Posts for tag: sleep apnea
We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).
The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.
What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.
Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.
There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.
If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”
Daily fatigue or complaints of your snoring from family have led you to see your doctor about the problem. After an exam and a test session in a sleep lab, your problem now has a name — obstructive sleep apnea.
This common sleep-related breathing disorder (SRBD) occurs when the soft tissues in the back of the throat over-relax during sleep. The relaxed tissues obstruct air flow to the trachea (windpipe) and cause “apnea,” where you cease to breathe. The lack of oxygen causes you to wake, even for a micro-second, to begin breathing again. This may occur multiple times throughout the night, diminishing the quality of your sleep and leading not only to drowsiness and daily fatigue but also contribute to cardiovascular disease or other systemic conditions.
The most effective treatment for sleep apnea is the use of a Continuous Positive Airway Pressure (CPAP) machine while you sleep. The machine delivers pressurized air to a face mask you wear while you sleep; the additional pressure keeps the airway open. However, a CPAP machine does have a few disadvantages, including discomfort while attached to the machine, nasal congestion and dryness, or claustrophobia. These effects can be so pronounced for some patients, they’re unable to adjust themselves to the machine.
If you have mild to moderate sleep apnea, there may be an alternative — a custom-fitted oral appliance we manufacture for you to wear in your mouth while you sleep. The appliance pulls the lower jaw forward resulting in a wider opening of the airway. In addition to being less cumbersome than a CPAP mask, an oral appliance is easier to wear, compact in size for easy travel and doesn’t require electricity.
While an oral appliance is an effective alternative to a CPAP machine for many patients, it does have a few disadvantages including problems with saliva flow (too much or too little), muscle or teeth soreness and minor tooth or jaw movement. Still, an oral appliance might be the right solution to relieve your sleep apnea over the long-term.
If you would like more information on treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Sleep Apnea FAQs.”