Sleep Better Columbus helps people with sleep apnea, snoring and the conditions associated with them, such as teeth grinding and fatigue. While there are numerous types of sleep disorders, Sleep Better Columbus is focused on providing high quality Sleep Medicine specifically related to treatment for Snoring and Sleep Apnea.Sleep Better Columbuss team and Dr. Mark Levy are a family. Teamwork and unity are a core principle, along with a passion for patient care. The team at Sleep Better Columbus have been helping people in their sleep apnea clinic with sleep apnea and snoring and the conditions associated with them, such as teeth grinding and fatigue for decades. Our Sleep Better Columbus team helps patients regain their health.

The Inspire Sleep Apnea Implant is a medical device that is implanted into the body for the treatment of snoring and obstructive sleep apnea (OSA) syndrome.

Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome is a disease caused by relapsing episodes of sleep apnea. This is a condition where breathing stops for more than 10 seconds, during which oxygen saturation in the blood is reduced by more than 4%.

OSA syndrome occurs during sleep, when the muscles of upper airways relax, causing the obstruction of the respiratory tract. This leads to deterioration of blood oxygenation and provokes short unconscious wake-up episodes throughout the night. An unhealthy pattern of sleep places stress on the body, causing increased blood pressure and development of severe diseases. The diseases caused by OSA can be physical, such as hypertension, myocardium infarction and stroke. They could also be mental, including depression, chronic fatigue syndrome, loss of memory and concentration.

Before any treatment, a sleep study or a polysomnography is needed. The polysomnography calculates the apnea index, which is the frequency of apnea episodes during one hour of sleep and determines the severity of the disease. The apnea index is considered significant if there are more than 20 apnea episodes per hour, regardless of the presence or absence of clinical symptoms.

The gold standard of treatment for OSA syndrome is CPAP-therapy. However, CPAP therapy is not for everyone as many people find it uncomfortable to sleep with the mask on the face and the machine itself can be loud, especially as it commonly sits near the head. Only 25% of patients can use CPAP-therapy for a long period of time.

Therefore, recently Inspire Medical Systems Inc. has come up with a very effective solution with the Inspire Sleep Apnea Implant.

How The Inspire Sleep Apnea Implant Works

The Inspire Sleep Apnea Implant is a battery operated device that promotes electrostimulation of the sublingual nerve. The battery life is approximately 10 years.

The main unit of this device is placed under the skin, on the front right side of the chest and it monitors the phase of breathing. The other electrode is implanted for stimulation of the sublingual nerve, which creates muscle tension. This opens the upper airways and allows the tongue to stick out, and helps keep the airways open during sleep.

In addition to the two electrodes, this device also includes a handy small remote switch, which actually turns on the device before sleep and switches it off once awake. This disables the electrodes from disturbing the processes of communication and eating during the active phase of the day, when a person needs physiological narrowing of the larynx and tongue movements for these processes.

The patient may feel light involuntary contractions of the larynx, or tongue movements during initial use of the device. These movements do not cause pain, instead just a minor discomfort. These unpleasant effects disappear after the first few uses of the device.

Generally, the implant should be checked 1 or 2 times per year. However, depending on the situation, an Inspire therapy-trained doctor may consult patients more or less often.

The Inspire Sleep Apnea Implant is only suitable for:

Patients who are more than 22 years old.

Patients who have been diagnosed with moderate or severe obstructive sleep apnea syndrome.

Patients with an apnea index in the range of 20 to 65.

Patients who are not comfortable with using CPAP therapy or did not have the desired effect.

Patients with a body mass index of less than 32.

Body mass index (BMI) = weight (kg) / height^2 (m2).

A person with a weight of 80 kg and a height of 170 cm has

BMI = 80kg / (1.7m ^ 2) = 80 / 2.89 = 27.68 kg/ m2

The Inspire Sleep Apnea Implant could potentially replace CPAP therapy as 'the gold standard' of treatment for obstructive sleep apnea syndrome. A study by Dr. Ryan J. et al. has shown that after implantation of the Inspire Sleep Apnea Implant, snoring is greatly decreased. A percentage of
o or soft snoring changed from 22% at beginning of the treatment to 88% at 12 months and 91% at 24 months after the treatment. Also, the apnea index was reduced from 31 to 14. 82% of the patients in the study reported a nightly use of this therapy for five years. Therefore, it is evident that this method is highly effective and easy to use!

There was also another interesting study by Dr. Patrick J. from the Pittsburgh University Medical Center. The study found that stimulation of the sublingual nerve at the base of the tongue reduced the severity of obstructive sleep apnea by 68% and reduced the number of sleep apnea episodes from 29 to 9. Oxygen saturation of the blood also improved; daytime drowsiness decreased, and the quality of life of patients improved overall.

