Did you know you spend one-third of your life asleep? Yes, it's true, which means the quality of your sleep has a very real impact on the quality of your life.
Sleep Disordered Breathing (SDB) comprises two key areas:
- Obstructive Sleep Apnea
SDB affects more than 40 percent of the population, with that percentage increasing for people over the age of 50. Fortunately, Sleep Disordered Breathing can be treated with a variety of dentist-prescribed anti-snoring/apnea appliances.
Quality of sleep and sleep medicine are two relatively new areas within medicine, with growing awareness of the serious health consequences associated with snoring. With the ability to now diagnose and treat sleep-related conditions, many people are experiencing a greatly enhanced quality of life.
Dentists and physicians will meet many people with SDB. These patients could have chronic medical conditions, which are in part related to sleep disorders. Therefore, each patient should be screened and issued practical advice for the treatment of their individual sleep disorder.
Apnea is Greek for "without breath," where the tongue is completely sucked against the back of the throat and blocks breathing.
Snoring is caused by a narrowing of the upper airway during sleep. This can be due to large tonsils, a long uvula (the small piece of soft tissue that dangles from the soft palate over the back of the tongue) or excessive flabby tissue in the throat. All of these areas relax during sleep.
In other cases, nasal congestion from allergies or deformities of the cartilage between the two sides of the nose can contribute to narrowing of the airway.
However, the most common cause of narrowing of the upper airway is a tongue muscle that becomes too relaxed during sleep. When relaxed, the muscle is sucked into the back of the throat with each breath taken.
Snoring occurs when air travels faster through a narrow tube than through a broad one. This rapidly moving air causes the relaxed soft tissues of the throat to vibrate. It is this vibration that creates the sound of snoring.
By keeping the airway open, air travels more slowly, reducing throat vibrations and thus reducing or stopping snoring. One of the most effective ways to keep the airway open during sleep is by holding the tongue forward.
Snoring can progress into a condition known as Obstructive Sleep Apnea (OSA). Airway obstruction causes the heart rate to fall below normal, with decreases in blood oxygen levels. The obstruction will not clear until oxygen levels to the brain fall low enough to partly wake the sleeper with a release of adrenaline. This is an automatic body reaction and is intended to prevent suffocation. The airway obstruction is usually broken with one or several gasps to take in fresh air.
This event may happen hundreds of times a night for someone who suffers from OSA, which means the sleeper does not get a deep, restorative sleep. Such a condition greatly affects body chemistry and poses many serious health risks.
Sleep apnea occurs when the tongue falls back into the throat and obstructs the airway. Apnea episodes, in which the snorer gasps for breath, can happen hundreds of times per night.
Snoring and sleep apnea reduce deep, restorative sleep. This results in extreme tiredness through the following day, which can negatively affect personal, intellectual and physical performance and quality of life.
Obstruction of the airway causes the heart rate to fall below normal, with decreases in blood oxygen levels. The obstruction will not clear until blood oxygen levels fall low enough to trigger the brain to send a signal for a release of adrenaline to prevent suffocation. The airway obstruction is usually (but tragically not always) broken with a gasp for air and, due to the adrenaline release, an increased heart rate.
Reduced blood oxygen levels during the night also cause the brain to send signals through the nervous system to protect vital organs, the heart and the brain. To compensate for the low blood oxygen levels, blood vessels are instructed to tighten up to increase blood flow, to ensure the heart and brain get the required amount of oxygen.
This tightening of the blood vessels causes hypertension and high blood pressure. Night-induced blood pressure continues into the day, even with normal breathing.
Reduced blood oxygen levels can also stimulate the production of red blood cells. This thickens the blood and slows circulation, worsening the overall situation.
Apnea episodes cause disrupted sleep, leading to excessive tiredness and sleepiness during the day, thus increasing the risk of car accidents.7,8
A study released in November 2006 and published in the Journal of the American Academy of Physician Assistants linked OSA, and therefore snoring, to cognitive dysfunction and vascular dementia. Due to cyclical oxygen desaturation from recurring asphyxia, stopped-breathing episodes during sleep reduce oxygen to local brain tissue, causing an infarct and tissue damage with permanent neuropsychological dysfunction.
OSA is directly linked to:
- Hypertension/high blood pressure: 30 to 80 percent of patients with hypertension have sleep apnea.9,10,11
- Cardiovascular disorders12,13,14
- Obesity-altered body chemistry/glucose levels affect the body's metabolism.17
- Dementia/memory problems due to starved oxygen to the brain
- Reflux/heartburn/GERD: 85 percent of sufferers have SDB; in many cases, treating SDB also treats reflux/heartburn.15
- Nocturnal asthma/COPD