Sleep apnea is a disorder that causes momentary interruptions in breathing while a person sleeps.
This pathology negatively influences the quality of sleep of the sufferer, but also of those around the affected person.
One of the most significant and annoying symptoms of apnea is snoring.
Fortunately, we are talking about a sleep disorder that has a solution.
In this article, we tell you what happens to people who suffer from sleep apnea and hypopnea syndrome (SAHS).
The difference between the two is that the first involves the total closure of the airways, while hypopnea is partial.
What is sleep apnea?
SAHS is mainly classified into two types:
Obstructive sleep apnea.
Known by its acronym, OSA or OSA, it is the most common typology within this type of disorder.
The person with nocturnal apnea experiences repeated pauses in breathing lasting at least 10 seconds while sleeping.
This happens because the airways become narrowed or completely blocked, preventing sufficient air from reaching the lungs.
As a result, the little oxygen that does get into the lungs does so with difficulty and the person snores.
Partial obstruction
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SLEEP APNEA
When the lungs do not receive the air they need and the oxygen concentration drops, the person unconsciously interrupts sleep to clear the airways.
The sudden attempt to breathe will result in a sound similar to the sound someone makes when choking.
The phases of sleep change as we sleep, and these episodes usually occur in the deepest stages.
Breathing returns to normal when sleep is lighter.
In this way, the breathing cycle is maintained until the next apnea episode occurs.
Central sleep apnea
In this case, the origin of the disorder is in the brain, which does not send the necessary orders to the muscles to breathe.
Therefore, it is not the result of an obstruction in the airways.
This type of respiratory apnea is often experienced by people with diseases such as heart failure, tumors or brain infections.
Although not all people who snore suffer from sleep apnea, snoring is one of the clearest symptoms of this disorder.
Who is affected by this sleep disorder?
According to the National Consensus on SAHS, it is a common sleep disorder.
It affects a significant part of the population: between 4-6% of men and between 2-4% of middle-aged women and almost 2 million people in Spain.
As Dr. Patricia Bratos, a specialist in orthodontics, explains, as the person gets older, the presence of apnea can become more evident, although childhood apnea does exist.
That is why, in people over 65 years of age, this disorder reaches 25% of the population.
On the other hand, apnea in infants and children is less frequent, affecting a smaller percentage ranging between 1 and 3%.
Even so, there is a variant known as newborn apnea, in which case it would be advisable to consult a pediatrician.
Infant apnea
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CHILDHOOD APNEA
How to diagnose sleep apnea
Until now, there was only one way to diagnose apnea: by performing a sleep study in specialized medical centers.
The most reliable test is called nocturnal polysomnography and consists of recording different variables to determine the quality of sleep.
The patient can also opt to undergo other simplified studies, such as respiratory polygraphy.
The relationship between dental health and apnea
Recent studies have changed the way apnea can be diagnosed.
Today, the dentist may be the first filter to detect a sleep disorder in one of his or her patients.
One such report, published in the Journal of Clinical Sleep Medicine, exposed the relationship between dental wear and OSA.
After analyzing the sleep of 30 patients, a statistically significant association was found between the severity of apnea and the wear of their teeth.
But this is not the only evidence that the condition of teeth can be a tool to identify patients at risk for sleep disorders.
A second study in the 2019 Journal of Oral Rehabilitation corroborates this relationship between apnea and oral health.
But tooth wear is not only associated with this sleep disease, but also with oral dryness (xerostomia) and bruxism.
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Main symptoms of apnea
Sleep disorders generate a poor quality of rest and can seriously damage our lives.
In fact, OSA is often considered a chronic disorder.
Dr. Bratos explains that, in addition to the characteristic snoring, apnea presents a series of symptoms that cause sleep problems:
Waking up feeling tired in the morning.
Waking up during the night with a choking sensation.
Experiencing drowsiness during the day.
Feeling bad mood and irritability.
Falling asleep easily during periods of inactivity.
Frequent headaches.
Lack of concentration.
Loss of memory.
Ask for a specialist’s opinion
If you experience any symptoms of OSA, consult your dentist.
Risk factors for developing SAHS
As we have already mentioned, sleep apnea has its origin in airway obstruction.
In turn, this blockage can be caused by a large tongue or tonsils, excessive fatty tissue in the throat or in the relaxation of the muscles of the mouth.
The American Dental Association (ADA) points out that, although apnea can be experienced at any age, men are more prone to it.
Other common risk factors include:
Overweight and obesity.
Family history of sleep apnea.
