When Sleep is Not Restful
Most of us expect that after a reasonable amount of sleep, we will awaken feeling rested, refreshed, and ready to meet our day. For a great number of people, this is not the case. One cause of nonrestful sleep is a condition known as sleep apnea. The most common form of this disorder is obstructive sleep apnea, where muscles surrounding the throat relax during sleep, blocking the airway. The result is a cessation of breathing and often, gasping for air. The tissues in the body are deprived of oxygen and the brain is deprived of REM sleep during these events. Sleep apnea is associated with a greater risk of heart attack, stroke, metabolic disease, acid reflux, and obesity. The apnea sufferer may also have difficulty awakening or concentrating, daytime sleepiness or experience irritability or depression. It is now known that children are sometimes mistakenly misdiagnosed with ADD when in fact they are actually suffering from sleep apnea.
The incidence of obstructive sleep apnea in the population is projected to be about one fourth of males and one tenth of females. Astoundingly, an estimated 9 in 10 with the condition remain undiagnosed. Of those undiagnosed individuals, the average lifespan is only 58 years old! Clearly, obstructive sleep apnea has significant health implications.
Screening for sleep apnea is done in both medical and dental/orthodontic settings. A questionnaire, physical exam as well as radiographic studies can be administered to determine a patient’s risk for the disorder. If obstructive sleep apnea is considered a possibility, the patient can be referred for a sleep study to determine if they indeed have the condition.
Treatments can include lifestyle changes (weight loss, changing sleep positions or habits), oral appliances (palatal expansion and appliances that re-position the jaw or tongue during sleep), breathing devices (masks that blow air under pressure through the airway, keeping it open during sleep), and surgery to correct the structural abnormalities causing the disorder (soft tissue surgery to remove excess tissue, or jaw surgery to change the jaw structure or position).
As the pervasiveness and implications of sleep apnea become more clearly understood, it is imperative that screening for this condition become a standard part of a thorough medical, dental or orthodontic exam.