Sleep Apnea and Airway Management
Disordered Breathing during Sleep
Sleep apnea is a commonly diagnosed problem today. Treatment for sleep apnea typically involves the use of a continuous positive airway pressure (C-PAP) device, and/or a jaw repositioner (Mandibular Advancement Device) worn on the teeth. Sometimes surgery is done as well (UPPP). All of these methods are attempts to force the airway to remain open, or patent, while we sleep.
We should know by now that when we change one part of the body, we affect all other parts in some way. So it follows that when we force air into the lungs, or hold the jaw forward, or surgically remove the uvula, there will be repercussions in othe parts of the body, which will attempt to adjust itself toward homeostasis. There is mounting evidence that confirms a previously well-known inter-connectedness between seemingly disparate health problems. It should come as no surprise that all parts and systems within the body are connected, and communicate with each other, and yet our medical model has evolved to treat diseases as separate conditions, often managed by several different specialists.
As I have written in other places on this website, the most critical element to keep your body alive is regular breathing, balancing inhalation and exhalation, with efficient exchange of oxygen and carbon dioxide through your lungs. The most effective way to keep clean air flowing into your lungs is to breathe deeply, smoothly, and rhythmically throughout the day and night, while awake, and while asleep.
We humans need to breathe through our noses. If you cannot breathe through your nose, it could be BECAUSE YOU DON’T BREATHE THROUGH YOUR NOSE! Try a quick test. Sit in a comfortable position, upright, and relax your shoulders. Take a deep breath, and allow your body to relax on the exhale. Now focus on breathing only through your nose for 2 minutes. If you have to breathe through your mouth a little, that’s OK, but really try to only breathe through your nose, calmly and slowly. In and out. See if you notice any difference in the ease with which air passes through your nasal passages. If you notice a difference, then it is likely that you could make a significant improvement in your well-being by simply practicing breathing through your nose for 20 minutes or so, twice per day.
Improper Breathing and Bruxism
When your nervous system detects that your O2/CO2 balance is off, your sympathetic nervous system (fight or flight) is activated, and the body makes urgent attempts to open your airway. This can involve gasping for air, clenching the teeth together, pushing the tongue forward against the insides of the teeth, and sometimes grinding of the teeth, especially the front teeth.
Sore jaw muscles, tooth wear patterns, and morning headaches can all be signs of sleep apnea.
Anyone who is suspected to have sleep apnea can be screened very easily, and if there are clear indications, a sleep study should be ordered by your physician. We can help you with this process.
Sleep Apnea Screening and Monitoring
If you suspect you may have sleep apnea, it is best to consult with your physician, and have an overnight polysomnogram (sleep study) conducted by a board-certified sleep physician. If you have been diagnosed with sleep apnea already, and are experiencing difficulty getting used to your CPAP, or if you are unable to tolerate this type of device at all, then you can call my office and we can schedule a sleep apnea consultation.
I use the Medibyte system to screen and monitor patient we are treating for airway management. This relatively simple, take-home kit, gives a fairly comprehensive set of data about your sleep breathing effectiveness, including blood oxygen concentration, chest and abdominal effort, air flow, and sleep noises.
The Mandibular Advancement Device
There are many devices on the market today, custom and mail-order, which are advertised as sleep apnea devices. Out of all the devices I’ve worked with over the years, I’ve come to prefer the SomnoDent line of appliances for their craftsmanship, comfort, and reliability.