Sleep Apnoea

What is Sleep Apnoea?

It is believed that sleep apnoea affects millions of people every year, but since it occurs at night while you sleep, people are unaware they are suffering and thus it goes undiagnosed. Signs and symptoms include unrefreshed sleep, daytime sleepiness, depression, morning headaches and going to the toilet frequently throughout the night. For many, gagging or gasping for air at times whilst sleeping or loud snoring is common.

Sleep Apnoea results from the tongue and soft palate collapsing onto the back of the throat while you sleep. This obstructs the upper airway, causing airflow to be restricted or completely stop; often for more than 10 seconds at a time. Your brain signals the body that there is a lack of oxygen and adrenalin is released and you arouse, this is where you may gasp for breath. Your airway will regain tonus and open, forcing the obstruction in your throat to clear and then your breathing will begin again. This is an obstructive apnoea; the process repeats itself over and over again through the night. In severe cases some people can lose breath for as much as 40 seconds over 60 times an hour.

Obstructive Sleep Apnoea | Modern Dentistry | Canberra Dentist

The combination of low oxygen levels and consistent, disturbed, and interrupted sleep can causes the patient to feel exhausted throughout the day, but in some cases the patient does not even know how bad their sleep really is. Thus it is vital that if you have any symptoms you have a sleep study to assess your risk of sleep disordered breathing; as the ill effects of sleep apnoea can contribute to a host of very serious health concerns like cardiovascular disease, stroke and heart attack.

Types of Sleep Apnoea

Obstructive Sleep Apnoea (OSA) - Is the most common sleep related breathing disorder, where the upper airway repeatedly collapses during sleep. During an obstructive breathing event, someone with OSA continues to breathe but cannot get enough air into the lungs because the upper airway becomes too narrow or closes completely, this is known as an obstructive apnoea. The soft tissue in the back of your throat or tongue base collapses and then obstructs your airway resulting decreased oxygen intake. The brain detects the oxygen deficiency which then leads to multiple momentary arousals to draw breath - profoundly interrupting your deep sleep.

Central Sleep Apnoea - Is another condition where your airway does not become blocked, but instead your brain does not send the signal to your muscles to breathe. In this type we may need to refer you to a specialist.

Mixed Apnoea - Is a combination of both central and obstructive Sleep Apnoea. If you have mixed Sleep Apnoea you may experience snoring, but you may find that treatments designed to help airway obstructions will not fully stop apnoeic episodes. Though your brain briefly arouses you in order for you to resume breathing, your sleep is constantly interrupted. This leaves you feeling fatigued the next day.

Who’s at risk?

Those that suffer an increased risk of suffering from sleep apnoea are males who are moderately to severely overweight, and those over the age of 40. But almost anyone can suffer; even petite women and children. This potentially life threatening disease is a lot more common than generally expected and should be taken very seriously.

What are the signs and symptoms of Sleep Apnoea?

Tiredness/fatigue and irritability in the mornings and during the day
Snoring
Daytime sleepiness
Depression
Frequently waking throughout the night to go to toilet or get a drink
Regular Morning Headaches
Worn teeth caused by clenching or grinding of teeth
Poor memory
Reflux problems
Dark circles or bags under or around the eyes

Why is it so harmful?

Repetitive airway collapse can lead to large pressure fluctuations in the lungs and oxygen deficiency which places stress on the heart and cardiovascular system. Consequently in people with OSA, the risk of high blood pressure, stroke and sudden cardiovascular death during sleep is increased as is diabetes. Studies have shown a 33% increase in cardiovascular disease in patients with OSA. Most recently, OSA has been associated with an increased risk of cancer death. Thus it is imperative that once diagnosed with OSA you are adequately treated. But the strains on the system from arousing over and over due to lack of oxygen, as much as 500 times a night; inhibit your body from getting the refreshing sleep it needs. Not only is OSA a major, often unrecognised, cause of daytime sleepiness, it can also be an associated risk factor for very serious medical conditions:

Sleep Apnoea Causes | Modern Dentistry | Canberra Dentist

How do you get diagnosed?

Because sleep Apnoea occurs at night while you should be sleeping deeply, diagnosis isn’t as easy as a quick visit to your local GP or dentist. In the first instance you will be referred to a Sleep Physician to have a sleep study test.

