FOR IMMEDIATE RELEASE Sunday, October 10, 1999
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Dentistry Offers Help To Manage Sleep Apnea and Snoring
HONOLULU -- Some 10 percent of all working-age men, with nearly all of them having a history of loud, continuous snoring, will involuntarily stop breathing at various times during their sleep for 10 or more seconds. This makes for a restless night and exhaustion in the morning.
Estimates are that this stoppage of breath, called obstructive sleep apnea, occurs some six times more in men than women.
"Obstructive sleep apnea can be debilitating and, if persistent, may develop into serious medical complications," said James E. Eckhart, D.D.S., in a presentation about snoring and sleep apnea to dental professionals attending the 140th Annual Session of the American Dental Association here.
In his presentation, Dr. Eckhart covered the anatomy and physiology of the upper airway, explaining how snoring and sleep apnea occur.
In describing snoring, he said that as we fall asleep, the soft tissues at the back of the throat, the muscles that line the airway and the tongue muscle all relax. As relaxation occurs, the tongue drops back into the airway, causing it to narrow. As air passes through this narrowed airway, it moves faster and causes the tissues to vibrate against one another, which in turn causes the rattling familiar to anyone who lives with a snorer.
However, he explained that the more serious condition, obstructive sleep apnea, occurs when the soft tissues in the back of the throat completely close off the airway because of the increasing pressure. The effect is similar to what happens when a person tries to suck a thick milkshake through a narrow straw. Eventually, the straw simply collapses.
This airway obstruction can lead to a reduction in oxygen reaching the brain and blood, and the brain signals the airway muscles to tighten up and unblock the air passage. The result is a loud gasp or snort and breathing begins again. Through the night, the process of blocking and unblocking the airway disrupts sleep, often leaving sufferers of sleep apnea debilitated and exhausted in the morning.
"Help is available for snoring and sleep apnea," Dr. Eckhart said. "Most snorers and people with sleep apnea are undiagnosed and untreated. Symptoms may include restless sleep, headaches, mood changes, daytime sleepiness and debilitation."
He also discussed methods to treat snoring and obstructive sleep apneas. In consultation with their patient's physician, it might be possible for a dentist to fabricate a comfortable, custom-fitted oral appliance that opens the air pathway during sleep and returns breathing to normal.
Strategies to minimize snoring include sleeping on your side; losing weight if you are obese; relieving nasal congestion; minimizing bedroom light, noise and extremes in temperature; avoiding large meals just before bedtime; avoiding strenuous exercise within two or three hours of bedtime; avoiding alcohol or sleeping pills within four hours of bedtime; and avoiding caffeine, nicotine or other stimulants within four hours of bedtime.
"Great strides have been made in the development of medical and surgical therapies, providing a broad range of treatment options for patients," he said. "If you have symptoms of sleep apnea, it is important to be evaluated by a physician specialist prior to any treatment."
Medical and dental treatments can include airway pressure (CPAP) treatment, which consists of a small air blower connected by a flexible plastic hose to a cushioned mask that covers the nose and is most effective for persons with severe sleep apnea.
Another option is an oral appliance, a small plastic device that fits over the lower and upper teeth or tongue and slightly moves the jaw forward to move the base of the tongue forward and open the airway.
Dr. Eckhart also said that surgery in the throat or jaw (a common form of which is laser-assisted uvulopalatoplasty [LAUP] to remove a portion of the soft palate and most of the uvula) and radio frequency surgery (a newer procedure that employs a customized electrode to deliver radio frequency energy to the tongue or soft palate, causing the soft tissue and palatal muscles to tighten or scar) are also viable considerations.
For more information about this and other oral health care issues, visit the ADA's website at http://www.ada.org.
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