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.
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