Sleep Apnoea/Snoring Treatment

Many patients suffering from snoring and sleep apnoea often assume that only ear, nose and throat (ENT) specialists can correct their condition.

Snoring is a loud, unpleasant condition occurring during sleep when the soft palate at the back of the throat relaxes too much, causing tissues to vibrate and resonate sound. Chronic snoring is potentially serious and can lead to more severe sleep-related issues like sleep apnoea.

The term sleep apnoea comes from a Greek word meaning ‘without breath’ and refers to brief, temporary interruptions to breathing while asleep. Sufferers repeatedly stop breathing when the soft tissue at the back of the throat collapses completely, obstructing the airway.

Each period without breath can last for 10 seconds or more – and sometimes as long as a minute. The sleeper is unaware and the process may be experienced up to hundreds of times during the night. This can be life threatening, as sleep apnoea has been linked to high blood pressure and other cardiovascular complications.

What is Obstructive Sleep Apnoea (OSA)?

The time we spend sleeping is synonymous with the amount of rest we get and the rejuvenation that comes from it. However, patients who suffer from Obstructive Sleep Apnoea are deprived of the rejuvenating rest that only comes from deep sleep.

Obstructive Sleep Apnoea is a potentially dangerous sleeping disorder characterized by frequent disruptions to normal breathing as the sufferer sleeps. Apnoea is a Greek word that means “without breath”. Known as OSA for short, the condition causes the patient’s airflow to either be partially or completely blocked for 10 seconds or more. This­­ occurs when the tissues around the windpipe – and surrounding muscles that keep the airway open – collapses during a state of relaxation (sleep) to such an extent that it obstructs the airway.

Although the breathing pauses only last for seconds at a time, apnoea episodes can occur throughout the night, thus preventing the person from reaching the deeper stages of sleep. While most adults require 8-9 hours of sleep every day, studies indicate that at least 20% of it should be spent in deep sleep, in order for the person to be refreshed and fully functional the following day.

Obstructive sleep apnoea can affect both males and females, irrespective of age. Statistics however show that middle-aged men who are overweight or consume alcohol frequently are at a higher risk of developing the condition.

Symptoms of OSA

Most people associate the sleeping disorder with its most common manifestation of loud and persistent snoring. There are in fact many signs and symptoms that accompany the OSA condition. The symptoms may be divided into two broad categories: Nighttime and Daytime. The so-called nocturnal symptoms occur as a direct result of the sufferer’s airway being obstructed during sleep, such as snoring or choking. The daytime symptoms, on the other hand, mostly occur due to the sleep deprivation caused by the OSA condition.

Sleep apnoea treatment cannot begin until these signs and symptoms are identified and brought to the attention of a trained sleep physician who is qualified to carry out a proper diagnosis. Delayed OSA treatment can have serious health implications, including medical conditions like high blood pressure, heart attack, stroke or even sudden death.

If you spot a few or most of the following symptoms – particularly if you are middle-aged and overweight – do not hesitate to make an appointment to see your medical or sleep physician for a diagnosis:

• Snoring: This is the most common symptom that almost every OSA patient suffers from. If the snoring is loud and persistent, it does not only cause annoyance to a bedroom partner, it is one of the most telling signs that you may be a OSA sufferer. It must however be clarified that not all snorers are diagnosed with sleep apnoea.
• Choking/gasping for air: Another telling symptom that usually follows after the breathing pauses. If you have been observed to choke repeatedly throughout the night, do not ignore the symptom.
• Excessive fatigue during the day: A direct – and unsurprising – consequence of OSA-related sleep deprivation.
• Morning headaches: Waking up to frequent bouts of headache.
• Dry mouth in the morning: Especially for OSA sufferers who are mouth breathers.
• Heartburn in the middle of night
• Depression and anxiety
• Bed-wetting: Mostly affects children.
• Forgetfulness/ lack of concentration: Due to excessive fatigue
• Decreased libido

OSA Diagnosis (Sleep study)

If you suspect that you may be suffering from Obstructive Sleep Apnoea, the best thing you can do is consult your medical or sleep doctor about your concerns. To receive an accurate diagnosis, your physician may recommend that you go for a sleep study, or what is known as a polysomnography.

Administered by a qualified sleep physician, a polysomnography utilizes several physiological monitors to record your breathing patterns, brain and physical activity while you sleep. The study shows the number of arousal events that exceed preset markers, the frequency of which determines whether or not you have a sleeping disorder, and its level of severity. The sleep study can either be carried out at a sleep clinic or in your own home.

Risks of untreated sleep apnoea and health complications

Obstructive sleep apnoea (OSA) is a serious medical condition associated with several health risk factors:

• Cardiovascular problems: The cessation in breathing causes decreased oxygenation of the blood, which over time, can lead to complications like heart rhythm disturbances and heart failure.¹
• Stroke: Studies show that people with moderate to severe OSA are 4 times more likely to have a stroke.²
• Diabetes: When you struggle for air in your sleep, stress hormones are being released that can raise blood glucose levels.³
• Cancer: Studies show that people with moderate to severe OSA are 3 times more likely to die from cancer.²
• Death: Studies show that people with moderate to severe OSA are 4 times more likely to die.²
• Cognitive impairment

Sleep Apnoea Treatments

Continuous Positive Airway Pressure (CPAP)

This is the first line of treatment administered via a breathing mask as a person sleeps. Although CPAP is effective in treating OSA symptoms, many struggle to get accustomed to wearing the mask to sleep or the noise produced by the CPAP machine. It is true however that the noise generated by the CPAP is preferred over the snoring.

Surgery

Typically recommended as a last resort when patients have problems coping with CPAP therapy. Surgeries performed on outpatient basis include Somnoplasty. Other more invasive types of surgery – usually reserved for those with severe OSA issues – include nasal and mandibular advancement surgery.

Lifestyle changes

Examples of holistic treatments include weight loss, change of sleeping position and limiting intake of alcohol, tobacco and sleeping pills.

Dental appliances

How can the dentist help?

A dentist who is trained in sleep medicine and the use of Oral Appliance Therapy (OAT) is able to customize a dental device that not only alleviates your immediate symptoms like – snoring or choking – but also treat your condition over time. OAT is a non-invasive, non-surgical treatment option frequently recommended for OSA patients who have problems complying with CPAP therapy.

The most commonly prescribed dental appliance is the Mandibular Advancement Splint/ Device (MAS/ MAD). The oral sleep device works by repositioning the lower jaw/ mandible (largest facial bone) such that it prevents your tongue from falling back and obstructing your airway during sleep. The dentist who specialises in OSA treatment can supply, fit and periodically adjust the oral appliance, consisting of a set of splint for your upper and lower jaws.

Working closely with your medical practitioner or sleep physician, the dentist is able to employ clinically-tested Oral Appliance Therapy (OAT) methods to recondition your breathing habit and restore your health in a safe and effective way.

Contact our team today if you are suffering from snoring or sleep apnoea. Our practice is equipped with oral appliances to prevent airway obstructions and help remedy your condition.  Our team looks forward to helping you learn more about these devices so you can enjoy safe, quality sleep and wake up feeling refreshed again.