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Obstructive Sleep Apnoea
Snoring - research has shown that snoring is a potentially serious problem which may have long-term medical consequences. Predisposing factors include increasing age, obesity, sedative drugs and smoking/alcohol consumption. It can lead to chronic sleep deprivation, poor concentration, morning headaches, and impaired relationships with others especially spouses and partners. In more severe cases, the snorer may stop breathing for short periods at night (see obstructive sleep apnoea).
Obstructive sleep apnoea (OSA) - is a sleep disorder in which breathing is interrupted by a physical block to airflow despite respiratory effort. Each episode, called an apnoea lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. The standard definition of any apnoeic event includes a minimum 10 second interval between breaths, with either a neurological arousal, a blood oxygen desaturation of 3-4% or greater, or both arousal and desaturation. Clinically significant levels of sleep apnoea are defined as five or more episodes per hour of any type of apnea. The individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance
In addition to the effects of snoring, the consequences of untreated sleep apnoea include, mood or personality changes, fatigue and irritability, choking attacks at night and decreased libido. The reduced alertness can be dangerous and result in an increased risk of accidents on the roads or at work. Sufferers from OSA are also significantly more likely to develop high blood pressure, heart attacks and stroke.
Sleep Study - when a person presents with snoring, we must decide whether they are a straight-forward snorer or whether they are blocking off their wind pipe and may have obstructive sleep apnoea (OSA). Although the history and examination may be suggestive of OSA, it is usually necessary to carry out an overnight sleep study to confirm the diagnosis.
MDG uses the most recently developed, scientifically proven technology FDA approved with the Watch PAT system. Please see Evaluation of a portable device based on peripheral arterial tone for unattended home sleep studies. BAR A, PILLAR G, DVIR I, SHEFFY J, SCHNALL RP, LAVIE P. Chest 2003;123(3):695-703. The Watch PAT200 is a portable device based on the peripheral arterial tone (PAT) signal and is a simple non-invasive device designed for unattended home sleep studies. The equipment is simple to set up and does not usually impair the normal sleep pattern. The next day the equipment is returned to MDG for analysis.
Treatment of Snoring/Obstructive Sleep Apnoea
There are several treatment options for OSA depending on the severity of the condition. Many individuals with mild to moderate OSA will benefit from a mandibular advancement splint (MDS). An MDS is a dental appliance moulded to the shape of your teeth like a mouthguard or fitted by a dentist and worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway. They do this by repositioning and holding the mandible (lower jaw) in a protruded position during sleep and/or by lifting your soft palate. Holding the lower jaw forward tends to also bring the tongue forward and exert tension on the muscles of the tongue making it more rigid and less floppy overcoming obstruction of the throat. The effect of this treatment is usually a significant reduction in daytime sleepiness and other associated symptoms, together with the abolition of snoring. Many people say that they feel like a ‘new person' after purchasing a mandibular advancement splint.
There are a number of appliances on the market, ranging in price from the $100, marginally effective "do it yourself" models, to custom fitted, adjustable and proven effective models at $2,500.
Your dentist will advise you not to use a mandibular advancement splint for any length of time without dental supervision, as incorrect fitting can cause damage.
People who are diagnosed with severe OSA may require treatment with continuous positive airways pressure (CPAP). These individuals are referred to their general practitioner (along with a copy of their sleep study) for further medical follow up.
For more information see http://www.helpguide.org/life/sleep_apnea.htm
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