Sleep Apnea Dentistry

sleep apnea dentistryObstructive sleep apnea, or OSA, occurs when a person stops breathing for 10 seconds or longer, repeatedly during a sleep session. This form of sleep apnea is often accompanied by snoring because the obstructing tissues tend to vibrate as air enters the body.

Research and media attention have made some of the effects of sleep apnea commonly known. They include but are not limited to:

• Anxiety
• Attention problems
• Daytime fatigue
• Depression
• Diabetes
• Falling asleep at inappropriate times
• Fibromyalgia
• Gastric reflux
• Heart attach
• Hypertension
• Impotence
• Increased risk for heart attack
• Irritability
• Memory, concentration problems
• Muscle pain/fatigue
• Snoring
• Stroke
• Weight gain

New research from Emory University tells us that an enzyme called NADPH oxidase play a role on blood vessels located in the lungs of sleep apnea patients. One in 50 women and one in 25 men have sleep apnea, a potentially serious condition that can increase risk for heart disease and vascular disease. In the study performed on mice, oxygen deprivation caused pulmonary hypertension, which means the heart’s right side could not effectively pump blood through vessels. The oxygen deprivation (chronic intermittent hypoxia) also causes blood vessels in the lungs to make more NADPH oxidase. While NADPH oxide is good in that it makes superoxide, a free radical that helps the immune system eliminate bacteria, it also inhibits nitric oxide, a chemical that relaxes blood vessels. Read the full article in American Journal of Respiratory Cell and Molecular Biology.

A number of factors contribute to a patient developing sleep apnea. Anatomy, heredity, weight, and diet are a few. In the US, an estimated $1.9 billion is spent on healthcare for sleep apnea patients in the ER and ICU. In addition, the 10% decrease in productivity for sleep apnea patients results in about $75 billion lost annually.

What are dentists doing to combat sleep apnea in their patients? Dentists can work with physicians and sleep labs in an interdisciplinary approach for oral appliance therapy (OAT). This conservative treatment often works well for CPAP-intolerant patients. An oral appliance holds the lower jaw forward so that soft tissues do not collapse and block airflow during sleep. A few oral appliances reposition the tongue or force nose breathing, but these are less common.

Popular appliances include:

• Adjustable PM Positioner
• AMP Ultra
• aveoTSD
• Clasp-Retained Mandibular POsitioner
• CPAP Pro
• Elastomeric Sleep Appliance
• EMA – Elastic Mandibular Advancement Appliance
• Herbst Telescopic Appliance
• Hilsen Adjustable Positioning Appliance
• Klearway Oral Appliance
• MDSA – Medical Dental Sleep Appliance
• MIRS – Mandibular Inclined Repositioning Splint
• NAPA – Nocturnal Airway Patency Appliance
• NORAD Appliance
• Nose Breathe Appliance
• OASYS
• OPAP – Oral Pressure Appliance
• OSAP
• SAAMS – Sleep Apnea Management System
• SEGA – Sleep Apnea Goldilocks Appliance
• Silencer System
• Silent Nite
• Snore-Aid
• SnoreFree
• SnoreGuard
• SNOR-X
• SomnoGuard 2.0
• SomnoGuard AP
• SomnoGuard AP Pro
• SomnoMed MAS
• TAP – Thornton Adjustable Positioner
• TheraSnore Adjustable
• TRD – Tongue Retaining Device
• Z-Appliance

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