Inspire Sleep Apnea Cost

The Inspire Sleep Apnea Implant costs approx. $15,000-25,000, not including operational costs. Furthermore, the battery cannot be replaced after it is depleted and a new unit will need to be implanted. The implant can also move out of place over time. In comparison, the CPAP device costs approx. $1,500 to $ 3,000, which is much cheaper.

Inspire Sleep Apnea Side Effects

Implantation of the Inspire Sleep Apnea Implant is a surgical procedure with possible complications, as with any medical procedure. There are risks of infections after surgery, a temporary weakening of the tongue, post-operative bleeding, pain or discomfort in the implant area.

People with the following concerns are not suitable candidates for this device:

Patients suffering from central apnea or mixed apnea with more than 25% of the total apnea index.

Patients who have any anatomical issues that would compromise the performance of upper airway stimulation, such as the presence of a complete concentric collapse of soft palate.

Patients with any existing condition or procedure that has compromised neurological control of the upper airway.

Patients who are unable or do not have the ability to operate the sleep remote.

Patients who are pregnant or planning to become pregnant.

Patients with an implantable device that may be susceptible to unintended interaction with the Inspire system - allergic or rejection response to implanted materials.

The Inspire Sleep Apnea Implant therapy is FDA approved and proved to be an effective solution for obstructive sleep apnea syndrome. Currently, the therapy is being reviewed and approved by insurance companies on a patient-by-patient basis.

In addition to the two electrodes, this device also includes a handy small remote switch, which actually turns on the device before sleep and switches it off once awake. This disables the electrodes from disturbing the processes of communication and eating during the active phase of the day, when a person needs physiological narrowing of the larynx and tongue movements for these processes.

Medical studies have revealed that approximately 4% of all middle aged men and 2% of women have some form of sleep apnea. Sleep apnea has been defined as a series of breathing cessation episodes during sleep that are caused by blocked or collapsed pharyngeal tissues in the airways that results in its victims having significant interrupted sleep. The most popular form of treatment for sleep apnea is the application of an apnea machine or Continuous Positive Airway Pressure device (CPAP), which is a small compressor that exudes air through tubing and a small face mask to open up the blocked airways.

Sleep apnea sufferers usually snore excessively, experience significant day time drowsiness and lack of energy, and are often overweight (which can cause the throat tissues to collapse). Untreated sleep apnea can lead to serious health problems. Sleep apnea causes its victims to not receive proper amounts of oxygen to the body as a result of the blocked or collapsed airways. Over the long term, this lack of oxygen puts undue pressure on the heart which can result in increased blood pressure, palpitations, or stroke. Thus, it is very important to address any potential airway blockage issues, such as snoring, with a doctor before long term damage is done.

Unfortunately, statistics show that 80% of sleep apnea cases go undiagnosed in the United States. The main reason being because most sleep apnea sufferers believe that it is
ormal to snore and that nothing can be done to treat the condition. In fact, nothing could be further from the truth, just small lifestyle changes can have an immediate impact on eliminating or lessening the condition such as: losing weight, not using certain medications, and avoiding the supine position while sleeping. If these changes don't improve the situation, the application of an apnea machine may be required.

How is Sleep Apnea Diagnosed?If your Doctor suspects you have sleep apnea, you will be asked to go to a sleep laboratory for testing. Typically, the testing requires a two night stay. The first evening is used to determine if sleep apnea is present. While a person sleeps, a polysomnography computer uses various electronic patches, which are attached to the body that can determine if the episodes of breathing cessation are occurring. In the event a confirmation of sleep apnea exists, then the person will be asked to stay the next night, where they will use a apnea machine while they sleep to see if the apnea condition can be remedied.

One of the indicators that sleep labs look for in determining the severity of a persons sleep apnea is the number of terminations in breathing that are taking place (apnea) and the declines in airflows that cause sleep arousal (hypopnea). These disturbances are summarized on an hourly basis and referred to as the apnea-hypopnea index (or respiratory disturbance index). Medical studies show that if a person has over 15 of these disturbances in a one hour period, that long term mortality rates are increased and that they are more subject having secondary heart related issues.

Apnea Machine OptionsAn apnea machine uses very specialized air pressures to open up blocked airways and tissues. An apnea mask, which is attached to the nose, mouth, or both receives the air pressure from the apnea machine and delivers to the blocked airways. It is important to note that there are many different types of apnea masks and that it is essential to have a comfortable one (studies show CPAP compliance drops significantly if the mask is uncomfortable). Unlike like apnea masks, there are only a few different models of apnea machines and most operate under the same principle. The most popular, the CPAP (Continuous Positive Airway Pressure) delivers a constant, steady airflow to its users.

