapy One strong reason that many people do not like their CPAP machine is because the air pressure is higher than normal. This dental sleep device is made to work along with your CPAP machine, letting it attach directly to the dental device. When used together, you can use a lower pressure, making it more comfortable for you.


If you are tired of not getting the sleep you need to keep you awake in the day, or would like to try an alternative to your CPAP machine, an oral appliance for sleep apnea is just what you need. It will enable you to stop snoring and breathe better, letting you and your bed partner wake refreshed. Many people find it helps after only a single night.


Oral appliances are custom-made by a dentist to provide you with the best relief. Personal customizing makes them more comfortable and sure to help you.


Where to Get Tested


A custom-made dental appliance for sleep apnea must be made to help your particular type and severity of sleep apnea. By contacting Dr. Kumar Vadivel, DDS, FDS RCS, MS, is a Board Certified Periodontist, you can be on your way to getting tested for sleep apnea and toward getting better sleep. He has two offices, one located in the Carrollton, TX area, and the other in the Grapevine, TX area. You can contact his office today at (817) 756-8578 for more information about sleep apnea treatment or to set up a consultation.