Dental Sleep Medicine
The most common type of sleep apnea is known as obstructive sleep apnea. People who have it experience potentially dangerous pauses in their breathing while asleep, which can occur dozens or even hundreds of times a night, causing them to wake up or snore loudly as they struggle to breathe. These intermittent gaps in breathing are known as apnea episodes and they occur when your airway collapses in on itself, preventing air from reaching your lungs.
This sets off a cascade of problems:
- When breathing stops, oxygen levels plunge, which activates the sympathetic nervous system that controls the fight or flight response.
- Adrenaline levels soar
- Heart rate climbs
- Blood pressure rises, constricting blood vessels.
- Snoring can occur as your body labors to pull in oxygen.
Instead of being a period of restoration and relaxation, nightly sleep becomes a chaotic and often noisy struggle to breathe.
“You’re not getting oxygen, you have this very high level of sympathetic activity, and to make matters worse you’re generating huge levels of pressure in the chest,” said Dr. Virend Somers, a cardiologist at the Mayo Clinic who specializes in sleep disorders. “You’re generating negative pressure inside the chest to pull in air, but the air isn’t coming in. You’re distorting the structures in the chest like the heart and the atrium and this is happening hundreds of times a night. When you repeat this insult every night over many years, you eventually get structural and functional changes in the body.”
The severity of sleep apnea is determined by the number of times in an hour that a person has a cessation in breathing that lasts at least 10 seconds. Five to 15 times an hour is considered mild. Fifteen to 30 episodes is moderate. And more than 30 of these events is classified as severe. The prevalence of sleep apnea has been rising in recent years, and the consequences of not treating it can be devastating, said Dr. Meir Kryger, a professor at the Yale School of Medicine and the author of “The Mystery of Sleep: Why a Good Night’s Rest is Vital to a Better, Healthier Life.”
Obstructive sleep apnea increases your risk of a host of metabolic diseases, including the following:
High blood pressure: When oxygen levels fall, your body responds by raising your blood pressure to boost the flow of oxygenated blood to your organs. That’s why high blood pressure and obstructive sleep apnea go hand in hand. Research suggeststhat up to 50 percent of people with high blood pressure also have sleep apnea. Although the evidence is mixed, many studies have found that the standard treatment for sleep apnea, known as continuous positive airway pressure, or CPAP, lowers blood pressure. Some clinical trials suggest that it can have a particularly significant impact on sleep apnea patients with chronically elevated blood pressure, known as hypertension.
Cardiovascular disease: There’s a striking link between sleep apnea and heart disease, the leading killer of Americans. Obstructive sleep apnea increases the risk of heart disease by 30 percent and heightens your risk of having a stroke by 60 percent. According to the National Commission on Sleep Disorders Research, sleep apnea contributes to about 38,000 cardiovascular deaths annually and $42 million in related hospital costs.
Type 2 Diabetes: A growing body of evidence suggests that people with obstructive sleep apnea are more likely to develop diabetes, especially those who are overweight. One explanation for this is that chronic activation of the sympathetic nervous system impairs blood sugar control. Large studies have found that even after controlling for other risk factors, sleep apnea is “independently associated with glucose intolerance and insulin resistance and may lead to type 2 diabetes.” Studies have found that treating sleep apnea reduces insulin resistance and improves blood sugar control in people with diabetes.
Weight gain: While not everyone who has sleep apnea is obese, there’s a strong link between the two: About half of all people who are obese suffer from sleep apnea. One reason is that obesity promotes the development of soft tissue in the mouth and throat, which leads to a narrowing of the airway. But sleep apnea itself might cause you to gain weight because it disrupts your sleep, making you tired and fatigued. “In our studies, when people have apnea they tend to have put on a lot of weight in the year before their diagnosis,” said Dr. Somers. “If you’re sleepy, you’re not exercising enough and you’re eating the wrong things. You need energy so you’re eating a lot of carbohydrates. We think that having sleep apnea can potentiate the likelihood of you getting fat.”
About Dental Sleep Medicine at The Beacon Dental Clinic
As director of the Beacon Dental Group Dr Edward G Owens is a hospital affiliated Prosthodontist. He has been working successfully with oral appliances to treat snoring and obstructive sleep apnoea since 1997.
He collaborates with major hospital sleep disorder clinics and has been active in the management of oral sleep appliances and the development of Dental Sleep Medicine in Ireland.
Dr Ed Owens is one of a very small number of dentists qualified with recognised expertise in assessing and treating patients with Sleep Disordered breathing in Ireland. He is certified by the American Board of Dental Sleep Medicine as having undergone specialist education and qualification to best manage patients with a range of Sleep Disordered Breathing presentations and guide them into their optimal sleep, with the use of an individualised oral device.
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Article Source: The New York Times
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