However, for some CPAP users, the constant flow of air can become uncomfortable and not allow them to exhale properly. For these people, smart CPAP's have been created to allow for various levels of air pressure. In fact, these Bi-level apnea machines are called BiPAP's or Bi-level Positive Airway Pressure devices. A BiPAP apnea machine gradually uses increases and decreases air pressures so that its users can better tolerate airflow. As one would suspect, a BiPAP apnea machine is more costly than a CPAP because of the technology requirements needed to moderate air flow pressures but it certainly has been proven to help people who are having air pressure issues with CPAP Therapy.

Other Sleep Apnea Treatment OptionsIt is also important to note that surgical procedures and the use of dental devices have also shown to be successful to treat sleep apnea. However, these treatments are limited to very specific cases. Additionally, surgery can be costly and has inherent risks and rehabilitation factors and associated it.

Paying SourcesApnea machine therapy is reasonably priced, when compared to the costs of surgery, and does require a Doctor's oversight and prescription to use it. The good news is that most major insurance companies, Medicare, and Medicaid will reimburse for expenses associated with the therapy. However, it is important to note that sleep medicine is still a new concept for many Doctors and a person needs to make sure they are using a Doctor who is experienced in this field to ensure they are getting exposed to the latest apnea machine and apnea mask options.

Obstructive sleep apnea is the most common type of all. It happens when the soft tissues at the back of the throat, including the tongue, relax during sleep and block the airway. Once the airway is blocked, it causes a loud vibrating sound which we know as snoring. The second type is central sleep apnea. It is the less common type because it involves the central nervous system. This happens when the brain fails to send signals to specific muscles that control breathing. Also, snoring is not that evident for people suffering from central sleep apnea. The last type is complex sleep apnea wherein it is the combination of both obstructive and central sleep apnea.

What is Sleep Apnea?

Sleep Apnea is a common nighttime breathing disorder that affects more than 15 million Americans. Sleep apnea affects men and women of all ages; even children can suffer from sleep apnea. Without treatment, living with the disorder may cause significant complications including daytime sleepiness, increased risk of heart attack and stroke, mood disorders and poor daytime function. Most people who have sleep apnea do not realize that they have the condition; even though their sleep is frequently interrupted throughout the night. People suffering from sleep apnea will wake often through out the night due to their oxygen being restricted or completely cut off. When apnea sufferers awaken, normal breathing is restored; however, they do not enter a state of complete wakefulness. The apneic events can continue unnoticed because sufferers do not fully awake or recognize they are waking though out the night. With sleep apnea, breathing may temporarily stop or become shallow hundreds of times during a night's sleep.

A frequently reported symptom related to sleep apnea is daytime sleepiness, some times being so extreme people have reported drifting off at work or while driving. Other common complaints include lack of concentration and poor mental agility that can lead to poor performance at work and an unfulfilling life. In Greek, apnea means with out breath. There are two types of Sleep Apnea, Obstructive Sleep Apnea (OSA), which is the most common, and Central Sleep Apnea.

The cause of Obstructive Sleep Apnea occurs when the air passage at the back of the throat becomes blocked. When muscles in the throat relax, this causes the soft palate to relax as well, which then narrows the airway. This same course of events also causes snoring, although, not all people who snore have obstructive sleep apnea. As one breathes in through the mouth or nose, the airway narrows further or completely closes and cuts breath short. The airflow restriction causes a gasping sensation, which prompts a period of shallow wakefulness. While partially awake, normal breathing is restored. This persistent blockage of the airway can happen several times an hour, replaying the course of events through out the night, causing a fragmented night of sleep.

Central Sleep Apnea occurs when your brain fails to send impulses to the body to breath. Central Sleep Apnea takes its name from the Central Nervous System, which regulates the body's necessary functions. This instability in the brain's respiratory control center can have several causes, the most common being central nervous system dysfunctions or individuals who have suffered a stroke. People who suffer from heart failure or other heart and lung conditions may also develop Central Sleep Apnea.

Who apnea affects...

Obstructive Sleep Apnea can affect men and women, at any age, and even children can develop sleep apnea. Men are at greater risk. The risk increases if you are over weight and over forty years of age. Other risk factors include a large neck size; 17 inches or greater for men or 16 inches or greater for women. Large tonsils or a large amount of tissue at the back of your throat can cause increased blockage and higher risk as well. Obstructive Sleep Apnea can run in families, suggesting that there may be a genetic component.

How apnea affects your body and mind...

There are many different effects sleep apnea can have on you, both physically and mentally, ranging from mildly irritating to life threatening. One effect is excessive daytime sleepiness. Most people do not realize when they drift off for a moment or two, but the effects can be devastating. Sufferers may notice they have a problem concentrating and an increase in forgetfulness or trouble learning new things. Some of these symptoms of sleep apnea can be confused with symptoms of depression because they are so similar; personality changes, irritability, mood swings, memory problems, feeling lethargic and perhaps even feeling depressed are some of the shared similarities.

Signs and Symptoms...

