Oral Appliances – A Solution to OSA

Twenty four percent of the American population is affected by sleep apnea—obstructive sleep apnea (OSA) to be exact. This sleep disorder not only keeps one from breathing during the night, but other diseases and complications, such as heart disease, stroke, and dangerous daytime fatigue, have been linked to OSA. With over 50 million Americans dealing with sleep apnea, it’s a relief to know that there are solutions and treatment options.
One in particular appears to be making headway, despite CPAP being the number one treatment option. With over forty designs to ensure comfort and the perfect match, oral appliances (OAs) are here to stay. More and more patients are being reimbursed by insurers for OAs. There are two types of OAs to help ensure that the patient is as comfortable as possible with the treatment: mandibular repositioning appliances (MRAs) and tongue retaining (TR) devices.
Mandibular repositioning appliances, sometimes referred to as mandibular advancement appliances, comprise of two splints molded to the upper and lower teeth. The upper jaw is used as an anchor to bring the lower jaw forward. This advancement of the lower jaw brings the tongue forward and gives a little rigidity back to the excess tissue in the back of the throat. This, in turn, clears up the airway to give way to easier breathing.
For those that don’t find MRAs right for them, TR devices use two fused splints with an elastic sleeve to get the job done. The sleeve is used to hold the tongue forward. Thus, achieving the same cleared airway as an MRA would produce. Although some consider this more uncomfortable that MRA use, TR devices are perfect for patients that have few teeth or use dentures. Because MRAs use the upper teeth as an anchor to extend the lower jaw forward, patients with few real teeth or none at all may find it difficult and impractical to use.
Whichever device or appliance one opts for, experts give three rules to any OA usage. The OA should ensure an ease of titration. When using any of the over forty OA designs, make sure that there is full coverage. This will ensure that there won’t be any teeth movement or bite shifts—and that those pricey braces from so long ago haven’t gone to waste! And finally, you want to make sure that the device is adjustable to make sure that you have the perfect fit.

Sleep Apnea and Other Diseases

            Being the most common sleep disorder, sleep apnea is something we all know we shouldn’t be messing with. Obstructive sleep apnea (OSA) alone poses a huge obstacle to healthy living: it disrupts sleep. While some can’t even bear the idea of not getting a full night’s rest, loss of beauty sleep isn’t the only thing that sleep apnea is guilty of. There are deadly links between sleep apnea and heart disease, and OSA and diabetes.

            When one looks more deeply into sleep apnea, it causes so much more than just a loss of sleep. Hypertension, arrhythmias, congestive heart failure (CHF), stroke, and sudden cardiac death are all linked to this sleep disorder. The risk of stroke and sudden cardiac death is increased with sleep apnea. Arrhythmias and sleep apnea go hand in hand. A patient with arrhythmias is more likely to have to deal with sleep apnea than a patient without arrhythmias. A patient with severe sleep apnea is 4.3 times more likely to develop significant ventricular arrhythmia than someone who gets the privilege of sleeping soundly throughout the night. An article from a CHF clinic inTorontogave alarming statistics. Half to sixty percent of their CHF patients suffered from sleep apnea as well. In those CHF patients, the struggle with OSA increases the mortality rate by three to four times. Twelve percent of the CHF patients without sleep apnea died. However, twice as many patients with sleep apnea—twenty four percent—died as well. Of all those patients, zero percent of those with treated sleep apnea lived to fight another day. The study showed that the development of cardiomyopathy and CHF in severe OSA patients would likely be avoided with long term CPAP treatment. OSA patients treated with CPAP were reported to experience a seventeen percent lower incidence of cardiovascular events than those who did not receive treatment. While sleep apnea and heart disease appear to go hand in hand, there are treatments and solutions to help ensure that loss of sleep is the only thing one will have to worry about.

            Not only is this sleep disorder a heart breaker, but those with sleep apnea and diabetes have a lot more to worry about than not getting a full night’s rest. Patients that suffer from type 2 diabetes and OSA are at a higher risk for severe retinopathy. This can lead to loss of sight. Retinopathy occurs when the blood vessels in the retina of the eye are blocked or are leaky. This keeps light from getting to the retina and can ultimately damage vision. Neuropathy and other foot problems can come up as well, which can lead to amputation. Neuropathy is nerve damage that can cause long term complications of diabetes. This can lead to foot ulcers and slow healing wounds which can give way to infection. In the worst case scenario, the infection would lead to amputation.

