A dentist’s role in OSA

Many people associate being overweight and having a large neck as the two main reasons why people have obstructive sleep apnea. However, the size and configuration of the tongue, soft palate, tonsils and adenoids can be part of the reason why air is being prevented from entering the lungs.

Dentists play a larger role in treating sleep apnea that most people realize. For example people with sleep apnea tend to clench their jaws and grind their teeth during apneic episodes. This can result in worn out teeth, and dentists are usually the first people to notice the signs and come to the conclusion that it may be related to sleep apnea.

Cagle a member of the American Academy of Dental Sleep Medicine said, “Most dental issues are not life or death situations, but when we’re helping a person with sleep apnea, that’s definitely helping them to extend their life and quality of life”

To determine whether you have sleep apnea, the most common test that done is the polysomnography, where a person undergoes an overnight study and is monitored to see how often breathing is stopped over the course of a night. Severe cases of sleep apnea can register over 100 instances as the night goes on. The standard treatment for sleep apnea is to use CPAP or continuous positive airway pressure: air is pumped through a mask into the mouth and nose preventing any unwanted collapse of the airways.

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Sleep Studies & Sleep Scoring

In order to determine whether or not you suffer from sleep apnea, a sleep study must be conducted. This is called a polysomnography. It is a comprehensive recording of biophysical changes during sleep such as brain (EEG), eye movements (EOG), muscle and skeletal activity (EMG), heart rhythm (ECG), respiratory airflow and effort, and peripheral pulse oximetry.

However, this is not a simple process wherein the patient basically walks into a sleep lab and sleeps soundly for the whole night. Rather, the patient must go to the sleep lab in the early evening due to the preparation time. It takes about one to two hours to be introduced to the setting and to get “wired up.” The polysomnography records a minimum of twelve channels or leads. These leads require a minimum of twenty-two wires that are attached to the patient. The wires lead from the patient and converge into the central box that is connected to the computer system. This system records all of the information as well as stores and displays the data. The sleep study takes around six hours to gather all of the necessary information.

Once the sleep study is complete, the sleep scoring takes place. Scoring of the data is interpreted with the necessary background information of the patient including their medical history and a complete list of drugs being taken by the patient. Sleep efficiency is also determined. This is calculated by dividing the number of minutes asleep by the total number of minutes in bed.

There are four stages of sleep. The first three stages are referred to as non-REM while the last stage is called REM, or “rapid eye movement.” When someone is sleeping lightly, they are in the first or second stages of sleep. The second stage of sleep makes up the majority of sleep time. Stage three is referred to as slow wave or deep sleep. The fourth stage, REM, takes up twenty to twenty-five percent of sleep time.

All of this information goes into account when the sleep specialist is trying to determine whether or not someone has sleep apnea. It is important to confirm or deny having this sleep disorder as it is crucial that it be treated right away. If you or someone you know might suffer from this disorder, have a sleep study conducted as soon as possible.

Snoring

            Sleep apnea is the most common sleep disorder that keeps people turning sleeplessly in their beds. One in eight people suffer from this. With sleep apnea comes a list of side effects: nocturnal awakenings, hypertension, daytime sleepiness, and snoring. Snoring is the third leading cause of divorce today. It keeps the partner up, awake, and on edge.

            Snoring is caused by the soft tissues toward the back of the throat. When one is asleep, the soft palate and uvula lose their rigidity, and on account of gravity, fall back and collapse into the airway. This greatly reduces the size of the opening which results in higher air pressure. This makes for a higher velocity of airflow which causes the limp tissues to vibrate. Anatomical reasons play a huge factor into snoring. Those with large tonsils, a long soft palate, a large tongue and uvula, and excess fat deposits are more likely to snore and keep their partner from getting a full night’s rest.

            Don’t worry though—a full and peaceful rest isn’t just a make-believe fairytale! There are treatment options for snoring that include good sleep hygiene, weight loss exercise, CPAP therapy, oral appliances (OAs), and surgery. CPAP therapy makes breathing possible and easier by clearing the airway with continuous positive airway pressure. OAs reposition the lower jaw, tongue, soft palate and uvula while stabilizing the lower jaw and tongue. This increases the muscle tone of the tongue so that it can get out of the airway during sleep.

            If you’re being kept up by incessant snoring, or if you’re the snoring culprit yourself, consult with a sleep specialist to explore the several treatment options that can give you a full night’s rest.

CPAP to the Rescue

            We all know who the big bad wolf of the sleep disorder world is: sleep apnea. We’ve heard of the horror stories of how this unrelenting wolf keeps its victims from having a full night’s rest. However, like any good story, this one has a hero to save the day: continuous positive airway pressure, but you can call him CPAP for short. This is the best, non-surgical treatment for sleep apnea. Its method of respiratory ventilation is a fairly simple concept. The patient wears a snug mask that avoids any air leakage. A tube that connects the mask to the small and portable appliance delivers heated and humidified air through a nasal or face-mask under pressure. This air pressure then keeps the tissues at the back of the throat open during sleep to avoid any airway blockage that results in OSA.