A common sign of obstructive sleep apnea is a sore or dry throat in the morning upon waking. Frequently people with apnea will wake several times during the night, sometimes by their own snoring, or from a choking or gasping sensation caused by their airway being blocked. These wakeful periods during the night interrupt their sleep and cause daytime sleepiness, which is another well documented symptom. Some other symptoms may be observed; such as forgetfulness, mood changes, headaches or a decreased sex drive. People with central sleep apnea may experience many of the same symptoms as people with obstructive sleep apnea.

How is it diagnosed?

Only a medical professional can diagnose Sleep Apnea. If you're suspicious you have sleep apnea or suffer from the common symptoms, see your health care provider. Your health care provider may suggest that you have a sleep test done to determine the cause of your symptoms; the test usually includes a polysomnogram or a Multiple Sleep Latency Test. A polysomnogram will electrically monitor your heart rate, breathing and muscle activity throughout a night of sleep. A sleep specialist and your health care provider will analyze the electronic records created. A Multiple Sleep Latency Test (MSLT) will simply measure how long it takes you to fall asleep or if you are apt to fall asleep when you would normally be awake. If sleep apnea is discovered during the sleep study, you may be asked back for further testing to detect the most appropriate treatment.

What to expect...

Sleep tests are typically done at sleep centers or hospitals. When you arrive, you will have a private room, which may be decorated to feel more like home than a medical facility. Some hospitals or centers allow you to bring your own clothes to sleep in, to promote relaxation and a sense of ease. Your room will be near the monitoring area where the sleep technicians can monitor the information collected by the polysomnograph. When you are ready to sleep the technicians will attach the monitoring devices. Most people have little trouble sleeping with them on as they consist of a few electrodes, a belt to monitor your heart rate and breathing, and an oximeter fitted over a fingertip to measure the oxygen level in your blood.

If your health care provider desires you to have a MSLT, it will most likely be done at a sleep center or hospital as well. The test is done to measure the amount of time it takes for you to achieve sleep, or to determine if you are predisposed to fall asleep when you should be fully awake. A sleep technologist will video tape you while you sleep to record your movements during the night or to note the number of times you drift off during your normal waking hours.

What can be done?

There are several different treatment options for sleep apnea ranging from conservative therapy to major surgery.

The most common treatment is Continuous Positive Airway Pressure (CPAP). A CPAP machine consists of a specially fitted mask that covers your mouth and/or nose while you sleep. The machine delivers a continuous flow of air into your nostrils. The pressurized air flowing into your airways promotes open airways so breathing is not impaired while you sleep.

Some people with obstructive sleep apnea find their cure with dental devices. These appliances are specially designed to keep airways open during sleep. Dentists that have a specialty dealing with obstructive sleep apnea, customize the devices for the wearer.

Surgery is a treatment option for apnea as well. Surgical options often involve procedures that attempt to increase the diameter of the upper airway.

Individuals with sleep apnea may be instructed to make lifestyle changes. Some suggestions may include weight loss to alleviate constriction of the throat. Avoidance of alcohol, over-the-counter sedatives and other unnecessary sedating agents is also recommended, as these may further relax the muscles at the back of your throat.

What to do?

See your doctor for an evaluation if you feel that you are experiencing the symptoms mentioned above like daytime sleepiness, snoring and gasping, morning headaches, or waking through out the night. Only a trained health care provider can diagnose sleep apnea. Your health care provider will evaluate your sleep troubles and may refer you to a sleep specialist, who has special training in sleep medicine. Sleep apnea is a serious medical condition that may lead to other conditions such as high blood pressure, heart attack, irregular heartbeat or stroke so early treatment is desirable.

What is Sleep Apnea?

Sleep Apnea is a common nighttime breathing disorder that affects more than 15 million Americans. Sleep apnea affects men and women of all ages; even children can suffer from sleep apnea. Without treatment, living with the disorder may cause significant complications including daytime sleepiness, increased risk of heart attack and stroke, mood disorders and poor daytime function. Most people who have sleep apnea do not realize that they have the condition; even though their sleep is frequently interrupted throughout the night. People suffering from sleep apnea will wake often through out the night due to their oxygen being restricted or completely cut off. When apnea sufferers awaken, normal breathing is restored; however, they do not enter a state of complete wakefulness. The apneic events can continue unnoticed because sufferers do not fully awake or recognize they are waking though out the night. With sleep apnea, breathing may temporarily stop or become shallow hundreds of times during a night's sleep.

A frequently reported symptom related to sleep apnea is daytime sleepiness, some times being so extreme people have reported drifting off at work or while driving. Other common complaints include lack of concentration and poor mental agility that can lead to poor performance at work and an unfulfilling life. In Greek, apnea means with out breath. There are two types of Sleep Apnea, Obstructive Sleep Apnea (OSA), which is the most common, and Central Sleep Apnea.

