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Sleep Apnea: Causes, Symptoms, and Treatments

TMJ Sleep ApneaPeople of all ages worldwide experience sleep apnea symptoms. Sleep apnea is a symptom of serious conditions where patients stop breathing mid-sleep. Sleep apnea is often broadly underestimated as just a cause of snoring, so many people with sleep apnea neglect to seek diagnosis and treatment for it.

Untreated sleep apnea leads to worsened symptoms and a heightened risk of serious complications for health conditions like diabetes, hypertension, dementia, chronic respiratory disease (asthma), and heart disease. As experts in dental sleep medicine, we advise our patients to seek treatment because of these serious health risks.

We also know firsthand that patients need comprehensive education on the condition to get the proper treatment and improve health outcomes. To learn more about sleep apnea, find out more in this guide or book an appointment with a dental sleep medicine expert today.

What Is Sleep Apnea?

 

There are two varieties of sleep apnea disorders, both of which share the occurrence of a symptom called apnea during sleep, hence the name “sleep apnea.” In other words, “sleep apnea” is not the term for a particular disorder but rather the characterizing symptom of a sleep apnea disorder.

 

Sleep apnea is a physiological symptom in which a person stops breathing or has breathing problems during sleep, pausing ten seconds or more between each breath. This interrupts the body’s healthy respiration (breathing) cycle, causing a drastic plummet in blood oxygen levels and a spike in CO2 levels. This oxygen deprivation (asphyxiation) sends the brain into survival mode to almost instantly wake the individual to some degree, if not entirely, to facilitate manual breathing.

 

Sleep apnea causes two main types of breathing sleep disorders: obstructive sleep apnea (OSA) and central sleep apnea (CSA).

 

Obstructive Sleep Apnea

 

The condition known as “OSA” (obstructive sleep apnea) occurs when the flow of oxygen through the throat (the trachea or “windpipe”) is physically obstructed, causing sleep apnea. This is the more common type of sleep apnea disorder, which we cover on our blog.

 

Many patients with obstructive sleep apnea fall asleep with their mouths open. The pharynx and larynx (muscles of the throat) relax during sleep—which already leads to a narrowed airway—but when the mouth is open, these throat muscles cannot support the soft palate. Without stability, this structure at the roof of the mouth cannot serve as the tongue’s typical resting spot, so the tongue hangs out in the back of the oral cavity, obstructing airflow at the esophageal opening.

 

However, tongue positioning is not the only cause of OSA. Sometimes, the constriction of the relaxed pharynx and larynx is large enough to obstruct the trachea during sleep, which is essentially how OSA still occurs for many patients who sleep with their mouths closed. Other cases may involve nasal airway congestion, leading patients to breathe out of their mouth instead of the nose.

 

Central Sleep Apnea

 

Emergent central sleep apnea (CSA) differs from OSA because a physical blockage does not cause mid-sleep apnea in breathing but rather malfunctions in the brain stem.

Risk Factors and Causes of Sleep Apnea/Respiratory Sleep Disorders

 

There is not a singular cause of obstructive sleep apnea. However, the following conditions and characteristics are linked to a higher risk for sleep apnea.

  • Adult males
  • Post-menopausal women
  • Excess weight
  • Enlarged tonsils or adenoids
  • Large tongue
  • Small jaw bone
  • Enlarged thyroid
  • Family history of sleep apnea
  • Nasal disruption
  • High blood pressure
  • Chronic lung diseases like asthma
  • Other sleep disorders
  • Nonalcoholic fatty liver disease

 

Without treatment, having sleep apnea increases the risk of worsening the symptoms of the condition itself and the progression of comorbid medical conditions. This can involve increased complications after major surgery and can even lead to sudden death for patients also living with cardiovascular system conditions like atrial fibrillation.

Signs + Symptoms of Sleep Apnea

 

Symptoms of obstructive sleep apnea include:

  • Loud snoring: Snoring is the best-known sign and most common symptom of sleep apnea, but not everyone with the condition snores (especially if they have central sleep apnea).
  • Dry mouth, sore or dry throat, and nasal congestion.
  • Abruptly waking up with a choking sensation or gasping for air.
  • Morning headaches.
  • Daytime fatigue or excessive daytime sleepiness.
  • Forgetfulness or trouble concentrating.
  • Mood and sex drive fluctuation.
  • Restless sleep or insomnia/similar sleep disorders.
  • Breathing stops or is interrupted during sleep.

You keep hearing complaints from your bed partner about you snoring loudly, having long pauses in breathing during sleep or exhibiting other symptoms.

Sleep Apnea Tests and Diagnosis

 

If you have any of the above symptoms, seek a professional sleep apnea diagnosis. Start by visiting your general practitioner to discuss these symptoms, get a physical exam, and get a sleep clinic referral for a sleep study. A GP cannot diagnose sleep apnea.

