If you often feel tired and sleepy during the day, even after sleeping for seven or more hours, which is the recommended amount for adults by the American Academy of Sleep Medicine (AASM), visiting your dentist to check for sleep apnea might be a good idea.
Although it is common, many people do not realize they have it. Symptoms like snoring, breathing pauses, and gasping for air happen during sleep, so individuals may not notice them and remain undiagnosed.
Your dentist can help identify the problem and assist you in obtaining a medical evaluation. Once you have a confirmed diagnosis, you can explore treatment options. We at Los Angeles Advanced Dentistry offer various solutions to help alleviate sleep apnea symptoms. Our dental services in Los Angeles, CA, have successfully assisted many patients in finding effective relief.
What is Sleep Apnea?
Sleep apnea is a sleep disorder that affects breathing. It involves unusual breathing patterns while a person sleeps.
Those with sleep apnea often experience repeated pauses or reduced breathing during the night. These breathing pauses typically last 10 to 30 seconds, but some can last a minute or longer. These interruptions can lead to waking up several times, lowering sleep quality. However, many people do not fully wake up and may not realize their breathing is abnormal while they sleep.
Sleep apnea sometimes happens due to a blocked airway during sleep. In other cases, the issue comes from the brain not correctly signaling the muscles that control breathing. If you do not treat sleep apnea, it can reduce the oxygen supply to your brain and body, leading to health issues, including:
- Cardiovascular disease
- Metabolic disease
- Workplace errors
- Stroke
- Excessive daytime fatigue and sleepiness
- Traffic accidents
- Death
Types of Sleep Apnea
Below are the three main types of sleep apnea:
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most common type. Studies suggest that approximately 10% to 30% of adults in the United States have OSA, but many do not receive a diagnosis. It happens when there is a blockage in the mouth and throat. For example, the tongue can fall back against the soft palate during sleep. This condition may cause the soft palate and uvula to block the throat. It can make breathing difficult or even stop at times.
OSA can result in snoring as the tongue and soft palate vibrate. It may also cause individuals to wake up feeling unable to breathe. In OSA, the lungs function normally, and the body attempts to breathe but struggles to obtain enough air through the upper airway.
The likelihood of having OSA increases between the ages of 30 and 70. Research indicates that 56% of those over 65 are at significant risk for OSA. It affects men more than women, individuals with extra body weight, pregnant individuals, and those who sleep on their backs. Some signs include:
- Waking up during the night or feeling tired during the day
- Waking up feeling anxious
- Snoring or gasping for air while sleeping
- Frequent headaches
- Waking up with a dry mouth
- Feeling confused or having trouble focusing at work or school
Central Sleep Apnea
Central sleep apnea also affects breathing at night, but it is not due to a blockage in the airway. Instead, it is due to issues in the nervous system. Unlike OSA, there is no snoring it involves the brail. The brain briefly stops sending messages to the muscles that help us breathe. Some people may not show any symptoms, while others might experience:
- Constant fatigue
- Daytime drowsiness
- Headaches after waking up
- Trouble sleeping well
If a nervous system issue causes sleep apnea, other symptoms might appear. These symptoms vary based on the affected parts of the nervous system. They may include:
- Breathing difficulties
- Weakness or numbness in different body areas
- Problems with swallowing
- Voice changes
Possible causes include:
- Medications, especially sedatives like opiates
- Sleeping at high elevations
- Congestive heart failure
Complex Sleep Apnea Syndrome
Complex sleep apnea syndrome combines obstructive sleep apnea (OSA) and central sleep apnea. Sometimes, this syndrome is evident during the first sleep study, while other times, it shows up when standard treatments like CPAP machines do not help.
The symptoms are similar to those of OSA and can include:
- Brief awakenings during sleep
- Feeling tired during the day
- Confusion upon waking
- Headaches or dry mouth
- Trouble sleeping or poor sleep quality
A 2006 review of 223 individuals with sleep apnea symptoms found that 15% had complex sleep apnea syndrome, 84% had OSA, and only 0.4% had central sleep apnea.
Common Groups Affected by Sleep Apnea
Sleep apnea can affect anyone, including children and older adults. Certain physical traits are often common in those with obstructive sleep apnea, such as a large neck, structural issues, and excess weight that narrows the upper airways. This condition can include nasal blockages, enlarged tonsils, a small jaw with an overbite, and a low-hanging soft palate.
