Sleep Apnea

Many times people don’t realize that sleep apnea is the reason for symptoms that they are experiencing. Sleep apnea interrupts breathing during sleep and can be a major health risk. It is important to recognize the symptoms and be evaluated by a professional. More often than not, it is your dentists who can recognize whether or not a patient is at risk.

What is sleep apnea?

Dr. Darren McKeever: Sleep apnea is when during the sleep period, due to either anatomy or a central nervous system disorder, people fall asleep and something stops them from being able to get air from the outside to the inside. Basically something is cutting off the airway, whether it be their tongue, or whether it be something associated with the soft palate. Basically the result is the same. No matter what is causing the apnea, people just can not breathe and get oxygen into their lungs while they are asleep.

How does someone know they could be suffering from sleep apnea?

Dr. Darren McKeever: That is really the scary part. More often than not people have symptoms that they just can not explain. They do not put two and two together. They do not realize that when maybe they are falling asleep during the day, or they feel miserable when they wake up, they do not realize that the cause is sleep apnea. More often than not people find this out either because a spouse complains for the longest period of time, for example, “You’re snoring too much.” Or, “I heard you stop breathing in your sleep.” Maybe they go to a physician and the physician looks down their throat and says, “Gee, maybe we should check you for sleep apnea.” More often than not, it is dentists who actually can find this out, because we are always looking at people’s throats and a well-trained dentist would recognize whether or not a patient is at risk.

What are some causes of sleep apnea, or risk factors associated with it?

Dr. Darren McKeever: In very, very few cases it is a central nervous system disorder, where people just for whatever reason stop respiring in their sleep. More often, it is caused by an anatomical issue. When people fall asleep, we are usually laying back and the tongue, which is nothing but a group of muscles, goes flaccid just like all the other muscles in your body and as it submits itself to gravity and falls backwards, it then closes off the airway. Now the two sources of oxygen, either your mouth or your nose, are blocked from the outside to your lungs. This does not have to be something that is associated with being overweight. It can truly just be an anatomic issue in some people. I have some fit patients who are very fit, but the anatomy is just all wrong for letting air in while they are asleep. Very often we see this associated with people who are very overweight or sometimes just a little bit overweight.

How is sleep apnea treated? 

Dr. Darren McKeever: The gold standard in treatment is called a CPAP device. The CPAP device is a positive pressure device that people wear. It looks sometimes like a little bit of a mask that goes over their nose and mouth. Sometimes it can be what is called a nasal pillow, which just goes underneath their nose and has little protrusions that go up into the nostril. While they are sleeping, the device is forming positive pressure through a hose and that is enough air to open the airway while people are trying to breathe. That is the gold standard. Unfortunately, a lot of people do not want to wear a CPAP device. They do not find it attractive or they feel it is annoying. They do not see the full benefit of it and they give up on that.

A secondary means is an oral appliance that actually fits to the upper and lower teeth that pulls the lower jaw forward and that gives the tongue just enough room as it relaxes so that it is not hitting the back wall of the throat. Not as good as a CPAP but more often than not better than nothing.

What can people do on their own to try to deal with or curtail their sleep apnea?

Dr. Darren McKeever: Well, they have been trying all sorts of things with this. Nasal strips, sleeping on your side. Really, the reality is, first you need to know how bad your apnea is. If you have apnea, you have to be seen by a physician. A sleep study has to be done. During the sleep study they can see how many times an hour you either stop breathing, or just how low your oxygenation level goes. Without knowing those things, people really can’t treat apnea. There is all sorts of over the counter devices and things that might help a little bit, but the true reality is, depending on the severity of the apnea, people really should not fool around with this on their own. It can result in having a heart attack. You can lose enough oxygen that the muscles in your heart do not have enough oxygen and all of a sudden if they do not get oxygen, they are going to stop.

I do not know about you, but I personally do not recommend people play with this one on their own. See a physician. Get evaluated. Let the physician either treat it or put your mind at ease that it is not a risk factor.

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If you are interested in speaking with Dr. Darren McKeever, visit or call 973-839-8180 to schedule an appointment.

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