What is Sleep Disordered Breathing & Obstructive Sleep Apnea?

What is OSA?

Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. Sleep apnea can pose significant health risks and affect your overall quality of life. Obesity, family history, and anatomy are some of the few causes for sleep apnea. Some risks include: congestive heart failure, high blood pressure, and diabetes.

Who is at risk?

Approximately 25% of the population suffer from sleep apnea and over 80% of sleep apneics are undiagnosed!

Some studies show one in five adults may have OSA. Nine percent of middle-aged women and 25% of middle-aged men may have sleep apnea.

Present estimates are 80-90% of sleep apnea is undiagnosed.

Dental professionals with specific dental sleep medicine training like D. Kreuz are in a unique position to identify and help patients at risk. Patients at higher risk may include:

Middle aged to older men
Post-menopausal women
Larger neck sizes (17"+ in men, 16"+ in women)
Tongue and jaw size anomalies
Enlarged tonsils, adenoids, uvula
Limited nasal airway due to anatomy, injury or allergies
Smokers
Family members with OSA
Snoring. Some studies point to a link between snoring (partial airway obstruction) and increased risks for cardiovascular, but more research is underway. More seriously, snoring may progress to, or is often a symptom of, a life threatening sleep breathing disorder known as Obstructive Sleep Apnea.

When does it happen?

OSA occurs when the muscles relax during sleep, causing soft tissues in the back of the throat to collapse and block the upper airways. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing the last at least ten seconds during sleep. Most pauses last between ten and 30 seconds, but some may persist for a minute or longer. This leads to abrupt reductions in blood oxygen, putting strain on your brain and cardiovascular system. Oxygen levels can fall as much as 40% or more in some case.

Your body reacts to the lack of oxygen by alerting the body, causing a brief arousal from sleep that restores normal breathing. This pattern can occur dozens to hundreds of times in a single night. You may or may not be aware of these arousals, as some awake fully, while others will be affected in their deepness of sleep only. The result is a fragmented quality of sleep that often produces an excessive level of sleepiness during the day. It can also produce other serious health effects.

Most people with OSA snore loudly and frequently, with periods of silence when airflow is reduced or blocked. They then make choking, snorting, or gasping sounds when their airway reopens. Other symptoms include:

Mouth breathing
Fatigue
Morning headaches
Chronic cough or sore throat
Difficulty concentrating
Grinding or clenching
Frequent waking or urination at night
Memory problems
Dry mouth
Depression
Irritability, mood changes
Poor performance
Weight gain
Stress

How do I know if I have OSA?

Dr. Kreuz, and her team, may perform periodic screening to assess your risk. This would include a questionnaire, a medical history review, and an oral examination. Based on her findings, she will discuss with you her clinical assessment and make recommendations for further screening, and/or referral to a sleep physician for additional testing.

Dr. Kreuz may recommend, in some cases, a take-home evaluation using a portable sleep monitor. It is self-administered with detailed instructions to help you. The results are reviewed by a third party sleep physician and recommendations are forwarded to Dr. Kreuz to review with you. This may be option if your risk is assessed as low and you are considering a simple snoring appliance.

Snoring

What's all the noise about?

Snoring can be more than bothersome to your bed partner!

Snoring is a common problem in 30 to 50% of the population and can affect not only your health and the quality of your sleep but also that of your bed partner.

Health effects can be seen due to frequent sleep interruptions common in snore sufferers.

Why do we snore?

In our upper airway, air must pass through many soft structures in our nose, mouth, and throat. When we are asleep, the muscles in our throat, neck, and tongue relax and for some, narrow or obstruct the passage of air.

Snoring is a partial blockage of air and produces vibrations in these tissues that we hear as snoring. The volume of snoring can vary from a quiet purr to a freight train, but all signal a reduction in the passage of air and oxygen.