Sleep Apnea & Sleep Disorders

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is the most common form of sleep apnea. It occurs when the upper airway becomes partially or completely blocked during sleep. This obstruction restricts airflow and causes temporary interruptions in breathing.

Central Sleep Apnea (CSA)

Central sleep apnea occurs when the brain does not send appropriate signals to the muscles responsible for breathing. As a result, the effort to breathe may become diminished or temporarily absent during sleep.

Symptoms

Sleep apnea often goes undiagnosed because the person experiencing the breathing interruptions is asleep when they occur. However, a patient or their family members may notice symptoms such as:

• Regular, loud snoring, particularly when accompanied by pauses in breathing or gasping and choking sounds

• Excessive daytime sleepiness

• Frequent morning headaches

• Dry or sore throat upon waking

• Difficulty falling asleep or staying asleep

• Fatigue, low energy, or difficulty concentrating during the day

• Mood changes, irritability, or other emotional changes

• Waking frequently during the night to urinate (nocturia)

Not everyone with sleep apnea experiences all of these symptoms. Additionally, symptoms such as snoring can occur without sleep apnea. However, when symptoms persist and begin affecting quality of life, a medical evaluation and consultation with a sleep specialist may be appropriate.

Causes and Risk Factors

Sleep apnea can have several underlying causes. Identifying contributing factors is important when determining the most appropriate treatment.

The two primary types are obstructive sleep apnea (OSA) and central sleep apnea (CSA). Complex sleep apnea syndrome, which involves features of both OSA and CSA, is less common.

Risk factors for sleep apnea may include:

• Obesity or excess weight

• Larger neck circumference

• A narrow or obstructed airway, including an airway affected by a large tongue, tonsils, or adenoids

• Age and sex, with men and individuals over age 40 generally at greater risk

• A family history of sleep apnea

• Certain medical conditions, including hypertension, type 2 diabetes, and cardiovascular disease

• Certain medications, particularly sedatives and opioids

Associated Health Risks

When left untreated, sleep apnea can contribute to significant health problems and may increase the risk of:

• Cardiovascular problems

• Type 2 diabetes

• Mood disorders

• Weight gain and obesity

• Memory problems and cognitive decline

Diagnosis

A comprehensive sleep evaluation is typically needed to confirm a diagnosis of sleep apnea. This may include a detailed medical history, physical examination, and sleep study (polysomnography). Sleep studies are performed by sleep specialists and may be conducted at home or in a sleep laboratory.

Treatment

Treatment for sleep apnea depends on the underlying cause and severity of the condition.

Continuous positive airway pressure (CPAP) is one of the most common treatments. CPAP provides respiratory support through a mask worn during sleep and is typically prescribed through a pulmonologist or sleep specialist.

Although CPAP can be highly effective, some patients find it uncomfortable or have difficulty using it consistently. For appropriate patients, customized oral appliances can provide an alternative treatment option. Lifestyle modifications may also help reduce symptoms and improve sleep.

Other Sleep Disorders:

Snoring

Snoring is commonly caused by vibration of tissues in the throat and nasal passages during sleep. While occasional snoring may be harmless, it can become a concern when it disrupts sleep, affects a bed partner, or is associated with daytime sleepiness or irritability.

If over-the-counter treatments are unsuccessful or other symptoms suggest the possibility of sleep apnea, medical evaluation may be appropriate.

Lifestyle changes, such as adjusting sleep position and achieving a healthy weight, may help reduce snoring. For appropriate patients, we may also recommend a customized oral appliance designed to help reduce or eliminate snoring.

Bruxism (Teeth Grinding and Jaw Clenching)

Bruxism refers to involuntary grinding of the teeth or clenching of the jaw. It can occur while awake or during sleep and may contribute to tooth damage, jaw discomfort, headaches, and facial pain.

Symptoms may include:

• Disrupted sleep

• Morning headaches or facial pain

• Earaches

• Painful or loose teeth

• Sore or tender jaw muscles

• Pain while eating

• Clicking or popping of the jaw

• Difficulty opening or locking of the jaw

Clicking, popping, or locking may indicate a more significant temporomandibular joint (TMJ) problem. If you experience these symptoms, contact our office for an evaluation.

We offer customized oral appliances to help manage bruxism. In more severe cases, therapeutic injections may also be recommended as part of an individualized treatment plan.