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 Snoring and Sleep Apnea 
 
The following is one in an ongoing series of columns entitled Integrative Dentistry by . View all columns in series
Approximately 40 million Americans have some sort of on-going or chronic sleep disorder causing snoring and another 20 to 30 million have various intermittent sleep apnea. When there is an obstruction to the airway during breathing, such as an enlarged tongue, nasal blockage, enlarged tonsils or uvula (the soft tissue hanging at the back of the soft palate at the entrance of the throat), snoring results. As the air passes rapidly through the constricted air passages, loose tissues in the airway vibrate, causing the snoring sound.

Snoring appears to be more common under certain types of conditions. It’s more common in people that are overweight or have excess fat around the neck, use of alcohol or drugs, 60% men and 40% women snore with the likelihood of increased snoring with age. Snoring also is more prominent with people that sleep on their backs, or in positions where the head is in such a position where the structures of the airway are obstructed. Snoring usually occurs when one is inhaling, instead of exhaling.

Snoring by itself is not serious. However, sleep apnea (obstructive sleep apnea-hypopnea syndrom ,OSAHS), is a medical problem. There are today, sleep disorders clinics and physicians that treat sleep breathing problems. The clinics give a questionnaire to determine the likelihood of dozing off in a variety of daily situations

Sleep apnea is a associated with total obstruction of the airway in which breathing stops all together. The origin of the word apnea comes from the Greek language meaning "want to breath". Breathing must stop totally for at least 10 seconds or longer, by definition, to be called sleep apnea. To determine if a snoring falls into the category of sleep apnea, the sleep disorder clinics give a questionnaire which tries to find out the likelihood of dozing off in appropriate times during the day. Scoring 10 or higher is considered hypersomnolent, or sleep apnea. Then a plysomnography (PSG) test is performed. The person stays overnight at the clinic to perform the sleep test. The cost for this test is around $1200.00. Insurance often pays for PSG if the doctor needs it to diagnose the condition.

There are three types of apnea:

The most common type is called "obstructive sleep apnea." This is characterized with total obstruction of the airway, total collapse of breathing, with effort to breath. The other two types are not that common and have to do with a problem with the central nervous system (central sleep apnea) or in combination with obstruction of the airway (mixed sleep apnea). Sometimes when there is a fall in the blood oxygen level, there may be an episode of shallow breathing, where the airflow is decreased by 50% during sleep and may last for 10 or more seconds. This is called hypopnea. This is more of a mild interruption of breathing.

One side affect of sleep apnea is interrupted sleep. Studies have shown when sleep is disturbed, the quality of life is also affected. Some of the side affects include headaches (especially in the morning), fatigue, difficulty concentrating, falling asleep at inappropriate times, high blood pressure, irregular heart rate, heart attack and stroke. Questions to ask yourself to determine if you suffer from sleep apnea include:

  • Wake up very tired in the morning
  • Have a hard time concentrating
  • Headaches, especially on awakening in the morning
  • Falling asleep easily during the day
  • Sleepy and fatigue during the day
  • Depressed or easily get angry, especially on awakening in the morning

So what does one do about snoring or the more serious sleep apnea? There are many products available that boast to totally cure snoring, and give peace to your loved ones who have to hear the snoring. Usually a jab from a loved one in bed will cause the snoring to stop. The problem with that is the loved one will continually be awakened.

Other treatments include a lubricant spray that promises to stop the snoring. The manufacturer claims the lubricants, including almond oil, olive oil, sunflower oil, vitamins B6,C and E will help you stop snoring. A device called the Harmony Sleep Companion that vibrates and wakes you when snoring starts, so you can roll over on your side is another means available to stop snoring. Cutting the uvula is the surgical means of removing the flap hanging in the back of the throat. It’s painful and about two thirds successful for snoring.

Radio wave treatments called SOMNOPLASTY, shrinks the tissue in air passages. This treatment involves a small radio frequency generator attached to a needle that pierces the tongue, throat or soft palate. This is not painful, even though it sounds as though it is. For half an hour the inner tissue is heated to 158 to 176 degrees Fahrenheit causing the inner tissues to shrink. You may or may not see results, for which you need to wait a week or two. The procedure may have to be repeated. Although not painful, this should be the very last resort for treatment.

Another device fits on the nose and keeps the nasal passages open by applying pressure to the septum. Your dentist can make guards to stop snoring. There are two types: mandibular advancement devices, or MADs, keep the lower jaw forward. Tongue retaining devices (TRD), holds or pulls the tongue forward out of the airway. The tongue, therefore wont fall back into the airway causing obstruction. The purpose of each of these guards is the same—to keep the airway open wide enough to prevent breathing and sleeping problems and snoring.

If you suspect that you have severe sleep problems and snore, the sleep center is a good place to start. After filling out the questionnaire and possibly doing the overnight sleep test, they can determine what treatment will be the best route to take. If you simply snore and don’t have severe sleeping problems, avoid alcoholic drinks, tranquilizers, and sleeping pills before going to bed. Make sure your nasal passages are open and that you don’t suffer from sinus allergies or any thing else clogging your nose. A gentle elbow or jab from your loved one in bed is not a bad idea either. Sweet dreams.

      
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 About The Author
Flora Stay, DDS holds a doctor of dental surgery degree from University of California, San Francisco. She is the founder of ...moreFlora Stay DDS
 
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