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Snoring and Sleep Apnoea
40% of adult men and 30% of women snore, this percentage increases with age. Snoring may be an indicator of a serious underlying condition known as Obstructive Sleep Apnoea (OSA).
Symptoms of Obstructive Sleep Apnoea (OSA)
Consider going to your dentist if you are suffering from the following symptoms:
- Loud and repetitive snoring — OSA suffers often follow a pattern of loud snoring followed by episodes of silence, and then gasps for breath.
- Excessive daytime sleepiness — most people with OSA have difficulty staying awake during the day, regardless of how much sleep they have. This can occur while at work, watching TV, driving the car, or even sitting behind your desk at work.
- Erratic mood shifts — people with OSA are more susceptible to depression and increased irritability.
- Morning headaches.
- Intellectual deterioration,i.e- poor memory
- Restless sleep.
- Bedwetting/passing urine at night.
- Breathlessness at night or day.
- Reduced sexual activity.
- Heart burn at night.
In association with Sleep Studies Australia, Face Value Dental can offer a comfortable and convenient way to monitor your sleeping patterns. We also offer the luxury of choice – you can select the time and place of your sleep study to fit in with your lifestyle and schedule, all without waiting lists!
What is Sleep Apnoea?
Apnoea means ‘the absence of breath’. Sleep apnoea occurs when the airway from the mouth to the lung collapses during sleep. The person with sleep apnoea may have hundreds of these episodes throughout the night, disrupting their sleep and reducing oxygen supply to vital organs. Sleep apnea is a common condition affecting about 5% of adults. Fortunately effective treatment is available and once treated the person with sleep apnoea leads a normal healthy life.
The main features of Sleep Apnoea are snoring, pauses in breathing during sleep and excess daytime sleepiness. Affecting 2 out of every 10 Australian adults, snoring does more than disrupt your sleep.
Many Obstructive Sleep Apnoea sufferers are not aware they have a problem. Sleep apnoea leads to excessive daytime sleepiness, lack of concentration and poor memory. Over time, medical research has demonstrated links between sleep apnoea and high blood pressure, heart disease and stroke.
Other symptoms which can occur in untreated Obstructive Sleep Apnoea are personality changes, mood disorders, depression, social side effects, 12 times more likely to be involved in a car accident, low sex drive, poor short-term memory and difficulty in concentrating.
Types of Sleep Apnoea
There are two main types of sleep apnoea, the most common is obstructive sleep apnoea, occurring when relaxed throat muscles prevent breathing, and central sleep apnoea, affecting the brain signals that send messages to the muscles that control breathing. Although rare, some people may be diagnosed with complex sleep apnoea; this is a combination of both central and obstructive.
1. Obstructive Sleep Apnoea (OSA)
Obstructive sleep apnoea – Whilst sleeping the muscles in your throat, located just above your larynx, relaxes to the point of cutting off your air supply. This lack of oxygen and increase in carbon dioxide in your blood is registered by your brain, which sends a signal to the muscles that have relaxed. This results in a reflex action that, although you may be unaware of it, wakes you up. You resume breathing and fall back to sleep almost immediately.
One of the main contributing factors of sleep apnoea is obesity; having a large neck can add extra pressure on your airway contributing to the collapse of the muscles responsible for keeping the airway open. As well as being healthy for you, often the loss of five to ten kilograms can significantly reduce the severity of your sleep apnoea. Excess alcohol, particularly at night can also cause a delayed reaction by your brain to signal a wake-up response, causing a longer period of non-breathing and adding to the amount of episodes experienced.
2. Central Sleep Apnoea (CSA)
The second type of sleep apnoea is Central Sleep Apnoea (CSA): Central Sleep Apnoea is much less common than Obstructive Sleep Apnoea. Central Sleep Apnoea is due to a brain signal problem and not a blockage of the airway. It is caused by a dysfunction in the area of the brain stem responsible for the muscles controlling the lungs and breathing. Some causes of central sleep apnoea include; the result of an injury to the brain stem or complications from surgery to the cervical spine, a degenerative neurological disease, stroke, or encephalitis, an inflammation causing swelling of the brainstem.