It is imperative that you have a sleep study prior to being fitted with any sort of treatment for sleep disordered breathing. Even if you think you just snore, it is possible that you have some level OSA and may need to see a specialist. Healthcare funds recognise this and will not give any rebate for any treatment of sleep disordered breathing snoring or OSA unless the patient has had a full sleep study which has been analysed by a sleep physician.

At Modern Dentistry we will first need to schedule a professional sleep study to properly and legally diagnose your condition as Snoring or Sleep Apnoea. You can choose to perform your study in a hospital situation with all the latest technology. But not everyone is suited to undergo a hospital based sleep evaluation and so may elect to schedule an in-home evaluation.

Snoring and Obstructive Sleep Apnoea Treatment Solutions

If you or a loved one snores, the problem can be more than just a social embarrassment. Historically those who were afflicted with the condition were left to live out their restless lives without a treatment solution. There are many non-surgical alternatives to traditional snoring and sleep apnoea therapies. Sleep disorders, if left untreated, can result in a host of serious negative side effects to your overall health and mental well-being.

SomnoDent® Devices

For those who suffer with mild to moderate sleep apnoea, treatment may be a dental device such as a mandibular advancement device/splint (MAD or MAS). Our recommended oral device is, SomnoDent® - effective for treating mild to moderate sleep Apnoea. This device is worn while you sleep and works to open your airway by bringing the lower jaw, tongue and associated soft tissue forward stopping it from collapsing during sleep. This appliance maintains the patency of your airway and thus greatly reduces or eliminates the snoring and apnoeic events.

When considering this form of snoring/sleep apnoea treatment it is very important to get a consultation and have the device fitted in an accredited dental clinic with advanced training in sleep apnoea, such as Modern Dentistry, and to return for regular visits to prevent any dental problems from occurring. The appliances may also need periodical adjustment to help secure a better fit and ensure optimal efficiency.

Sleep Apnoea Mouthguards | Modern Dentistry | Dentist Canberra

SomnoDent® devices are EXCEPTIONALLY COMFORTABLE

88% of patients reported regular use of SomnoDent® device1
Discreet and silent
Unique soft inner liner available

SomnoDent® devices are HIGH QUALITY

Customized using the highest quality acrylic which does not discolour or attract odours
3 year warranty against manufacturing defects
SomnoDent® devices are UNIQUELY COMPLIANT
The First and only dorsal fin oral device with micro-recorder that objectively records compliance data
SomnoDent® devices are CLINICALLY PROVEN
91% of patients reported improvement in sleep quality with SomnoDent®1

Mouthguards for Sleep Apnoea | Modern Dentistry Canberra | Canberra Dentist

Continuous Positive Airflow Pressure (CPAP)

For patients with severe obstructive sleep apnoea the most common treatment is Continuous Positive Airflow Pressure (CPAP). This is a device that involves a mask, tubes and a fan. The device uses air pressure to maintain a patent airway whereby the continuous motion enables air to pass unobstructed through your airway, resulting in diminished obstructions of the airway throughout your sleep. Many patients struggle to tolerate CPAP because of the mask and continuous air pressure experienced throughout the night.

However, if tolerated, CPAP therapy offers a considerable boost to energy levels in the day for most patients, while also boosting their overall health. It is a non-invasive form of therapy is a safe and very effective treatment. New CPAP devices are lighter, quieter, and more enjoyable to use, so if you’ve previously tried a machine in the past but gave up on treatment due to discomfort, call us to see what advancements have been made.

CPAP Sleep Apnoea Devices | Modern Dentistry | Canberra Dentist

Surgical options

For extreme cases, sleep Apnoea can also be treated surgically. Currently the costs and success rates associated with surgery can differ considerably, and success is not guaranteed. Speak with us and research your options carefully before going through any lengthy, painful, and costly procedures.

Don’t wait to start getting help

If you think you or a loved one currently suffers from Sleep Apnoea or any other sleep condition and would like to receive snoring treatments at Modern Dentistry, please contact us and we will be delighted to organise a consultation.

Atul Mehta, Jin Qian, Peter Petocz, M. Ali Darendeliler and Peter A. Cistulli "A Randomized, Controlled Study of a Mandibular Advancement Splint for Obstructive Sleep Apnea", American Journal of Respiratory and Critical Care Medicine, Vol. 163, No. 6 (2001), pp. 1457-1461.