Snoring and Sleep Apnea

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SNORING 

The act of breathing through the open mouth so that the currents of inspired and expired air cause a vibration of the oral soft tissues, thus giving rise to a harsh, snorting sound.

 

 

SLEEP APNEA

 

There are two distinct forms of sleep apnea: Central and Obstructive. Breathing is interrupted by the lack of effort in Central Sleep Apnea; in Obstructive Sleep Apnea, breathing is interrupted by a physical block to airflow despite effort. In Mixed Sleep Apnea, there is a transition from central to obstructive features during the events themselves.

 Obstructive sleep apnea occurs when the tongue and soft tissues in the back of the throat collapse blocking airflow into the lungs for a period greater than 10 seconds. The harder one tries to breathe, the tighter the airway seals. This airway obstruction persists until the brain partially awakens the person. Unconsciously, he/she will close the jaw returning the tongue and throat to a normal position. The sleep apnea cycle – falling asleep, jaw relaxing, airway collapsing, unconsciously awakening with a gasp, falling back asleep – can repeat itself 50 or more times per hour during the night. With a blocked air passage, one does not receive enough oxygen. Both the awakenings and oxygen deprivation can then trigger other health problems.  

Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram.

 

Populations at risk 

In adults, the most typical individual with obstructive sleep apnea syndrome is obese, with particular heaviness at the face and neck. Men are at the highest risk. The hallmark symptom of obstructive sleep apnea syndrome in adults is excessive daytime sleepiness. Typically, an adult or adolescent with severe long-standing obstructive sleep apnea will fall asleep for very brief periods in the course of usual daytime activities if given any opportunity to sit or rest. This behavior may be quite dramatic, sometimes occurring during conversations with others at social gatherings.

 Other signs and symptoms

Additional signs of obstructive sleep apnea include restless sleep, and loud snoring (with periods of silence followed by gasps). Other symptoms are non-specific: morning headaches, trouble concentrating, irritability, forgetfulness, mood or behavior changes, decreased sex drive, increased heart rate, anxiety, depression, increased frequency of urination, nocturia (getting up during the night to urinate), esophageal reflux and heavy sweating at night.The most serious consequence of obstructive sleep apnea is to the heart. In severe and prolonged cases, there are increases in pulmonary pressures that are transmitted to the right side of the heart. This can result in a severe form of congestive heart failure (cor pulmonale).

A SIMPLE TREATMENT OPTION 

There is a new solution available to those who snore or have sleep apnea - the TAP®, an oral appliance (OA) similar to an athletic mouth guard that is worn while sleeping. Compared to other treatment modalities, OA therapy has several advantages, including simplicity, reversibility, cost-effectiveness, and broad applicability for varying degrees of snoring and sleep apnea. An OA can be used to treat simple snoring, upper airway resistance syndrome (UARS), and full-blown obstructive sleep apnea (OSA). OA therapy offers the simplest, most logical way to initiate treatment in most cases as it is readily accepted by most patients. It can also be used in conjunction with other forms of treatment.The advantages of OA's over other sleep apnea treatment options include relatively low cost, good success rates (efficacy comparable to surgery/uvulopalatopharyngoplasty [UPPP]), increased rates of compliance (ranging from 50-100%, more preferred than CPAP), a more benign adverse-effect profile, rapid effect, and easy termination without complications. Additionally, OA insertion can be performed as a single-stage procedure in an outpatient setting. OA’s are recommended for mild-to-moderate obstructive sleep apnea and in patients with BMIs less than or equal to 30 who fail or cannot tolerate CPAP.

 

TREATMENT OPTIONS 

 

The device pictured below is the "Silent Nite", by Glidewell Labs. It is mostly used to treat snoring and mild sleep apnea.

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Below is the "TAP T" also made by Glidewell Labs. It is used to treat snoring and a more moderate to advanced form of obstructive sleep apnea.