What Is Sleep Apnea? Symptoms and Treatment Guide

What is sleep apnea?

What is sleep apnea? Sleep apnea is a sleep breathing disorder where pauses in breathing occur while sleeping due to airway issues. Disrupted breathing during sleep leads to poor sleep quality and many severe health consequences. A physician or sleep specialist is required to give a sleep apnea diagnosis, which involves a thorough evaluation and sleep study test. The most common type of sleep apnea is obstructive sleep apnea (OSA). A key diagnostic measurement to determine the severity of OSA is the Apnea-Hypopnea Index (AHI), which measures the average number of breathing pauses per hour of sleep. According to the American Academy of Sleep Medicine, severity of OSA in adults is categorized as an AHI of 5-15 for mild OSA, 15-30 for moderate OSA, and greater than 30 for severe OSA. Symptoms such as involuntary sleepiness increase with severity of OSA.

Types of Sleep Apnea

Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea Syndrome (CompSAS) are the three main primary types of sleep apnea. Symptoms of each type may be similar, however, the cause of breathing issues varies based on the type of sleep apnea. Evaluation from a medical professional is necessary for accurate diagnosis and treatment.

Obstructive Sleep Apnea (OSA)

OSA, the most common type of sleep apnea, is typically caused by a physical blockage of the airway. The airway may become impeded as the throat muscles and oral soft tissues relax during sleep, which may cause loud snoring or choking sounds. Treatment for OSA requires multidisciplinary care, often including your dentist, primary care doctor, and sleep medicine physicians. Your dentist may be the first to catch signs of OSA, and can help with OSA treatment once a diagnosis is confirmed.

Central Sleep Apnea (CSA)

CSA results in abnormal breathing due to a brain signal failure. In this rare neurological condition, signals from the brain to your airway muscles are not delivered, which results in issues breathing during sleep. CSA has been linked to conditions including heart failure, stroke, and certain medications.

Complex Sleep Apnea Syndrome

This condition presents as a combination of both OSA and CSA. This condition may become noticeable when patients with OSA are using standard positive airway pressure (CPAP) therapy. Even after airway blockage is resolved, breathing pauses continue to occur from impaired brain signaling.

What are the Common Symptoms of Sleep Apnea?

Sleep apnea symptoms can be tricky, as many people may not attribute symptoms to possible sleep apnea. Plus, many of the signs of sleep apnea occur while sleeping, which requires observation from someone else. Common symptoms may manifest during the day or night.

Here’s what you should look out for:

Nighttime Symptoms

• Loud and chronic snoring
• Pauses in breathing
• Gasping or choking for air
• Restless sleep / frequent awakenings
• Frequent need to use restroom during sleep

Daytime Symptoms

• Morning dry mouth or sore throat
• Excessive daytime fatigue
• Morning headaches
• Trouble concentrating or memory problems
• Irritability or mood changes
• Falling asleep involuntarily

What Causes Sleep Apnea?

There are many possible sleep apnea causes, several of which have dental manifestations. Oral structures play a huge role in the development of sleep apnea, which is why dental professionals are often the first to notice potential signs of sleep apnea.

Primary causes and risk factors for sleep apnea include:

• Narrow airway
• High-arched or narrow palate
• Smaller or recessed lower jaw
• Enlarged tongue
• Enlarged tonsils or adenoids
• Teeth grinding / clenching
• Temporomandibular joint (TMJ) issues
• Anatomical features (i.e. jaw shape, tooth position, thicker neck, soft tissue/muscle tone condition)
• Obesity
• Aging
• Smoking
• Alcohol use
• Sedatives
• Family history / genetics

Health Risks of Untreated Sleep Apnea

The short-term and long-term effects of sleep apnea are dangerous if ignored. Luckily, sleep apnea is a manageable condition with safe and effective treatment options that can improve your overall health and quality of life. Sleep apnea risks should be addressed promptly to avoid potential health complications.

Common short-term effects of untreated sleep apnea include:

• Fatigue-related accidents (i.e. workplace or car accidents)
• Mental health changes (i.e. depression)
• Mood changes / irritability
• Memory issues / trouble concentrating
• Morning headaches

Long-term effects from chronic oxygen deprivation may develop, including:

• High blood pressure
• Heart disease
• Diabetes
• Stroke
• Obesity
• Brain damage

How Sleep Apnea Is Diagnosed?

Screening for sleep apnea requires evaluation from a healthcare professional, including dental professionals. Your dentist may notice potential signs of airway obstruction during routine examinations, including a high-arched or narrow palate, small or recessed lower jaw, enlarged tonsils and/or tongue, temporomandibular joint (TMJ) issues, and worn tooth surfaces from teeth grinding. Advanced imaging, such as 3D digital scans, may also be taken to visualize your airway. If sleep apnea is suggested, your dentist can refer you to a physician or sleep specialist for further evaluation and a sleep apnea diagnosis.