The cause of Obstructive Sleep Apnea occurs when the air passage at the back of the throat becomes blocked. When muscles in the throat relax, this causes the soft palate to relax as well, which then narrows the airway. This same course of events also causes snoring, although, not all people who snore have obstructive sleep apnea. As one breathes in through the mouth or nose, the airway narrows further or completely closes and cuts breath short. The airflow restriction causes a gasping sensation, which prompts a period of shallow wakefulness. While partially awake, normal breathing is restored. This persistent blockage of the airway can happen several times an hour, replaying the course of events through out the night, causing a fragmented night of sleep.

Central Sleep Apnea occurs when your brain fails to send impulses to the body to breath. Central Sleep Apnea takes its name from the Central Nervous System, which regulates the body's necessary functions. This instability in the brain's respiratory control center can have several causes, the most common being central nervous system dysfunctions or individuals who have suffered a stroke. People who suffer from heart failure or other heart and lung conditions may also develop Central Sleep Apnea.

Who apnea affects...

Obstructive Sleep Apnea can affect men and women, at any age, and even children can develop sleep apnea. Men are at greater risk. The risk increases if you are over weight and over forty years of age. Other risk factors include a large neck size; 17 inches or greater for men or 16 inches or greater for women. Large tonsils or a large amount of tissue at the back of your throat can cause increased blockage and higher risk as well. Obstructive Sleep Apnea can run in families, suggesting that there may be a genetic component.

How apnea affects your body and mind...

There are many different effects sleep apnea can have on you, both physically and mentally, ranging from mildly irritating to life threatening. One effect is excessive daytime sleepiness. Most people do not realize when they drift off for a moment or two, but the effects can be devastating. Sufferers may notice they have a problem concentrating and an increase in forgetfulness or trouble learning new things. Some of these symptoms of sleep apnea can be confused with symptoms of depression because they are so similar; personality changes, irritability, mood swings, memory problems, feeling lethargic and perhaps even feeling depressed are some of the shared similarities.

Signs and Symptoms...

A common sign of obstructive sleep apnea is a sore or dry throat in the morning upon waking. Frequently people with apnea will wake several times during the night, sometimes by their own snoring, or from a choking or gasping sensation caused by their airway being blocked. These wakeful periods during the night interrupt their sleep and cause daytime sleepiness, which is another well documented symptom. Some other symptoms may be observed; such as forgetfulness, mood changes, headaches or a decreased sex drive. People with central sleep apnea may experience many of the same symptoms as people with obstructive sleep apnea.

How is it diagnosed?

Only a medical professional can diagnose Sleep Apnea. If you're suspicious you have sleep apnea or suffer from the common symptoms, see your health care provider. Your health care provider may suggest that you have a sleep test done to determine the cause of your symptoms; the test usually includes a polysomnogram or a Multiple Sleep Latency Test. A polysomnogram will electrically monitor your heart rate, breathing and muscle activity throughout a night of sleep. A sleep specialist and your health care provider will analyze the electronic records created. A Multiple Sleep Latency Test (MSLT) will simply measure how long it takes you to fall asleep or if you are apt to fall asleep when you would normally be awake. If sleep apnea is discovered during the sleep study, you may be asked back for further testing to detect the most appropriate treatment.

What to expect...

Sleep tests are typically done at sleep centers or hospitals. When you arrive, you will have a private room, which may be decorated to feel more like home than a medical facility. Some hospitals or centers allow you to bring your own clothes to sleep in, to promote relaxation and a sense of ease. Your room will be near the monitoring area where the sleep technicians can monitor the information collected by the polysomnograph. When you are ready to sleep the technicians will attach the monitoring devices. Most people have little trouble sleeping with them on as they consist of a few electrodes, a belt to monitor your heart rate and breathing, and an oximeter fitted over a fingertip to measure the oxygen level in your blood.

If your health care provider desires you to have a MSLT, it will most likely be done at a sleep center or hospital as well. The test is done to measure the amount of time it takes for you to achieve sleep, or to determine if you are predisposed to fall asleep when you should be fully awake. A sleep technologist will video tape you while you sleep to record your movements during the night or to note the number of times you drift off during your normal waking hours.

What can be done?

There are several different treatment options for sleep apnea ranging from conservative therapy to major surgery.

The most common treatment is Continuous Positive Airway Pressure (CPAP). A CPAP machine consists of a specially fitted mask that covers your mouth and/or nose while you sleep. The machine delivers a continuous flow of air into your nostrils. The pressurized air flowing into your airways promotes open airways so breathing is not impaired while you sleep.

Some people with obstructive sleep apnea find their cure with dental devices. These appliances are specially designed to keep airways open during sleep. Dentists that have a specialty dealing with obstructive sleep apnea, customize the devices for the wearer.

Surgery is a treatment option for apnea as well. Surgical options often involve procedures that attempt to increase the diameter of the upper airway.

