Sleep Apnea FAQ

Do you snore loudly at night or wake up feeling tired even after a full night’s rest? You could have a form of sleep apnea, which is a severe sleep disorder causing frequent stops and starts in breathing. Apnea is the Greek word for “without breath.” Because the oxygen to your brain is cut off many times through the night, usually during the REM (rapid eye movement) sleep stages, it results in poor sleep quality. Whenever your body feels the strain caused by the lack of oxygen, your brain sends signals to wake you up to resume breathing. Sleep apnea is most common in older people and people who are overweight or obese. Because people with sleep apnea are also more likely to develop diabetes, heart disease, hypertension, and strokes, it’s critical to get a proper diagnosis and treatment as early as possible.

The three main types of sleep apnea are obstructive, central, and complex/mixed. Obstructive sleep apnea causes your throat muscles to relax, which blocks your airways, preventing air from reaching your lungs and forcing you to wake up in a panic. Although you may wake up more than 200 times in the middle of the night, you might not even be aware of it. If you have central sleep apnea, the brain doesn’t send the needed messages to the muscles that control your breathing. Complex sleep apnea is a rare disorder combining elements from both obstructive and central sleep apnea. The severity levels of sleep apnea can range from mild to moderate and serious. Untreated sleep apnea may be fatal.

Sleep apnea symptoms will vary by type, severity, and patient, but these are the most common:

• Loud or frequent snoring
• Holding breath while sleeping
• Waking up choking or gasping
• Insomnia
• Morning dry mouth or sore throat
• Frequent headaches
• Daytime fatigue or drowsiness
• High blood pressure
• Irritability, depression, and mood swings
• Difficulty concentrating on tasks
• Forgetfulness
• Leg swelling
• Weight gain
• GERD (gastroesophageal reflux disease)
• Low energy levels
• Loss of interest in sex

Not all sleep apnea patients exhibit all of these symptoms. It should also be noted that loud snoring isn’t always caused by sleep apnea, and not all people with sleep apnea necessarily snore.

To be clinically diagnosed with sleep apnea, you must stop breathing at least 10 seconds per apneic event with at least five apneic events per hour of sleep. There are usually changes in brain waves and blood oxygen levels as well. Apneic events are measured using polysomnography or portable home monitoring equipment provided by your doctor. Your doctor may examine your head and neck and ask you to fill out a questionnaire about your sleep quality and habits. A polysomnogram measures your brain waves, eye movement, muscle activity, heart rate and rhythm, and changes in your blood oxygen levels during sleep. An oropharyngeal meter may be used to measure the back of your tongue and throat size to determine your likelihood of developing breathing difficulties. An acoustic rhinometer may be used to measure your nasal passages to detect obstruction or congestion issues.

While sleep apnea used to require overnight stays at a sleep center for diagnosis, there is a home sleep test you can request from our dentist office. We’ll ask you to wear a small sleep apnea device at night, which will collect data that Dr. Cavendish then sends to a neurologist for proper evaluation and diagnosis. If this is something that interests you, please contact our office for more details.

The number of times your breathing stops per hour is the preferred method for determining the severity of your sleep disorder. A person with mild sleep apnea has 5-15 apneic events per hour, while a person with moderate sleep apnea may see 15-30 events per hour. If you experience 30 or more apneic events per hour, you likely have severe sleep apnea. Sleep specialists also measure how low your blood oxygen levels dip and how long they remain below 90%. Other chronic medical conditions, including heart disease, hypertension, and type 2 diabetes, may be linked with more severe sleep apnea.

Type 2 diabetes patients experience insulin resistance, meaning their bodies cannot maintain a balanced level of glucose. When a person suffers from sleep apnea, it can cause insulin resistance to become more severe. Over time, this insulin resistance often leads to the development of diabetes.

Hypertension, or high blood pressure, is often linked with sleep apnea. Because your heart must work harder to pump oxygen throughout your body at night, this may lead to an increase in blood pressure. Both chronic conditions are commonly linked with obesity, which often causes high cholesterol levels in the blood and fatty deposits around the windpipe leading to airflow blockages.

Experts suggest one out of every five adults has mild sleep apnea, while one out of every 15 adults has moderate or severe sleep apnea. Some studies suggest there may be a hereditary link to sleep apnea, so your doctor may ask you about your family history during your evaluation.

Children can develop sleep apnea, although it’s far less common among children than adults. Children with larger-than-normal tonsils and adenoids are more likely to develop obstructive sleep apnea. Children with sleep apnea may also develop hyperactivity issues, resulting in poor school performance.

Sleep apnea may not always be curable, but several sleep apnea treatments are available to make its symptoms more manageable. The most common sleep apnea treatments include:

• Weight Loss – Because obesity and sleep apnea are often linked, your doctor may suggest losing weight to alleviate your symptoms. It may be necessary to change your lifestyle, incorporating more exercise and a healthy, well-balanced diet. You may also need to quit smoking.
• Nasal Decongestants – Over-the-counter nasal decongestants may help relieve snoring for patients with mild sleep apnea.
• CPAP Therapy – CPAP (continuous positive airway pressure) therapy is typically recommended for patients with obstructive sleep apnea. Your CPAP machine is connected to a sleep apnea mask worn over your face at night. The machine delivers air into your nose and mouth through the mask, which prevents your airways from collapsing while you sleep.
• Sleep Apnea Devices – Sleep apnea dental devices include custom-fitted mouth guards to hold your jaw in a forward position while you sleep. By pushing your lower jaw and tongue forward, your airways are kept open.
• Surgery – When all other sleep apnea treatments fail, surgery may be recommended to restructure the jaw or nasal passages. Surgery may also remove extra throat tissues.

CPAP therapy is usually one of the first treatments recommended for obstructive sleep apnea. Benefits of CPAP therapy include:

• Improved sleep quality
• Increased energy levels
• Increased job performance
• Less irritability and mood swings
• More daytime alertness

Yes. Most CPAP machines and facemasks will fit inside your carry-on luggage. However, since CPAP machines are considered necessary medical equipment, they may travel in their own case without being considered an additional carry-on item. You may want to get a letter from your doctor explaining what your CPAP machine is and why you need to travel with it, although they’re common. Most security personnel should be familiar with them. Because sleep apnea doesn’t ever take a vacation, you shouldn’t either without taking your sleep apnea treatment with you when you travel.

Research has shown that more people are likely to use their sleep apnea mouth guards consistently compared to sleep apnea machines. Because they’re custom-fitted for each patient, sleep apnea mouth guards are often more comfortable to wear at night. Similar to an orthodontic appliance or sports mouth guard, these devices hold the lower jaw forward to keep the airways from collapsing at night. Dental devices may not be suitable for all patients with sleep apnea. They’re typically recommended for people with mild to moderate sleep apnea. Schedule a consultation with Dr. Cavendish to learn more.