Either a polysomnography overnight sleep study or home sleep test will be required to confirm a diagnosis. A polysomnography (PSG) sleep study test is considered the gold standard for diagnosing sleep apnea and is usually performed in a sleep center or hospital. Devices are used to record measurements like brain activity, oxygen levels, heart rate and rhythm, breathing and airflow, snoring, sleep patterns, and body movements during your sleep in a controlled setting.

Home sleep apnea tests involve the use of a portable device to be used at home during sleep for a specific period of time. These devices are also designed to record measurements of variables, but usually only monitor a few variables compared to regular sleep studies. The device is then returned to your healthcare provider to be reviewed.

What are the Treatment Options for Sleep Apnea?

Sleep apnea treatment varies depending on type and severity. Moderate to severe cases of sleep apnea typically require CPAP therapy, oral appliances, or surgical interventions to manage symptoms. Whereas mild cases of sleep apnea may be improved with non-invasive lifestyle changes. A polysomnography test (PSG) is the gold standard test performed by your doctor or sleep medicine specialist to diagnose sleep apnea in order to determine an appropriate and customized treatment plan tailored to your exact needs and condition. Great Lakes Family Dental Group can work with your team of healthcare professionals to implement effective custom-fitted oral appliances when recommended.

CPAP Therapy

Continuous Positive Airway Pressure (CPAP) therapy is a common treatment option for patients with sleep apnea. This approach is non-invasive and provides pressurized air through a mask to facilitate breathing during sleep. Other types of positive airway pressure (PAP) machines are also available (i.e. Auto-Adjusting Positive Airway Pressure, Bilevel Positive Airway Pressure), which mainly differ in how the air pressure is delivered.

Oral Appliance Therapy (Dental Devices)

An effective CPAP alternative for mild to moderate sleep apnea is oral appliance therapy. Your dental professional can create a custom dental device designed to reduce airway obstruction during sleep. Two common types of oral appliances for sleep apnea are Mandibular Advancement Devices (MADs) and Tongue-Stabilizing Devices (TSDs). MADs, which closely resemble mouthguards, help shift your lower jaw (mandible) and tongue forward, creating more airway space. TSDs use a suction-like cup to gently keep the tongue in a forward position to prevent airway blockage.

Lifestyle Changes

Lifestyle changes may be the recommended treatment option for patients with mild sleep apnea. Lifestyle changes may also be recommended for patients with moderate to severe sleep apnea in combination with other treatments. Common risk factors for airway obstruction include obesity, alcohol, sedatives, tobacco, and sleeping on your back. Consequently, weight management focusing on a healthy diet and consistent exercise, avoiding alcohol and sedatives, quitting smoking, and sleeping on your side instead of your back are common recommendations for improved quality of life and lowering sleep apnea risk.

Surgery (for severe cases)

Severe cases of sleep apnea may require surgical intervention to improve quality of life. In many cases, non-surgical treatments will be attempted before surgery. Your medical professional will determine if surgical intervention is necessary. Surgery may be recommended in more than one different area, depending on your diagnosis. Types of surgical options can include upper airway surgery, nasal surgery, nerve stimulation surgery, tongue surgery, jaw surgery, and weight-loss surgery.

How Great Lakes Family Dental Group Can Help?

Dental sleep medicine is a key part of dentistry that focuses on treating sleep apnea and other sleep-related disorders using advanced dental technology and appliance therapy. Great Lakes Family Dental Group sleep apnea specialists work in collaboration with you and your physician to help you manage sleep apnea. Our skilled dental professionals play an important role in screening for sleep apnea and can refer you to top qualified sleep specialists for a definitive diagnosis and treatment plan. With our patient-centered care and personalized guidance, Great Lakes Family Dental Group is committed to supporting sleep apnea diagnosis and providing effective custom oral devices. The earlier sleep apnea is diagnosed and treated, the better the chances of having improved health outcomes. Schedule a consultation with one of our conveniently located Great Lakes Family Dental Group offices today.

When to See a Specialist?

Have you had to ask yourself, ‘do I have sleep apnea?’ If so, this is a sign that you should consult with a healthcare professional. Chronic sleep apnea can be life-threatening, which is why it is important to consult a healthcare provider immediately if you believe you have sleep apnea or are experiencing any concerning signs or symptoms. Early diagnosis and treatment are essential to prevent serious long-term health consequences.

So, when to see a doctor for sleep apnea? If you experience any of these red flags, seek immediate evaluation:

• Waking up with shortness of breath or trouble breathing
• Long pauses in breathing during sleep, typically witnessed by others
• Chronic snoring
• Chronic and excessive daytime sleepiness
• Persistent headaches
• Existing medical conditions (i.e. heart disease, diabetes, high blood pressure) becoming hard to manage
• Chest pain
• Cold sweats
• Insomnia
• Difficulty with memory or concentration
• Mental health changes
• Waking up from sleep frequently to use the restroom