With CSA, oral breathing, throat and abdominal breathing all cease at the same time. The periods of breathing interruption may last a few seconds, and breathing may be too shallow to provide oxygen to the blood and tissues. Central Sleep Apnoea may be associated with an irregular heartbeat, high blood pressure, heart attack, and/or stroke. It is is not associated with being overweight.
Face Value Dental works in conjunction with sleep physicians (medical respiratory specialists) for the diagnosis and treatment of sleep apnoea. In order to determine the severity of your sleep apnoea, a "sleep study" [polssomnography] is conducted to record your bodies function during sleep. The evaluation closely monitors eye movement, electrical brain activity, muscle activity, heart rate respiratory effort, airflow, and blood oxygen levels. These tests can be carried out in special sleep clinics or in an ambulatory situation in your own home. Once a diagnosis is made by the respiratory physicians treatment options can be determined. Treatment for mild to moderate sleep apnoea suffers may involve the use of an oral appliance and/or a reduction in predisposing factors such as weight loss.
A suite of diagnostic equipment called ECCOVISION [pharyngometer and rhinometer] measures your nasal passages and airway using sound waves. It is used to determine whether your airway enlarges with a change in your jaw position to predetermine if an oral appliance is likely to be effective. This removes some of the trial and error approach as not everyones airway responds favourably to oral appliances. Eccovision can also be used to optimise the positioning of the lower jaw relative to the upper jaw to maximise the airway opening.
Severe sleep apnoea sufferers and those not suitable for appliance therapy have CPAP [continuous positive airway pressure] as their choice of treatment. A mask is worn that is connected to a generator which pumps air into your lungs. It works very well but takes time to become used to.
It is important that sleep apnoea is treated as soon as possible as it has detrimental effects to your health and lifestyle.
If you would like further information regarding Sleep apnoea, please contact our practice (07) 3221 0677.
Sleep Apnoea FAQs:
Who gets sleep apnoea?
Sleep apnoea can occur at any age.
- In childhood, apnoea it is commonly the result of enlarged tonsils or adenoids or of some cranio-facial abnormality.
- In adulthood, apnoea becomes more common in middle age and is more common in men than in women, although after menopause women may be at increased risk.
Sleep apnoea is often associated with being overweight, particularly with excess fatty tissue around the neck. In people who are not overweight, it is likely that they have been born with a narrow airway or facial structure which leads to a narrow airway. Almost everyone who has obstructive sleep apnoea snores as snoring is also the result of narrow or floppy upper airways.
How is sleep apnoea diagnosed?
Signs and symptoms such as snoring, obesity, observed apnoea and sleepiness in the day may suggest that a person has sleep apnoea but the best way to be really sure is with an overnight sleep study.
In the sleep study, the patient is wired up and attached to computers which measure their sleep, their breathing and oxygen levels. Everyone experiences a small amount of disruption to breathing during sleep but someone with sleep apnoea may have as many as one hundred of these events per hour.
How is sleep apnoea treated?
With the help of a Mandibular Advancement Splint (MAS), treatment is painless and non invasive. The SomnoDent® MAS device, allows for full range of mouth opening and closing, which means you can talk or drink with the device in position and close your lips. It does not impinge on tongue space and will fit wholly inside your mouth, making the SomnoDent® MAS more comfortable and discreet than other MAS products.
In order to increase both the efficiency and comfort of the device, the SomnoDent® MAS is fully incrementally adjustable, forward and backward. Allowing it to be adjusted to the optimum position for comfort and effective treatment. Most patients generally find that it only takes a couple of nights to adjust to wearing the device for a good nights sleep.
Things to avoid if you have sleep apnoea.
There are some things that make apnoea worse and therefore should be avoided. Alcohol tends to relax muscles and may worsen apnoea as may sleeping tablets which depress the drive to breathe. It is advisable to try and maintain a regular sleeping pattern. Other things that disrupt sleep such as caffeine and eating late at night should also be avoided.
How successful is the treatment?
The use of the Mandibular Advancement Splint has proven to be a very effective treatment method for mild to moderate sleep apnoea. The MAS has shown to be twice as effective with the treatment of sleep apnoea then it’s alternate; A Continuous Positive Airway Pressure device (CPAP). Although in same cases CPAP may be a more appropriate method of treatment for you.
Your sleep health is important
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