            The CPAP appliance can be connected to nasal pillows, nasal masks, or full-face masks to ensure that the patient feels as comfortable as possible. CPAP is not only concerned with giving patients a full night’s rest, but comfort is also important. It is important to start with the lowest possible air pressure when using CPAP. This is determined by a process called titration. Using the lowest possible air pressure to get the job done ensures that the patient will be that much more likely not to feel like they’re using CPAP at all.

            There are many different kinds of CPAP therapy. There’s bi-level positive airway pressure (BiPAP) and auto-titrating continuous positive airway pressure. Think of it as the Justice League of sleep apnea treatment. BiPAP delivers a higher pressure of air during inspiration and a lower pressure during expiration. This difference between CPAP and BiPAP allows the patient to feel as if they’re not breathing out against such a high pressure. As one can imagine, this would be more comfortable for most patients. Auto-titrating CPAP is considered a “smart” CPAP machine because it makes pressure adjustments by itself throughout the night. The goal of this machine is to deliver the lowest possible pressure for each position or sleep level the patient is at. This variety of CPAP therapy just goes to show that patient comfort is taken seriously.

            However, just like any good superhero, CPAP does have its downfall. First of all, this treatment is not easy to use. Only forty-five percent of patients use it for more than four hours a night. Twenty-five to fifty percent of patients stop using CPAP altogether. Those with claustrophobia have a hard time adjusting to sleeping with a mask on their face throughout most of the night. It’s crucial to use CPAP as much as possible for the first few months so that the patient can become accustomed to it that much quicker.

            If used properly and accordingly, CPAP can be very effective. CPAP therapy can decrease the number of apneas and/or hypopneas a patient experiences every night. As a result, sleepiness is less likely the next day, cognitive functioning on tests improves, driving on driving simulation tests improves, and the number of accidents in the real world is decreased. Proper use of CPAP reduces hospitalization for cardiac and pulmonary causes. CPAP therapy can reduce the risks of the many conditions related to OSA, such as ischemic heart disease, abnormal heart rhythms, stroke, hypertension, and insulin dependence.

            While there are other treatment options for sleep apnea, CPAP is the best out there. Why? Well, dental appliances are not only invasive, but they must be worn every night. Surgery seems like a more permanent solution. However, it’s extremely painful, expensive, and there is no guarantee for success. At the moment, CPAP is the only treatment option that isn’t as invasive as dental appliances, and is not as excruciatingly painful and expensive as surgery.

            When it comes to the big bad wolf known as sleep apnea, here comes CPAP to the rescue.

 

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.

Why is Outsourcing the Best Option for Sleep Scoring?

Let us count the ways.

Sleep Scoring is not the sole activity that sleep labs busy themselves with within a day’s work. In fact, the sleep scoring is only a part of the many activities inside the sleep laboratory. Now, the thing about that is – Sleep scoring is very time consuming. And before anything else could actually be done, this is the first step. Now, many have turned to outsourcing, as it is not only the most logical but is the best choice – if not the only option! Here are five decisive reasons why outsourcing is the best option for your sleep laboratory!

(1)    Outsourcing sleep scoring activities saves time… a lot of it.

 

It is one of the most tedious activities inside the sleep lab. It takes time organize all the items in the database, to actually score, re-check the items on the data, record the data and forward everything. These activities are done by staff that also have a lot of other things they need to do. When you outsource, you hand these over to staffs whose only task is to score.

 

(2)    It saves not only time, but also money.

 

Instead of spending money on hiring more people or stalling some sleep lab activities since it scoring takes a lot of time, enlisting the help of an outsourcing scoring firm would only cost you not even half of the expenses that you are currently getting.

 

(3)    As it save you both time and money, it helps you increase work output.

 

Now, since you don’t need to do the scoring yourself on your lab, you get more time to dedicate on other activities. This increases the amount of work that you can do as you take your hands and mind off scoring.

 

(4)    It marries efficiency and accuracy in one.

 

Work becomes more efficient inside the lab. Not only that, you can also be assured that the accuracy of your scoring is top notch since you know that the people doing the scoring now are well trained professionals whose only task is to score and produce results.

 

(5)    It ultimately increases your profitability.

 

With more time, heightened efficiency and accuracy – this is the most natural order of things!

 

Save time, money and become more profitable.

N2sleep Diagnostics, Inc. offers the best sleep lab scoring service to date.

Head over to this link to sign up http://www.n2sleep.com/ResourcesforSleepCenters/SleepStudyScoring/tabid/15654/Default.aspx