Did you know that your personalized care at Raphaelson Dental Associates begins the moment you fill out your paperwork? Our dental family cares about you, not just a tooth or your mouth. We find that is it very important to know what is going on systemically with our patients, and sometimes we are given these clues from what we see your mouth. These clues can help us potentially save a person’s life.
Sleep Apnea awareness is becoming more relevant in the media since the terminal crash in Hoboken and the more recent accident in Brooklyn with the LIRR. We believe Sleep Apnea is not talked about enough, and that is why so many people go undiagnosed. Sleep apnea is very personal to some of our employees and their families. We have seen the negative effects it can have on a person’s health when it is left untreated and that is why we feel it is important to screen our patients for this potentially dangerous sleep disorder.
As mentioned above our personalized care starts with your paperwork- primarily your medical health history. Chronic headaches, high blood pressure, stroke, acid reflux, heart attacks, depression, and stroke have all been linked to Obstructive Sleep Apnea. If you have any of these conditions our team will dig a little deeper into your medical history and look for common physical oral signs of OSA. When the mandible (lower jaw) is pushed back; the tongue, fatty tissue of the neck, and muscles in the upper airway are also displaced backward. This causes an obstruction of the airway when a patient with OSA sleeps on their back (which happens to be the exact position they are in our operatory chairs). As dental professionals, we can see these obstructions and other common physical signs of OSA during a routine check up or dental exam. These common physical signs include heavy wear on teeth from grinding, a scalloped tongue, a higher Mallampati classification, enlarged tongue or uvula, a soft palate, and a narrow airway. During sleep, a patient with OSA clenches and grinds their teeth in order to wake up and resume breathing, which results in tooth wear. Patients with Class 3 or Class 4 Mallampati (see the picture below) usually have some form of OSA because of the small space in their throat that allows for the passage of air. A patient with a scalloped tongue is trying its best to push forward and open the airway again. When the tongue is in this state, the teeth can easily exert pressure on it to cause scallops or grooves at the edges.
If our dental professionals observe any of these physical signs of OSA and our patients experience any of its symptoms, we will refer them for a Sleep Study. A Sleep Study or polysomnography is the only way to diagnose OSA. Raphaelson Dental Sleep Center offers a convenient Home Sleep Study that measures the number of times you have stopped or reduced breathing per hour ( known as the Apnea-Hypopnea Index). It also measures the drop in your blood-oxygen levels. Keep in mind that oxygen values under 90 percent are considered low and dangerous. After you have completed your Home Sleep Study, a sleep physician will read the results to determine whether you have sleep apnea. If you have Obstructive Sleep Apnea, the sleep physician will let your know whether your results are mild, moderate or severe.
If you have any of symptoms of Obstructive Sleep Apnea please contact our office for a FREE Consultation. Common symptoms include: snoring, gasping for air, excessive daytime sleepiness, snoring, gasping during sleep, or insomnia. At Raphaelson Dental Sleep Center, our patients with Sleep Apnea are treated with an Oral Appliance. Oral appliances are custom and comfortable, they fit like a sports mouth guard or an orthodontic retainer. The oral appliance holds the lower jaw forward keeping the airway open, preventing the tongue and muscles in the upper airway from collapsing and obstructing the airway. Raphaelson Dental Sleep Center works with hundreds of medical insurance companies for Sleep Apnea treatment. Our sleep coordinators will contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your treatment.
Currently, seventy million Americans have sleep disorders and sleep apnea affects at least 12 million to 18 million of them. Sleep apnea is a disorder that causes uncontrollable pauses in breathing, or shallow breaths during sleep. Snoring is a common symptom, although you may have sleep apnea even if you do not snore. Untreated, sleep apnea can be potentially life-threatening, can lead to serious medical consequences and a decreased quality of life. Pauses in your breathing cause less oxygen to make its way to the brain, overworks the cardiovascular system and other organs in your body. People with sleep apnea are triggered to wake up suddenly out of sleep and gasp for air in a Flight or Fight response. These sleep apnea episodes will wake you up from a deep sleep into light sleep stage, never allowing you to get the restful sleep you need. The multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat. Sleep apnea can cause symptoms, including loud snoring, choking noises, poor sleep, and feelings of fatigue during the day. Long-term complications of sleep apnea can include an increased risk of heart disease, stroke, diabetes, obesity, depression, memory problems, viruses and sexual dysfunction. Sleep Apnea can cause accidents, learning or memory problems and a poor performance in school or at work.
