Sleep apnea is a sleep disorder that causes the airway to narrow or close during sleep. Dentists work with physicians to identify symptoms of sleep apnea and treat it with either a CPAP device or a customized oral appliance made by the dentist.
What is sleep apnea, and what are the risks people face if it goes untreated?
Dr. Monica Stiteler: Absolutely. Everybody knows what sleep is, and how important it is for us to regain energy, and just live a wonderful life. But sleep apnea is a serious breathing disorder. It occurs during sleep due to narrowing or total closure of the airway. It’s really an airway obstruction that occurs multiple times during sleep, and this significantly reduces the oxygen level in the body, disrupting our quality of sleep, and therefore, our quality of life.
Some of the risks that people face if it goes untreated? Constant exhaustion. So even after a full night’s rest, somebody may wake up in the morning completely tired and unsure why, even though they slept a full eight hours, they still don’t feel ready to have a full, busy day. One of the most significant consequences if sleep apnea goes untreated is actually death. So it is possible for people to die during their sleep because of that airway obstruction.
You know, there’s something I always like to tell my patients. People can go three weeks without food and still survive. They can last three days without water and still survive. But people, humans, cannot even last three minutes without oxygen. It is so important to our overall health and well-being that sleep apnea needs to be diagnosed and treated.
What are some causes of sleep apnea, and the warning signs that point to these causes?
Dr. Monica Stiteler: Absolutely. One of the strongest warning signs that indicates somebody is suffering of sleep apnea is actually snoring. 70% of patients who snore do have obstructive sleep apnea. Now, keep in mind that that’s not everybody. Many people snore, and it’s just part of their sleep. But snoring is actually the number one presenting symptom of sleep apnea. Some of the other factors that increase one’s risk for sleep apnea include excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway, especially around the neck area, can actually obstruct your breathing. So the positioning that you sleep in, especially if you’re laying on your back, and if you happen to be overweight and carry excess weight around your neck, can actually cause sleep apnea.
Neck circumference. People with thicker necks also may have narrower airways. Additionally, being male is a significant contributing factor. Men are two to three times more likely to have sleep apnea than are women. However, women increase their risk if they are overweight, and their risk also appears to rise after menopause. Age is a contributing factor, so being older. Sleep apnea occurs significantly more often in older adults. Family history, use of alcohol, sedatives, or tranquilizers can also increase one’s risk, and smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. It can increase the amount of inflammation and fluid retention in the upper airway.
How can a dentist determine if a patient has sleep apnea or is at risk for it?
Dr. Monica Stiteler: Absolutely. Dentists are very familiar with the oral cavity. You know, it’s the number one thing we do. We look at one’s teeth, and we look at their mouth. A common misconception is, a dentist only focuses on a patient’s teeth. As important teeth are to us in our profession, if a patient is not breathing properly and is at risk for dying, this is the number one reason why it is so important that dentists also evaluate one’s airway. When a dentist is looking at your teeth, they also actually take a peek at your throat. They look at your tongue size, and they look at your overall airway.
A dentist does not actually diagnose a patient with oral sleep apnea. However, they see warning signs. It’s important for the dentist. You know, oftentimes we actually have a questionnaire that our patients fill out, where we ask them if they are snorers, if they find that they wake up very, very tired in the morning despite having slept many hours. But in reality, the dentist works very closely with a physician. This is a board-certified medical physician who specializes in sleep apnea. Now, that patient will see both this physician and the dentist, and together they work together to evaluate, and they have a patient do a take-home or an in-lab sleep study. You’ve probably seen this in TV shows or movies, where somebody goes in and they’re sleeping in a scary-looking lab, on a table. The reality is that you can actually take this test at home.
So, it is important for a dentist to evaluate the patient and to identify symptoms of sleep apnea, and really bring it to a patient’s attention.
Can a dentist treat sleep apnea, or does the patient have to see a primary care doctor? And can you describe some of the treatment methods?
Dr. Monica Stiteler: Absolutely. The number one way to really effectively treat sleep apnea is by opening the airway. There is a device called a CPAP device, which is a positive airway pressure. It’s a mask. If you’ve ever seen it, there’s an episode of Seinfeld where he’s wearing this mask, and it looks like Darth Vader, this mask that he’s wearing. It’s very overwhelming. There’s actually an alternative to the CPAP device, and it’s called an oral appliance, which is something that the dentist would make for somebody. Although a dentist does not specifically diagnose the sleep apnea, they do treat sleep apnea by developing these devices. It’s very similar to a sports guard or a night guard, where many patients are grinding their teeth at night, so they wear something to protect their teeth, and it looks like a sports guard. But this is called an oral appliance.
I always tell my patients, “If you can use a CPAP device, and you wear it religiously every night, and it allows you to breathe well and get a good night’s rest, and you wear it every single night, then that’s great. But if you’re the type of person that you’ve been recommended to wear a CPAP, but you just don’t like how big it is, maybe your significant other doesn’t like looking at you while you’re wearing it at night, then an oral appliance is definitely something that will help you out.” It’s something that you would receive from your dentist.
What can people do on their own, at home, to try to deal with or curtail their sleep apnea?
Dr. Monica Stiteler: Maintaining a healthy weight is probably the best thing that anybody could do to try to curtail their sleep apnea. Regular exercise to increase your energy level, to tucker you out during the day so that you are exhausted at night, will help you get a better night’s rest. It’s very important to exercise your heart. In addition, the sleeping position is important. Try to pay attention in how you actually rest at night. If you are a back sleeper, laying on your side is actually a better alternative, because when you’re laying on your back, and if you do have a thicker neck, or more fat deposits around your neck, it will obstruct your airway. So laying on your side allows for an easier breathing at night. Additionally, a humidifier is something that many people find helpful. And lastly, just avoiding alcohol and smoking, minimizing your consumption of the alcohol, will help for an overall healthy lifestyle, and a better night’s rest.
If you are interested in speaking with Dr. Monica Stiteler, visit www.mckeeverdentalcare.com or call 973-839-8180 to schedule an appointment.