            In conclusion, sleep apnea is so much more than just loss of sleep. Heart disease, arrhythmias, hypertension, CHF, stroke, sudden cardiac death, retinopathy, neuropathy, blindness, amputation, and handicap placard—the list goes on and on! Sleep apnea is no laughing matter. And if you or a loved one suffers from this sleep disorder, be sure to get the proper treatment before you find yourself a victim of the myriad of side effects and you’re wandering around blind with one foot.

The Significance of Sleep Apnea

            While losing beauty sleep to some may seem like the end of the world, to others, a yawn here and there throughout the day is nothing that can’t be fixed by a good cup of coffee. However, sleep apnea affects so much more than just a few hours of beauty rest.

            In 2011, China welcomed it’s first ever Grand Slam tennis champion, Li Na. Li Na beat the world’s number one ranked tennis player, Caroline Wozniaki in Melbourne. However, it wasn’t an easy win. Li Na dropped the first set and it was down to a match point. After her shocking win, Li Na was asked why she appeared to be having trouble throughout the match. She said she hadn’t slept well the night before due to her coach-husband’s snoring. Snoring has been known to be a side effect of sleep apnea. And to think, because of sleep apnea, Li Na could have lost so much more than just beauty sleep—China could have been robbed of its first every Grand Slam tennis champion!

            Tennis champions aren’t the only things that sleep apnea could interfere with. OnApril 13, 2011, the Federal Aviation Administration announced that it suspended another air traffic controller for snoozing on the job. While that was the second suspension just that month, the FAA has already investigated five lapses in airports nationally. Four out of the five involved falling asleep on the job. While sleep apnea can interfere with one’s beauty sleep, the repercussions of that loss of sleep can be catastrophic. Not getting enough sleep during the night means daytime fatigue—and a higher chance of falling asleep on a job that affects the lives of many other people.

            Whether it be your country’s first Grand Slam champion or ensuring the safe landing of a plane carrying hundreds of people, sleep apnea can interfere with both scenarios and make the outcomes catastrophic. Sleep apnea is a serious disorder that should be dealt with as soon as possible—a life could depend on it.

Facts About Sleep Apnea

            Over 50 million Americans suffer from this. One in every eight people will have to struggle with its side effects. It’s the most common sleep disorder today. It’s called sleep apnea. An apnea is defined as a dramatic reduction in breathing or a pause of airflow for ten seconds or more. This results in a four percent drop in oxygen saturation in the blood—if not more. This disrupts sleep where in the individual moves out of a deep sleep into a more shallow sleep. Sleep apnea is defined as having at least fifteen apneas in just one hour. That’s quite a few times to be waking up in just one night’s rest!

            There are two types of sleep apneas. One is called central sleep apnea, or CSA for short. This is the more neurological malady. The second is called obstructive sleep apnea (OSA). OSA is the more physical malady of the two. When one falls asleep, the soft tissues toward the back of the throat lose their tone and rigidity. With a combination of gravity and the negative pressure associated with breathing, the soft palate and uvula fall back into the throat and collapse into the airway. This blockage is what causes OSA.

            An apnea is not the only thing out there that disrupts millions of the people’s beauty sleep. While not quite as severe as an apnea, a hypopnea also results in a four percent or more reduction in oxygen saturation in the blood as well as disrupts the level of sleep of the individual. A hypopnea is defined as a decrease in breathing.

            Apneas and hypopneas are measured by apnea indexes (AI) and hypopnea indexes (HI). Each index is measured by dividing the number of apneas or hypopneas by the number of hours of sleep. If one suffers from both, an apnea-hypopnea index (AHI) divides the number of apneas and hypopneas by the number of hours of sleep. While a sleep apnea is defined as having an AHI of at least fifteen episodes per hour, those that suffer from daytime fatigue, hypertension, insomnia, ischemic heart disease, low flow of blood to the heart, mood disorders, and stroke only have to experience five episodes per hour to be diagnosed with sleep apnea. Not only does sleep apnea make all of those problems and complications worse, but many of those are the very side effects that come with sleep apnea.

            Loss of beauty sleep isn’t the only thing that this sleep disorder is at fault for.