Fortunately, sleep apnea can be treated with a custom oral appliance, which supports the jaw in a forward position to help maintain an open upper airway. Lifestyle changes which include losing weight, reducing inflammation, improving your diet and starting a regular exercise routine will also help prevent Sleep Apnea.
1. Oral Appliance Therapy
Sleep Appliances are worn much like an orthodontic appliance or sports mouth protector. Worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat, oral appliances promote adequate air intake and help to provide normal sleep in people who snore and have Sleep Apnea. Oral appliances are considered first-line therapy for patients who have been diagnosed Obstructive Sleep Apnea according to the American Academy of Sleep Medicine. They are also a great alternative for patients that cannot tolerate their prescribed CPAP. The oral appliance holds the lower jaw forward keeping the airway open. It prevents the tongue and muscles in the upper airway from collapsing and obstructing the airway.
Our oral appliances at Raphaelson Dental Sleep Center are very sleek in design- consisting of smooth, durable and comfortable material. It is also one of the strongest appliances currently available, making it an ideal treatment option for all patients, especially those who clench or grind their teeth at night.
2. Maintain a Healthy Weight
When you are overweight the fat deposits around your upper airway can obstruct normal breathing. If you’re a man with a neck circumference over 17 inches (43 centimeters) or women over 15 inches (38 centimeters, you have a significantly higher risk for sleep apnea.
Obesity increases a person’s risk for Sleep Apnea and poor sleep causes obesity affecting a person’s Leptin and Ghrelin (it is a vicious cycle). Sleep Apnea is most common among adults over 45 who are overweight, especially men, but can also affect women, people of normal weight and even children.
If you’re overweight or obese start with a goal of losing ten percent of your body fat. Here are some tips that can help you:
Eat a high fiber diet: This means adding more fresh vegetables, fruit, nuts, seeds, sprouted beans or legumes, and ancient whole grains to your diet. Try to add at least 25–30 grams daily.
Eat foods that have healthy fats and high protein: Try cooking with coconut oil. It has natural fat-burning characteristics, and it benefits your gut too. Others healthy foods to add: olive oil, avocado, animal fats from lean meat, nuts and seeds. High protein foods are satisfying for hunger and help will help you build lean muscle too. Start off your morning with cage-free eggs, add some chicken to your lunch and maybe a fish to your dinner.
Get regular exercise: Exercise is not only essential to losing weight and live a healthy lifestyle but is also promotes a good sleep. It helps regulate hormones, burns calories and can break up nasal congestion. Go for a thirty-minute walk a couple of days a week. Park your car a little further from your destination. Take group classes at your local gym.
Natural oils: Grapefruit, cinnamon, and ginger oil can help control your appetite, hormones and digestive symptoms.
4. Avoid Excessive Alcohol and Smoking
Alcohol relaxes the throat muscles, including the uvula and palate, which are important for controlling breathing. Smoking and alcohol can cause inflammation and fluid retention in the airway. And just in case you needed another reason to quit, people who smoke are three times more likely to have obstructive sleep apnea. So try to stop smoking and skip your night cap. If you plan drink do it at least three hours before going to bed.
Over the counter sleep aids, sedatives, and some prescriptions can have the same effects. Keep in mind, you are still waking up at night with these over the counter and prescription sleep aids although you may not be conscious of it. They only way to get a better sleep is to treat the root problem. Also, a lot of these medications can cause you to be more groggy during the day.
5. Treat Acid Reflux, Congestion and Coughs
Acid reflux/heartburn, congestion, and chronic coughs can interfere with normal breathing. Nasal congestion leads to difficulty breathing through the nose and can worsen symptoms of obstructive sleep apnea. Acid reflux causes irritation and swelling around certain throat muscles. Coughs might also irritate your upper airways and increase snoring. Reducing exposure to allergies and raising your head while sleeping can help reduce reflux and congestion. A humidifier will help drain your sinuses and more air to move through your airways. You can also rub essential oils such as eucalyptus oil which is also found in Vicks Vaporub on your chest before sleeping to help naturally open your airways and soothe a stuffy nose or a sore throat.