During a sleep study, you will be monitored by experienced technicians to track your breathing patterns, limb movement, brain activity, and more while you sleep. The results will help clinicians discern whether you’ll have sleep apnea diagnosed or perhaps another sleep disorder revealed.

How Is Sleep Apnea Treated?

 

Once you have a sleep apnea diagnosis, the method or device a sleep specialist will recommend for treating sleep apnea depends on factors such as your type of sleep apnea, the severity (mild, moderate, or severe), and compatibility with continuous positive air pressure devices.

 

CPAP (continuous positive airway pressure) and BPAP (bilevel positive airway pressure) devices prevent sleep apnea by forcing the wearer’s upper airway passages open with a consistent flow of positively pressurized air. Air pressure devices and other breathing devices are the most common treatment for sleep apnea, but many patients are CPAP intolerant, so alternatives are often sought.

 

CPAP Intolerance is characterized by patients who struggle with wearing a CPAP consistently or for any amount of time. A few examples of CPAP intolerance include overheating, a claustrophobic feeling, an inability to adapt to breathing with the pressurized airflow, sensory overstimulation, excessive chapped lips and surrounding area, dry throat, or disrupted sleep.

 

Continuous Positive Airway Pressure (CPAP) Device Treatment Alternatives

 

CPAP intolerance is common, but neglecting treatment is a bad idea. There are three main options for CPAP alternatives, including lifestyle changes, hypoglossal nerve surgery, and our specialty, non-invasive oral appliance therapy (OAT).

Lifestyle Changes

Lifestyle can have a substantial impact on sleep apnea disorders. Losing weight and trying positional sleep therapy and healthy sleep breathing techniques can help prevent obstructive sleep apnea, and avoiding substances that impair the central nervous system (like sleeping pills and alcohol) helps reduce complications related to CSA.

 

Our blog is an excellent resource for more information on lifestyle changes that can improve health outcomes for sleep apnea disorders.

Nerve Stimulation Procedure

As explained earlier, the positioning of your tongue during sleep can cause sleep apnea by blocking airflow to the pharynx (throat air passages). Some patients with obstructive sleep apnea can have surgery on the hypoglossal nerve in the brain stem, which controls the tongue’s activity. The procedure involves installing a stimulating device on the hypoglossal nerve to keep the tongue active and positioned away from the throat.

Oral Appliances for Sleep Apnea

We believe oral appliance therapy (OAT)—a clinically proven and profound dental sleep medicine practice—is ​​one of the most effective and noninvasive options for CPAP-intolerant patients.

 

OAT involves a small, custom-fit device (similar to an orthodontic retainer) that patients wear in their mouths during sleep. It’s best for patients with mild to moderate obstructive sleep apnea, designed to keep the patient’s lower jaw forward, open the throat, and securely hold the tongue away from it. Patients with severe obstructive sleep apnea can use OAT if they are intolerant to CPAP therapy.

What to Expect with Oral Appliance Therapy to Treat Sleep Apnea:

 

Interested in our oral appliance therapy performed by board-certified dental sleep medicine practitioners for sleep apnea? Here’s a few things you should know:

 

 

  1. Patients can provide documentation of their CPAP intolerance diagnosis with their physician’s signature when submitting patient onboarding paperwork, but it is not a requirement.
  2. Our devices can treat mild to moderate sleep apnea with obstructive causes but not CSA. We can evaluate severe sleep apnea cases in which patients cannot tolerate CPAP to see if they could benefit from an oral device.
  3. After getting impressions for a custom fit device, it takes around three weeks for patients to get them. 
  4. When patients return to our offices to pick up their OAT device, our specialists will have them try it on to ensure a perfect fit and inspect for any flaws; if everything looks great and feels alright, our specialists will send you home with your new oral appliance and a care guide. 
  5. Sleeping with an oral appliance for sleep apnea can take days to weeks for a patient to get used to because their lower jaw and tongue do not usually rest where the device will be repositioning them. Still, most patients notice an immediate change in how well they can breathe with the proper repositioning from their new OAT device and will experience even more relief once they get used to wearing it. 

 

Contact TMJ & Sleep Solutions of Alabama today to start your journey toward better sleep with the help of qualified dental sleep medicine professionals.

 

What Does OAT Cost?

Learn more about the cost of oral appliance therapy here.

 

Can OAT Cure Sleep Apnea Disorders?

Sleep apnea cannot be cured by any form of treatment. Fortunately, consistent treatment minimizes symptoms and allows patients to get the healthy sleep they need.

 

What Do Patients Say About OAT?

Check out these reviews of our dental sleep medicine practice from patients who are now back to getting a full night’s sleep!