Signs and Symptoms of Sleep Apnea
Often, a bed partner notices sleep apnea symptoms before the person affected does. Many individuals may not realize they have sleep issues. You should tell your healthcare provider if you notice any of these signs:
- Snoring
- Feeling tired or sleepy during the day
- Choking during sleep
- Waking up frequently at night or feeling restless
- Sweating at night
- Difficulty concentrating, feeling irritable, or forgetfulness
- Dry mouth upon waking
- Mood changes, such as anxiety or depression
- Headaches
- Bedwetting
- Problems with sexual function
- Needing to urinate often at night
People with central sleep apnea may report insomnia or waking up repeatedly, often feeling like they are gasping or choking. In children, symptoms can be less obvious and may include:
- Poor school performance
- Difficulty swallowing and breathing through the mouth during the day
- Daytime sleepiness or sluggishness, often seen as laziness in class
- Inward movement of the rib cage while inhaling
- Excessive sweating at night
- Unusual sleeping positions, like sleeping on hands or knees
- Behavioral and learning issues
Diagnosing Sleep Apnea
To diagnose sleep apnea, your dentist will first review your symptoms. They will:
- Ask if you take any medications, like opioids, that could impact your sleep.
- Look for possible causes of sleep apnea.
- Inquire if you have traveled to high-altitude areas recently, as these can lower oxygen levels and trigger symptoms.
After asking you some questions, your dentist will use several methods to determine if you have sleep apnea. They will do the following:
Medical History
The dentist will review the information you give to identify symptoms and signs of the disorder. They will also check your family history to see if you might be at risk for the same condition. Additionally, they will assess if you have any complications from untreated sleep apnea, such as high blood pressure, type 2 diabetes, or atrial fibrillation.
Physical Examination
The dentist may perform a physical exam to check for sleep apnea. They will look for risk factors like large tonsils, obesity, and a thick neck. They will also examine the structure and size of your jaw. Furthermore, they will assess your heart, lungs, and nervous system for related issues.
Sleep Studies
To diagnose sleep apnea, dentists often use sleep studies. They might advise you to do these tests at home or in a dedicated facility. The tests will include the following items:
- Identify any events during your sleep that relate to sleep apnea symptoms.
- Measure the activity levels in your muscles that control breathing
- Check your blood oxygen levels while you sleep
- Monitor your brain and heart activity during rest
Treatment Options for Sleep Apnea
There are several ways to treat sleep apnea. Here are some of them:
Continuous Positive Airway Pressure Therapy (CPAP)
Besides changing your lifestyle, seeking sleep apnea treatment is essential. A common option is continuous positive airway pressure (CPAP) therapy. This method uses a machine with a mask or nose piece linked to a hose, supplying continuous airflow while you sleep. The air pressure keeps your airway clear and avoids interruptions in breathing.
Some people initially find it hard to sleep with a CPAP machine, but many adjust over time and start to sleep better. A CPAP device can quickly relieve symptoms, improve mental health, and increase energy levels. Therefore, consider using CPAP devices.
Recent advancements in CPAP technology have led to quieter, lighter, and more comfortable machines. If you had trouble with CPAP in the past, it might be worth trying the newer models.
Becoming used to the device may take a while, and you might miss your old sleeping habits. However, there are ways to help you adjust more quickly to CPAP. Here are some helpful tips:
- Make sure your mask fits properly.
- Choose a CPAP machine with a built-in humidifier.
- Reset the device if the airflow wakes you up.
- Keep the machine clean.
In addition to CPAP devices, dentists may recommend other treatments for sleep apnea. These include:
- Adaptive Servo-Ventilation (ASV)—Dentists often use this device for central and sometimes obstructive apnea. It learns your breathing patterns and automatically prevents pauses during sleep.
- Bilevel Positive Airway Pressure (BiPAP)—This device is for patients who struggle to adjust to CPAP. It is also suitable for those with central apnea who need help with weak breathing. BiPAP machines automatically change the pressure while you sleep, providing higher pressure when you inhale and lower pressure when you exhale. They can also deliver a breath if the mask detects you have not breathed for a few seconds.
- Expiratory Positive Airway Pressure (EPAP)—These devices fit over your nostrils and help keep your airway open. They are smaller than CPAP machines and are particularly helpful for patients with mild obstructive apnea.
Oral Appliance Therapy
Oral appliances are an increasing option for sleep apnea treatment. While they might not be as effective as CPAP devices, they can offer comfort for those who cannot use CPAP. Your dentist can recommend different approved oral appliances, often made of acrylic and fitting in your mouth like a sports mouthguard. Some may also help support the chin and head, aiding in adjusting the lower jaw’s position.
Oral appliances, particularly mandibular advancement devices, are a common treatment for sleep apnea. Healthcare professionals use these devices to help patients with obstructive sleep apnea. Experts can create custom oral appliances to keep the tongue from blocking the throat or to move the lower jaw forward.
A dentist or sleep specialist will assess your suitability for this treatment. However, these appliances can have side effects, such as excess saliva, soreness, and potential damage to the jaw, mouth, or teeth, especially if not fitted properly.
Surgical Options
Dentists may recommend surgery to treat obstructive sleep apnea. Surgeons perform many of these procedures on an outpatient basis. Dentists recommend surgery for patients with structural issues, like enlarged tonsils or a deviated septum, that block airflow. If other treatments do not work, surgery may be the next step.
Standard surgical options include:
- Tonsillectomy: This procedure removes the tonsils, which are often a cause of sleep apnea in children.
