How many of you are aware of what you do when you sleep? Do your partners tell you that you snore or stop breathing? If so, you may be one of many who suffer from sleep-disordered breathing.
Snoring is a partial blockage of the airway by the tongue, which causes the tissues in the throat to vibrate. Sleep apnea is a more severe blockage of the air passage, where the sleeper is jolted awake because they cannot receive oxygen. Both types of sleep disturbances prevent a sufficient amount of oxygen to the brain and can result in chronic fatigue, depression, irritability, and daytime sleepiness.
Sleep apnea can be a dangerous, even fatal, condition because it affects heart function. During apneic episodes, the sleeper's tongue blocks the airway and the oxygen deprivation causes the brain to release adrenaline, which increases the heart rate, and this can lead to heart attack.
According to the Public Health Agency of Canada, sleep apnea affects three out of four Canadians over the age of 45, and of those, "the prevalence of self-reported sleep apnea in adult men was nearly double that in adult women." The sleep disorder can affect anyone but age, obesity and body mass increase the risk. As men are generally larger and heavier than women, their weight can cause the airway to collapse. Alcohol and some medications can also add to the slackening of throat muscles, especially if the sleeper is on his back.
"Sleep apnea can affect people in three ways," says Dr. David Engelberg of Altima Healthcare's Sleep Well Centre in downtown Toronto. "Firstly, sleep apnea is associated with a number of medical illnesses and safety concerns, such as cardiovascular disease and motor vehicle accidents. Secondly, sleep apnea affects relationships with partners and spouses. Finally, disordered breathing at night can result in daytime sleepiness and reduced cognitive function."
Ed, a professor of Sociology at a downtown college in Toronto and Sleep Well client (who requested to print just his first name), suffers from sleep apnea, heart arrhythmia (irregular heartbeat), high blood pressure, and tooth grinding, a common accompaniment to sleep apnea. His nighttime experiences leave him feeling tired, weak, dizzy, and in want of more oxygen. He believes that age and the weakness associated with it, dehydration, and job-related stress are key factors in his sleep disturbance.
James, a 35 year-old real estate development analyst (who also requested we only use his first name), is under the care of Dr. Engelberg. James has moderate to severe sleep apnea. Of his condition he says, "I'm tired all the time and wake up and feeling as if I haven't slept. My wife has to deal with my loud snoring and her sleep has suffered as a result."
A common type of relief can be found in the CPAP (Continuous Positive Air Pressure) machine which helps people breathe through an oxygen mask at night. It works for some but not for others. When James tried it, he wasn't happy with the results. "The benefits of the CPAP device were short-lived as a result of my allergies and not being able to breathe properly through my nose."
A couple of years ago, Don, a client of mine, complained about his snoring that kept his wife awake. I found him an inexpensive oral sleeping device online which pushes the jaw forward and allows the sleeper's air passage to remain open to prevent snoring. "It saved my marriage!" he told me. Fantastic!
I saw Don recently and asked him how his sleep appliance was working for him. He said he stopped wearing it because it hurt his mouth. He's doing sleep tests now and will try the CPAP machine.
You Don't Have To Suffer
Often, dentists can help patients with sleep apnea and snoring, but Dr. Engelberg, a doctor and a dentist, knows that oral appliances can improve sleep while addressing the health issues that may interfere with the condition. "Sleep apnea is a medical diagnosis that should be made by a medical doctor, not a dentist," he explains, "But if a patient has sleep apnea and chooses to have an oral appliance, then they have to referred to a dentist."
Physicians and dentists should work cooperatively to provide patients with a CPAP machine or an oral appliance to suit their unique anatomical and medical needs. The appliance is not cheap ($2300) but those who have invested in it have nothing but rave reviews.
Since he got his appliance a few years ago, Ed has not experienced sleep apnea nor cardiac arrhythmia; his blood pressure is lower, and he enjoys restful sleep and daytime alertness.
James calls his new appliance "life-changing "and says that it's paid for itself; he sleeps through the night without disturbing his wife and experiences more energy during the day. "The appliance is user-friendly and easy to maintain," he says, "It's a must for those who struggle with snoring and the endless attempt at a good night's sleep."
If the CPAP doesn't work for Don, he may eventually wear one of Sleep Well's oral devices. For that I'll feel better that my client is healthier and happier -- and I know his wife will thank me for it.
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