Airway abnormalities: deviated septum, allergies, having sinusitis ….
Sleeping on the back.
Alcohol intake and use of sleep medications that relax the muscles of the mouth.
Tobacco use.
Sedentary lifestyle.
Treatment for obstructive sleep apnea
As a disorder that occurs when a person is asleep, many sufferers are unaware that they have OSA.
In fact, in most cases, it is the partner or a family member who detects the problem by observing the same pattern every night.
Above all, we are talking about loud snoring that alternates with repeated breathing pauses.
Although the habit of snoring is one of the symptoms most associated with apnea, it is important to note that not all people who snore suffer from this disorder.
Therefore, if in doubt, it is best to see a professional to make a diagnosis and establish a treatment.
There are two types of treatment for sleep apnea:
Orthoapnea
Another treatment to combat sleep apnea in mild and moderate cases is the Orthoapnea intraoral appliance.
Composed of two splints joined together by means of a screw, this mandibular advancement device favors the advancement of the maxilla to facilitate the passage of air.
Night splints
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ORTHOAPNEA
This normalizes the respiratory cycle and also functions as one of the remedies for snoring.
Since the purpose of Orthoapnea is to ensure restful sleep, it is custom-made for each person to make it comfortable.
In addition, it allows freedom of movement and even the ability to drink water and talk.
Continuous Positive Airway Pressure (CPAP)
Known as CPAP, this is a machine used in the most severe cases of apnea.
If a person’s breathing is interrupted too many times per minute, the practitioner determines that the disorder cannot be corrected by any other method.
Nocturnal CPAP works by constantly supplying the person with oxygen, forcing the airway to stay open.
Once prescribed, the patient must use it every night during his or her sleep hours.
Acquiring this routine can be somewhat complicated for some people, as it emits noises and makes the wearer feel a constant intake of air.
Therefore, at first, it is uncomfortable to sleep with it.
However, in cases where it is necessary to use it, one should be as consistent as possible with its use, as repeated shortness of breath can be dangerous.
Treatment for apnea
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CPAP
Surgery
When the treatments mentioned above do not work and fail to eliminate the annoying signs of apnea, it may be necessary to resort to surgery.
This is recommended by the American Academy of Dental Sleep Medicine, which explains the need for surgery in very severe cases.
Can I choose between using CPAP or Orthoapnea?
Although the use of Orthoapnea is simpler and less invasive than surgery, the truth is that they are not interchangeable.
Many people come to our dental clinic because they find the CPAP system uncomfortable and prefer to wear the splints.
However, if the patient has too many apneas per minute, our recommendation is to try CPAP.
Orthoapnea is indicated in milder cases and is not as effective for more severe cases.
The truth is that something that seems as simple as sleeping is impossible for many people.
Lack of sleep affects our quality of life, leading to states of anxiety, moodiness or depression.
Therefore, at the first symptoms that we notice -or that others perceive- the best thing to do is to get in the hands of a doctor or dentist so that he or she can propose a solution.
In this way, we will put an end to all those complications that, although at first seemed unimportant, are preventing us from enjoying the day to day and harming our health.
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Bibliographic references
- Archives of Bronchopneumology (2005). National Consensus on Sleep Apnea-Hypopnea Syndrome (SAHS). Vol. 41. No. S4. pages 7-9 (https://www.archbronconeumol.org/es-consenso-nacional-sobre-el-sindrome-articulo-13084320)
- Durán-Cantolla, J., Alkhraisat, M.H., Martínez-Null, C., Aguirre, J.J., Guinea, E.R., Anitua E. (2015). Frequency of Obstructive Sleep Apnea Syndrome in Dental Patients with Tooth Wear. Journal of Clinical Sleep Medicine.11 (4): 445-50. (https://www.ncbi.nlm.nih.gov/pubmed/25665693)
- Wetselaar, P., Manfredini, D., Ahlberg, J., Johansson, A., Aarab, G., Papagianni, C.E., Reyes Sevilla, M., Koutris M., Lobbezoo, F. (2019). Associations between tooth wear and dental sleep disorders: A narrative overview. Journal of Oral Rehabilitation. 46 (8): 765-775 (https://www.ncbi.nlm.nih.gov/pubmed/31038764).
- American Dental Association (ADA). Sleep apnea and snoring. (https://www.mouthhealthy.org/es-MX/az-topics/s/sleep-apnea-and-snoring)
- American Academy of Dental Sleep Medicine. (2015) Dentists treat sleep apnea, too. (https://www.aadsm.org/for_patients.php)
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