- Maxillary/mandibular advancement surgery: This surgery corrects throat blockages or facial issues that contribute to obstructive sleep apnea.
- Somnoplasty: This minimally invasive procedure uses radiofrequency energy to shrink soft tissues in the upper airway.
- Uvulopalatopharyngoplasty: This procedure removes soft tissue from the back of the throat to widen the airway.
Oral appliances, particularly mandibular advancement devices, are a common treatment for sleep apnea. Healthcare professionals use these devices to help patients with obstructive sleep apnea. Experts can create custom oral appliances to keep the tongue from blocking the throat or to move the lower jaw forward.
A dentist or sleep specialist will assess your suitability for this treatment. However, these appliances can have side effects, such as excess saliva, soreness, and potential damage to the jaw, mouth, or teeth, especially if not fitted properly.
Sleep Apnea Implants
One of the latest treatments for sleep apnea involves using a pacemaker system that stimulates muscles to keep your airway open while you sleep. The FDA has approved a new implant designed for obstructive sleep apnea. Although this technology is costly and still new, recent studies indicate it may be effective for treating patients with sleep apnea.
Lifestyle Changes for Sleep Apnea
If you have a mild case of sleep apnea, lifestyle changes can help improve your condition. These lifestyle changes may include:
- Follow a routine sleep routine.
- Exercising regularly.
- Avoid drinking alcohol and smoking.
- Use pillows to elevate your head at night.
- Manage your allergies if you have any.
Your dentist can provide guidance on where to begin. Even if you receive medical treatment, adjusting your lifestyle is important for reducing central and obstructive sleep apnea and enhancing sleep quality.
Weight Loss
Many health issues can raise the risk of sleep apnea, but sleep apnea, especially OSA, is most often seen in overweight or obese individuals. Extra weight leads to fat buildup in the neck, known as pharyngeal fat. This fat can obstruct the upper airway during sleep when the muscles relax.
Also, having a larger abdomen from excess fat can put pressure on the chest wall, which reduces lung volume. This smaller lung capacity limits airflow, increasing the chances of the upper airway collapsing while sleeping.
Losing weight can help ease sleep apnea symptoms for overweight people. While it may not completely cure the condition, it can significantly lower the number of breathing interruptions, reduce daytime sleepiness, and help lower blood pressure.
Sleeping Position
Sleeping on your back can cause your tongue and other soft tissues to block your airway if you have sleep apnea. Sleeping on your stomach also can hinder breathing. Instead, sleep on your side to keep your airway clear. If you struggle to stay on your side, consider using a pillow to help.
Become Active
Regular exercise can help decrease sleep interruptions, even if it does not lead to weight loss. It boosts your energy and keeps you alert throughout the day. Workouts like resistance training, yoga, or aerobic exercises can strengthen the muscles around your airways. As you gain strength, your muscles require less oxygen to function, allowing you to breathe more easily.
Steer Clear of Anti-Anxiety Medications, Alcohol, and Other Sedatives
Avoid alcohol and anti-anxiety medications before bedtime, as they can relax throat muscles and disrupt your breathing. These include drugs like Valium, Klonopin, Ativan, and Xanax; antihistamines such as Claritin and Benadryl; and opiates like Percocet, codeine, Vicodin, morphine, or sleeping pills.
Sleep Apnea in Kids
Many children experience obstructive sleep apnea, but it can be hard to notice. Besides snoring, children with this condition may show symptoms like:
- Strange sleeping positions
- Daytime drowsiness
- Bedwetting
- Falling grades or behavioral issues
- Pausing in breathing during sleep, along with gasping or snorting.
Complications of Sleep Apnea
Untreated sleep apnea can cause serious health issues, including:
Daytime Tiredness
Many people with sleep apnea wake up frequently, making it hard to have a good night’s sleep. This issue can cause you to feel irritable and sleepy during the day. Feeling tired can make falling asleep at work or school easier, which might result in accidents.
Liver Issues
Sleep apnea can result in abnormal liver function test results, sometimes indicating signs of scarring.
Surgery and Medication Concerns
Obstructive sleep apnea may cause problems with some medications and surgeries because of possible breathing issues.
Heart Issues or High Blood Pressure
A sudden drop in blood oxygen levels during sleep can pressure your heart and blood vessels. Obstructive sleep apnea can increase the risk of strokes, irregular heartbeats, and heart attacks.
Find a Sleep Apnea Dentist Near Me
It could signify apnea if you are often tired, even after a full night’s sleep, or if someone complains about your snoring. You may not discover your apnea condition until someone watches you when you are asleep. You might mistakenly attribute your headaches, fatigue, or irritability to stress.
If you notice the above symptoms, you should consult your dentist. Ignoring them can lead to serious health problems. We at Los Angeles Advanced Dentistry will help you find the appropriate sleep apnea treatment. Call us at 310-361-2080 to speak with an experienced dentist in Los Angeles, California.