Individuals with sleep apnea may be instructed to make lifestyle changes. Some suggestions may include weight loss to alleviate constriction of the throat. Avoidance of alcohol, over-the-counter sedatives and other unnecessary sedating agents is also recommended, as these may further relax the muscles at the back of your throat.

What to do?

See your doctor for an evaluation if you feel that you are experiencing the symptoms mentioned above like daytime sleepiness, snoring and gasping, morning headaches, or waking through out the night. Only a trained health care provider can diagnose sleep apnea. Your health care provider will evaluate your sleep troubles and may refer you to a sleep specialist, who has special training in sleep medicine. Sleep apnea is a serious medical condition that may lead to other conditions such as high blood pressure, heart attack, irregular heartbeat or stroke so early treatment is desirable.

However, for some CPAP users, the constant flow of air can become uncomfortable and not allow them to exhale properly. For these people, "smart CPAP's" have been created to allow for various levels of air pressure. In fact, these "Bi-level" apnea machines are called BiPAP's or Bi-level Positive Airway Pressure devices. A BiPAP apnea machine gradually uses increases and decreases air pressures so that its users can better tolerate airflow. As one would suspect, a BiPAP apnea machine is more costly than a CPAP because of the technology requirements needed to moderate air flow pressures but it certainly has been proven to help people who are having air pressure issues with CPAP Therapy.

Sleep Apnea is a condition caused by a lack of air passing through to the lungs during sleep; it is an episode that lasts for more than 10 seconds. This deficiency of air leads to a decreased saturation of oxygen levels in the blood, which results in oxygen deprivation of the brain and other bodily tissues, known as Hypoxia. In order to normalize blood oxygen levels, the brain instructs a micro awakening and commands the body to reopen the airways. The person wakes up for a short time and commences breathing, often noisily at first, and then falls back to sleep. Quite often, the person has no memory of these micro-awakenings in the morning.

During sleep, the muscles of the pharynx (part of the throat that sits behind the mouth and nasal cavity) overly relax and obstruct the airway, which is what causes the Sleep Apnea episodes. Such episodes can occur several times within an hour of sleep and any more than 10-15 episodes of Sleep Apnea within an hour is Obstructive Sleep Apnea Syndrome. This syndrome divides the night's sleep into hundreds of small fragmented mini sleeps, resulting in the person feeling exhausted as body's systems have not had enough time to rejuvenate over night. The oxygen deficiency also affects a person's metabolism, which is why an Obstructive Sleep Apnea sufferer wakes up tired, irritable and usually has a headache.

According to the American National Sleep Foundation, Obstructive Sleep Apnea syndrome costs the United States more than $100 billion annually. This is a very common problem, however it is not highly publicized, therefore many people are unaware of its existence.

When it comes to treatment of Obstructive Sleep Apnea, the gold standard is CPAP-therapy, which involves wearing a CPAP mask during sleep. Approximately 50% of patients do not like CPAP-therapy for a long period due to the intrusive nature of the CPAP mask. Furthermore, CPAP-therapy is not recommended for mild and moderate forms of Obstructive Sleep Apnea syndrome. So, what is the recommended treatment for this?

Sleep Apnea Dentists Can Help Treat Mild Obstructive Sleep Apnea Syndrome

Sleep Apnea Dentists can help treat mild and moderate forms of Obstructive Sleep Apnea syndrome through dental devices, which can also be used with CPAP-therapy for more effective results. The dental devices are easy to use, are compact, effective and affordable. The main function of these devices is to keep airways open to prevent the Obstructive Sleep Apnea episodes. These oral appliances have been used in medicine for nearly 30 years and have continuously improved in technology over the years. The most significant improvements have been comfort focused, namely the appearance of the device and materials used in construction.

There are three common types of dental devices worn in the mouth at night, and fitted by a dentist or orthodontist:

1) Tongue Retaining Devices (TRD)

These devices hold the tongue to ensure the airways are kept open.

2) OPA Devices (Oral Pressure Appliance)

These devices lift the soft palate (the tissue in the back roof of the mouth) and hold the tongue in a certain place to keep airways open.

3) The Mandibular Advancement Splines (MAS) or Mandibular Advancement Devices (MAD)

These are the most widely used oral devices for Obstructive Sleep Apnea syndrome. Their function is to hold the lower jaw in a forward position, thus allowing normal airflow to the lungs and preventing displacement of the lower jaw during sleep. As a result, the airflow is completely restored and the Obstructive Sleep Apnea episodes stop.

Modern Mandibular Advancement devices are individually made for the upper and lower jaws, and both are fixed to the jaws before bedtime. When attached to the jaw, this device creates an opening of the airways through the forward position of the jaw and tongue. The lower part of the device holds the lower jaw in a forward position at about 75% of the maximum forward movement. After two weeks of wearing this device, the patient undergoes a second re-examination in a sleep study. If required, the dentist can manipulate the device by moving the jaw forward several millimeters to further correct the issue.

The dental device is tailored to each person, as each mouth is unique. The methods used to ensure the correct device is made and fitted include: Cephalometry (measurement and study of the proportions of the head and face), computed tomography, magnetic resonance imaging, video endoscopy and lateral Cephalometry of the patient with and without the device in their mouth.

A dental device is usually recommended in the following situations:

1) Mild or moderate forms of Obstructive Sleep Apnea Syndrome (episodes of Apnea less than 20 within an hour);

2) A patient's unwillingness to use a CPAP-mask or undesirable results from using it;

3) A patient's unwillingness to do a surgical treatment or unsuccessful surgical treatment in the past;

4) Patient is in a healthy weight range (BMI- Body Mass Index is used to measure this);

5) Patient's willingness to use the dental device every night.

What to Consider before Visiting a Sleep Apnea Dentist

Dental devices are not recommended in treating patients with Central Sleep Apnea Syndrome, as this type of sleep Apnea is not associated with the narrowing of the upper respiratory tract, rather is it closely related to heart and lung issues.

For patients with severe forms of Obstructive Sleep Apnea syndrome, the oral device is not enough, and such patients are treated with CPAP-therapy.

There are also age restrictions; the oral devices are not suited to patients less than 18 years of age.

Diseases of the temporomandibular joint (the sliding joint that connects to jawbone to the skull) are quite common among patients with Obstructive Sleep Apnea syndrome. However, today there is no reason to discourage the use of dental devices in patients with this disease. Studies show that side effects, such as pain in the temporomandibular joint and chewing muscles are rare, usually weakly expressed and often only occurs in the initial stages of using the dental devices.

Bruxism is a more common disease among patients with Obstructive Sleep Apnea syndrome. In such cases, the use of oral devices helps prevent abrasion of teeth and significantly reduces the motor activity of the chewing muscles during sleep.

According to the latest data, it was found that:

• Many patients prefer to use oral devices with and without CPAP-therapy- 56-68% of patients continue to use oral devices for more than 30 months;

• The effectiveness of the devices depends on the design and manufacturing;

• Side effects of the use of devices are common but not critical- mainly salivation, uneasy sensations in the chewing muscles and discomfort for teeth at the beginning of treatment.

Obstructive Sleep Apnea affects approximately 20 million people in the U.S. alone, and millions more are affected worldwide. Over the last 10 years, significant research has been performed and now there is overwhelming evidence of the connection between Obstructive Sleep Apnea (OSA) and cardiovascular disease. Specifically, people affected by sleep apnea are at increased risk for hypertension (also known as high blood pressure), coronary artery disease (AKA atherosclerosis), heart attacks, strokes, cardiac arrhythmias, heart failure, diabetes, and even death.

Sleep apnea is a sleeping disorder which is characterized by abnormal pauses in the breathing pattern, or instances of abnormally low breathing during sleep. Each pause between successive breaths is called an apnea - a word derived from the Greek word apnoia which means without breath. In case of normal breathing, the frequency of pauses is constant and regular. When the normal breathing pattern changes due to various reasons, and the intervals between successive pauses start becoming irregular, it leads to sleep apnea disorder. Each irregular pause of breath is referred to as hypopnea. So, in case of normal breathing, each interval or pause is termed as an apnea, while in case of abnormal breathing it is termed as hypopnea.\n
Symptoms of sleep apnea

Individuals suffering from the disorder often do not know they have it. Certain symptoms can ascertain whether the individual is suffering from the disorder. The major symptoms include:

Insomnia

Restless sleeping patterns

Choking or gasping during sleep

Night sweats

Feeling excessively sleepy during the day

Snoring frequently and loudly

Trouble in breathing during sleep

Other symptoms indicating a possible disorder are:

Fatigue

Morning headaches

Loss of memory

Difficulty in learning new things

Irritability

Inability to concentrate for long

Depressions

Mood swings and/or personality changes

Dry throat when awaking

Frequent urination during the night

Causes of sleep apnea

The disorder generally occurs due to a fat buildup, or a loss of the muscle tone, especially during old age. In this particular disorder, the tracheal muscles ( rachea is the windpipe), the soft palate muscles at the base of the tongue, and the uvula (uvula is the triangular shaped small fleshy tissue hanging from the center in the back of the throat) relax to a considerable extent and collapse during the breathing activity. In simple terms, the windpipe becomes taut, or the layers of the windpipe adhere which restricts the flow of air into the lungs. The disorder can also occur due to a malfunction of neurons controlling the breathing process during sleep. This sleep disorder can be diagnosed by an overnight polysomnogram test - a sleep test which is extensively used to detect sleeping disorders and related problems.

Effects of sleep apnea

Even though the sleep disorder might appear to be a common and not-so-serious, it can lead to some serious health problems. If left untreated, the disorder can result in:

Depression

Sexual dysfunction

Hypertension

High blood pressure

Irregular heart beats

Coronary Heart Disease

Chronic Heart Failure

Worsening of Attention Deficit Hyperactivity Disorder (ADHD)

Types of sleep apnea

There are three types of sleep apnea:

Obstructive sleep apnea (OSA)

Central sleep apnea (CSA)

Mixed sleep apnea (MSA)

Even though all the three types of sleeping disorders differ as far as their causes and treatment is concerned, one aspect remain common - some parts of the respiratory system narrow down and impair the percentage of oxygen reaching the subject's lungs.

Obstructive sleep apnea (OSA)

This is a highly common form of the disorder found in majority of the individuals suffering from sleeping disorder. Obstructive sleep apnea is a physical disorder. This form of disorder is typically characterized by individuals who have:

More weight (overweight)

Small jaw line

A small air passage in the trachea (windpipe)

Large tongue

Tonsils

The main cause of OSA is the same as stated above for sleep apnea. The condition can further worsen if the subject consumes alcohol, ingests tranquilizers and sleeping pills.

Central sleep apnea (CSA)

This is a comparatively rare form of the sleeping disorder in which the tracheal muscles do not sag to much extent, and the air passage remains large enough so that enough air can pass through. However, in this particular disorder the diaphragm and the chest muscles temporarily fail to function effectively, which results in reduced oxygen levels in the blood. The decreased oxygen level affects normal metabolic working of the body, and the brain too receives less oxygen so the subject suffers from memory loss, slow learning, sluggish reflexes, and inability to concentrate for long.

Mixed sleep apnea (MSA)

In very rare cases, some individuals experience both obstructive sleep apnea and central sleep apnea simultaneously. In such cases, both the sleep disorders manifest themselves by interspersing with each other, and the individual may experience the effects of either of the disorders at one particular instance, or a combined effect of both. The pathological or psychological effects of this disorder cannot be predetermined or ascertained since many factors affect its manifestation.

Sleep apnea treatment

The treatment for the sleep disorder varies in accordance to the level to which the individual is suffering from it. Generally, the treatment can be administered in the form of therapies and surgeries depending upon how much the disorder is affecting the individual. The treatment consists of:

Therapies

Continuous positive airway pressure (CPAP)

This therapy is generally used if the individual has moderate to severe sleep disorder. The therapy consists of a machine which delivers air (oxygen) through a mask placed over the nose while asleep. The air pressure remains greater than that of the surrounding air, and is just strong enough to keep the air passages open.

Adjustable airway pressure devices

In this therapy, a special type of air pressure device automatically adjusts the air pressure and oxygen levels while asleep. The basic functioning of the device is similar to that used for CPAP therapy, however it is a more advanced model and supports bi-level positive airway pressure (BPAP). The device provides more pressure while inhaling and reduces the pressure while exhaling.

Adaptive servo-ventilation (ASV)

This airflow device learns and understands the normal breathing pattern, and subsequently stores the information in a built-in computer. While asleep, the machine regulates the air pressure to normalize the breathing pattern, and prevents any pauses in the breathing activity. ASV is more successful than CPAP while treating central sleep apnea in some individuals.

Oral appliances

This therapy involves wearing an oral appliance specially designed to keep the throat open. Oral appliances are easier to use. Some appliances are specially designed to keep the throat open by bringing the jaw forward, which can at times even relieve snoring as well as prevent mild obstructive sleep apnea.

Surgery

The main objective of sleep apnea related surgery is to remove any excess tissues from the nose or the throat which may be causing the blockage of the air passage. The surgical options include:

Uvulopalatopharyngoplasty (UPPP)

During this surgical procedure, excessive tissue is removed from the rear of your mouth, and from the top of the throat. At times, the tonsils and adenoids are also removed. This type of surgery can be successful in preventing snoring, however, from clinical findings it is observed to be less successful in treating sleep apnea, since the tissues farther down the trachea (windpipe) may still block the air passage. UPPP procedure is generally performed in a hospital, and requires administration of general anesthesia.

Maxillomandibularadvancement

In this procedure, the jaw is moved forward from the remaining facial bones. This enlarges the space behind the tongue and the soft palate, reducing the air obstruction. This procedure may require the services of an oral surgeon and/or an orthodontist, and may be combined with other surgical procedures to improve the likelihood of success.

Tracheostomy

This is a critical surgery, and it is only recommended when other treatments fail and the subject has severe or life-threatening sleep apnea disorder. In this procedure, an opening is made in the neck and a metal or plastic tube is inserted into the trachea through which we breathe. The opening is covered during the day, and at night, it is uncovered to allow air into the lungs. The tube helps to bypass the blocked air passage.